基于GRADE系统的耳穴疗法治疗癌性疼痛的Meta分析  

Meta-analysis of treating cancer pain using ear acupuncture therapy based on GRADE system

作　　者：巩文花 邹宇[1] 王婧[1] 刘芮寒 王芳[1] 

机构地区：[1]成都中医药大学护理学院,成都610075

出　　处：《中国临床护理》2018年第1期5-11,共7页Chinese Clinical Nursing

摘　　要：目的评价耳穴疗法治疗癌性疼痛的临床治疗效果。方法综合检索国内外大型数据库,经过严格筛选后运用Revman 5.3软件对符合标准的随机对照试验(randomized controlled trial,RCT)结果进行Meta分析,采用GRADEprofiler 3.6软件对结果证据质量进行评级。结果最终纳入11篇文献,共1 243例患者。分析发现耳穴疗法联合药物在恶心呕吐发生率[RR=0.50,95%CI(0.39,0.63)]、便秘发生率[RR=0.53,95%CI(0.44,0.65)]、疼痛评分[SMD=-0.52,95%CI(-0.74,-0.30)]、药物用量[WMD=-12.03,95%CI(-20.64,-3.41)]方面好于单纯应用药物,在疼痛缓解率[RD=0.12,95%CI(0.07,0.17)]、Kamofsky氏活动状态评分[WMD=0.98,95%CI(-0.46,2.42)]方面,与单纯应用药物差异无统计学意义。证据等级:疼痛缓解率评级为非常低,恶心呕吐发生率评级为低,便秘发生率评级为低,7d用药量评级为非常低,KPS评分评级为低,疼痛评分评级为低。结论耳穴疗法联合药物治疗癌性疼痛好于单纯应用药物。该结论的证据质量等级不高,研究结论需谨慎对待,需大样本、高质量的临床试验进一步证实。Objective To evaluate the clinical efficacy of ear acupuncture therapy in the treatment of cancer pain.Methods Related randomized controlled trials(RCTs)were searched in large databases at home and abroad and screened rigorously,followed by meta-analysis using the Revman 5.3 software.The GRADEprofiler 3.6 software was also used to rate the quality of the evidence.Results Eventually,11 articles was included,involving a total of 1 243 patients.It had been found that ear acupuncture combined with drugs was superior to simple drugs in lowering the incidence of nausea and vomiting[RR=0.50,95%CI(0.39,0.63)],constipation[RR=0.53,95%CI(0.44,0.65)],pain[SMD=-0.52,95%CI(-0.74,-0.30)],drug dosage[WMD=-12.03,95%CI(-20.64,-3.41)].However,there were no significant differences in the pain relief rate [RD=0.12,95%CI(0.07,0.17)]and karnofsky performance status(KPS)score[WMD=0.98,95%CI(-0.46,2.42)].The evidence level was very low for pain relief and 7-day medication rating,and low for the incidence of nausea and vomiting,constipation and KPS rating.Conclusion Ear acupuncture therapy combined with drugs is superior to simple drugs in the treatment of cancer pain.The evidence quality level of the conclusion is not high and needs large-sample,high-quality clinical trials to further confirm.

关 键 词：耳穴疗法 癌性疼痛 META分析 GRADE评级 

分 类 号：R248.9[医药卫生—中医临床基础]