摘要
目的系统评价体针治疗癌性疼痛的临床疗效和安全性。方法计算机检索中英文数据库,纳入运用体针治疗癌性疼痛的随机对照试验,检索时间为从建库至2022年8月31日,由2位研究者独立进行文献筛选和质量评估,并交叉核对,运用Rev Man 5.3软件对提取的数据进行Meta分析。结果共纳入16项随机对照试验共计1161例患者。合并分析,结果显示针药联合比药物在疼痛程度评分[SMD=-0.80,95%CI(-0.97,-0.63),P<0.001]、有效率[RR=1.25,95%CI(1.12,1.40),P<0.001]、镇痛起效时间[SMD=-0.80,95%CI(-1.07,-0.53),P<0.001]、生活质量[SMD=0.61,95%CI(0.36,0.86),P<0.001]方面更具优势,但对延长缓解持续时间无统计学意义[MD=1.17,95%CI(-0.23,2.58),P=0.10]。体针比假针刺在疼痛程度评分[SMD=-0.35,95%CI(-0.58,-0.13),P=0.002]、有效率[RR=1.63,95%CI(1.12,2.37),P=0.01]方面更具优势,体针比不治疗在疼痛程度评分[SMD=-0.61,95%CI(-0.88,-0.35),P<0.001]方面更具优势。体针或针药联合治疗癌痛不会增加相关不良事件发生率[RR=3.23,95%CI(0.71,14.75),P=0.13]。结论体针治疗癌性疼痛疗效确切,安全可靠。
Objective To systematically evaluate body acupuncture's clinical efficacy and safety in treating cancer pain.Methods The Chinese and English databases were searched by computer,and randomized controlled trials of acupuncture at meridian points in the treatment of cancer pain were included.The retrieval time was from the establishment of the database to August 31,2022.Two researchers independently screened and evaluated the literature quality,and cross-checked the data.Rev Man 5.3 software was used to perform a meta-analysis of the extracted data.Results Sixteen randomized controlled trials with 1161 patients were included.It is shown that compared with the drugs,the combination of needle and drug had more advantages in pain severity score[SMD=-0.80,95%CI(-0.97,-0.63),P<0.001],effective rate[RR=1.25,95%CI(1.12,1.40),P<0.001],analgesic onset time[SMD=-0.80,95%CI(-1.07,-0.53),P<0.001],quality of life[SMD=0.61,95%CI(0.36,0.86),P<0.001],but there was no statistical significance in extending the duration of remission[MD=1.17,95%CI(-0.23,2.58),P=0.10].Compared with sham acupuncture,body acupuncture had more advantages in pain degree score[SMD=-0.35,95%CI(-0.58,-0.13),P=0.002]and effective rate[RR=1.63,95%CI(1.12,2.37),P=0.01].Compared with no treatment,body acupuncture had more advantages in pain degree score[SMD=-0.61,95%CI(-0.88,-0.35),P<0.001].There was no increase in the incidence of adverse events associated with body acupuncture or combination therapy for cancer pain[RR=3.23,95%CI(0.71,14.75),P=0.13].Conclusion Body acupuncture is safe and effective in the treatment of cancer pain.
作者
张超月
孙鲁源
刘鑫
李珊珊
徐世芬
宓轶群
Zhang Chaoyue;Sun Luyuan;Liu Xin;Li Shanshan;Xu Shifen;Mi Yiqun(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;Shanghai Sixth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200233,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2023年第5期1538-1547,共10页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
上海申康医院发展中心临床三年行动计划(SHDC2020CR3015A):超声引导下针刺技术的可视化与标准化研究,负责人:宓轶群
上海市卫生健康委员会中医药传承创新发展三年行动计划(ZY(2021-2023)-0204):中医非药物疗法示范中心建设,负责人:宓轶群
上海市科学技术委员会上海市2020年度“科技创新行动计划”医学创新研究专项项目(20Y21903000):“扶正安神”法电针治疗癌因性失眠的随机对照试验,负责人:徐世芬
关键词
针灸疗法
体针
癌性疼痛
META分析
综述
Acupuncture therapy
Body acupuncture
Cancer pain
Meta analysis
Review
作者简介
通讯作者:宓轶群,主任医师,博士研究生导师,主要研究方向:针灸与超声医学联合进行精准治疗的临床与机制研究;通讯作者:徐世芬,主任医师,博士研究生导师,主要研究方向:针刺治疗脑病的临床与机制。
