针刺干预乳腺癌患者潮热症状的系统评价与Meta分析  

Systematic review and Meta-analysis of acupuncture intervention on hot flushes in breast cancer patients

作　　者：陶巍巍[1] 王跃[2] 宋春利[3] Tao Weiwei;Wang Yue;Song Chunli(Teaching and Research Department of Basic Nursing,School of Nursing,Dalian Medical University,Dalian 116011,China;Department of Blood Specialty,the Second Affiliated Hospital of Dalian Medical University,Dalian 116021,China;Department of Breast Surgery,the First Affiliated Hospital of Dalian Medical University,Dalian 116021,China)

机构地区：[1]大连医科大学护理学院基础护理教研室,116044 [2]大连医科大学附属第二医院血液科,116021 [3]大连医科大学附属第一医院乳腺外科,116011

出　　处：《中国实用护理杂志》2019年第23期1836-1841,共6页Chinese Journal of Practical Nursing

基　　金：辽宁省教育厅2016年度科学研究项目(W2016007);中央财政2018年省级重点学科建设项目(重大慢性病防治基础研究与转化平台项目)支持(〔2018〕415).

摘　　要：目的评价针刺对乳腺癌患者潮热症状的干预效果.方法计算机检索PubMed、Springer、EMBASE、Cochrane Library、Elsevier、Proquest、CBM、CNKI、万方数据库、临床试验注册库等10个中英文数据库,检索年限从建库到2017年8月,其中英文检索词为"breast tumors/breast neoplasms/breast tumor/breast neoplasm/breast cancer/breast cancers/breast carcinoma/mammary cancer/mammary neoplasm/mammary neoplasms/mammary carcinoma""hot flushes/hot flashes""acupuncture/electro-acupuncture/needle/acupoint",中文检索词为"乳癌/乳房癌/乳房肿瘤/乳腺癌/乳腺瘤""潮热/热潮红/血管舒缩症状""针刺/电针".由2名研究者对符合纳入标准的文献进行严格评价和资料提取,并对结果进行系统评价和Meta分析.结果系统评价11篇文献,Meta分析共纳入5篇文献,共692例研究对象.文献的偏倚风险分布方面,纳入研究偏倚风险较低,无中文文献纳入.Meta分析结果显示,与对照组相比,针刺治疗对潮热症状相关生命质量有改善作用(d=-3.14,95% CI-4.93^-1.34,P=0.000 6,I2=54%),但对降低该症状发生频率无显著效果.然而根据文献报道,与药物治疗相比,针刺的不良反应发生率较低.结论针刺对改善乳腺癌患者潮热症状相关生命质量有效果,安全性比较高.建议在国内开展大规模随机对照研究进一步验证.Objective To assess the effectiveness of acupuncture for hot flushes (HFs) in women with breast cancer (BC). Methods Ten databases (PubMed, Springer, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, CINAHL, CNKI, VIP, CBM, and Wan Fang Database) were searched from their inceptions to autumn 2017 without language restrictions. The searching terms in English and Chinese literatures were"breast tumors/breast neoplasms/breast tumor/breast neoplasm/breast cancer/breast cancers/breast carcinoma/mammary cancer/mammary neoplasm/mammary neoplasms/mammary carcinoma""hot flushes / hot flashes""acupuncture/ electro-acupuncture / needle/ acupoint". Finally, randomized controlled trials (RCTs) were aggregated to evaluate the therapeutic effect of acupuncture for HFs in women with BC. Results Eleven articles were systematically reviewed, and five trials (692 patients) were included in the Meta-analysis. Significant combined effects of acupuncture were observed in Hot Flash Related quality of life (d=-3.14;95% CI,-4.93 to -1.34;P=0.000 6;I2 = 54%), however, no effect was evident for hot flash frequency. The articles included had low risk of bias. No serious adverse effects were reported in the included studies. Conclusions Acupuncture are associated with significant effects on HFs in women with BC. Large randomized controlled trials (RCTs) were recommended to carry out in China to verify the conclusion.

关 键 词：针刺 乳腺肿瘤 META分析 潮热症状 系统评价 

分 类 号：R246.5[医药卫生—针灸推拿学]