灸法治疗化疗相关癌因性疲乏有效性及安全性的网状Meta分析
Network Meta-Analysis on the Effectiveness and Safety of Moxibustion in the Treatment of Chemotherapy-Induced Cancer-Related Fatigue
谷珊珊 1许云 1李显 1郭欣煜 2夏如玉3
作者信息
- 1. 中国中医科学院西苑医院,北京 100091
- 2. 北京中医药大学,北京 100091
- 3. 北京中医药大学循证医学中心,北京 100091
- 折叠
摘要
目的 运用网状Meta分析评价不同灸法治疗化疗相关癌因性疲乏(Chemotherapy-Induced Cancer-related fatigue,CICRF)的有效性及安全性,寻找可能适合CICRF的最佳灸法方案.方法 计算机检索中国知网(CNKI)、中国学术期刊数据库(WanFang Data)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrane Library,筛选出自建库至2023年8月有关CICRF的随机对照试验(Randomized Controlled Trials,RCTs).质量评价采用Cochrane协作网的偏倚风险评估工具,用RevMan 5.4.1及Stata 15.0软件进行Meta分析.结果 最终纳入15项随机对照试验,1 439例患者,包括6种灸法、4种治疗壮数、4种治疗持续时间、4种治疗频率和3种疗程.直接Meta分析结果显示,与对照组相比,灸法可有效缓解CICRF[SMD =-6.17,95%CI=(-7.35,-5.00),P＜0.000 01].网状Meta分析结果显示:①灸法排名:红外激光灸+常规护理＞艾灸+常规护理＞温针灸+常规护理＞麦粒灸+常规护理＞隔姜灸+常规护理＞雷火灸+常规护理＞常规护理;②治疗壮数排名:18壮/穴＞9壮/穴＞7壮/穴＞3壮/穴;③治疗持续时间排名:20 min/次＞15 min/次＞30 min/次＞大于30 min/次;④治疗频率排名:1次/天＞3次/周＞2次/天＞1次/周;⑤总疗程排名:2周＞3周＞6周.6项RCTs报告了不良反应,2例轻度水疱,1例皮肤过敏,3例轻度红斑,均未经处理自行消退,纳入研究的总脱落率为1%(18/1 439).结论 常规护理联合灸法可缓解CICRF,且安全性较好.红外激光灸联合常规护理、18壮/穴或20 min/次、1次/天,共治疗2周可能是最适合CICRF的灸法方案.
Abstract
Objective To evaluate the effectiveness and safety of different moxibustion methods in the treatment of chemotherapy-induced cancer-related fatigue(CICRF)using a network Meta-analysis method,and to search for the best moxibustion scheme that may be suitable for CICRF.Methods CNKI,WanFang Data,VIP,CBM,PubMed,Embase,and Cochrane Library were searched by computer,and randomized controlled trials(RCTs)on moxibustion treatment of CICRF from the establishment of the databases to August 2023 were screened.The quality evaluation adopted the bias risk assessment tool of the Cochrane Collaborative Network,and Meta-analysis was conducted using RevMan 5.4.1 and Stata 15.0.Results A total of 15 RCTs with 1 439 patients were included in the analysis,involving 6 moxibustion methods,4 kinds of number of moxa-cone,4 treatment durations,4 treatment frequencies,and 3 treatment courses.The direct Meta-analysis results showed that compared with the control group,moxibustion could effectively alleviate CICRF[SMD =-6.17,CI=(-7.35,-5.00),P＜0.000 01].The results of network Meta-analysis showed that,①the ranking of moxibustion was infrared laser moxibustion + routine care(RC)＞moxibustion + RC＞needle-warming moxibustion + RC＞grain-sized moxibustion +RC＞ginger-padded moxibustion + RC＞thunder-fire moxibustion + RC＞RC;②the ranking of number of moxa-cone was 18 moxa-cone/acupoint＞9 moxa-cone/acupoint＞7 moxa-cone/acupoint＞3 moxa-cone/acupoint;③the ranking of treatment time was 20 minutes/time＞15 minutes/time＞30 minutes/time＞over 30 minutes/time;④the ranking of treatment frequency was once/day＞3 times/week＞twice/day,once/week;⑤the ranking of total course was 2 weeks＞3 weeks＞6 weeks.Adverse reactions were reported in 6 RCTs,including 2 cases of mild blisters,1 case of skin allergy,and 3 cases of mild erythema,all of which resolved spontaneously without treatment.The total dropout rate included in the study was 1%(18/1439).Conclusion RC combined with moxibustion can alleviate CICRF and has good safety.Infrared laser moxibustion combined with RC,18 moxa-cone/acupoint or 20 minutes/time,once/day,and treatment for 2 weeks may be the most suitable moxibustion regimen for CICRF.
关键词
灸法/化疗相关癌因性疲乏/网状Meta分析/有效性/安全性Key words
moxibustion/chemotherapy-induced cancer-related fatigue/network Meta-analysis/effectiveness/safety引用本文复制引用
基金项目
国家重点研发计划(2018YFC1707406)
重大科技攻关计划(CI2021A01807)
国家自然科学基金面上项目(8207142801)
育苗基金培育专项(ZZ11-069)
出版年
2024
国家科技期刊平台
NSTL
万方数据