穴位刺激治疗成人癌因性疲乏的系统评价再评价  

Acupoint Stimulation for Cancer-related Fatigue in Adults:An Overview of Systematic Reviews

作　　者：李沛瑾 侯丽[1] 王前 冯利 LI Peijin;HOU Li;WANG Qian;FENG Li(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China;National Cancer Institute,National Clinical Research Center for Cancer,Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]国家癌症中心,国家肿瘤临床医学研究中心,中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《中国中医药信息杂志》2023年第10期48-55,共8页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：首都卫生发展科研专项项目(2020-2-4026);北京协和医学院学科建设项目(2020-JKCS-001)。

摘　　要：目的评估和总结迄今为止关于穴位刺激治疗成人癌因性疲乏系统评价/Meta分析的质量及结果。方法检索中国知识资源总库(CNKI)、中国生物医学文献数据库(CBM)、万方数据知识服务平台(万方数据)、中文科技期刊数据库(维普网)、PubMed、Web of Science、CINAHL、Scopus、OVID、Embase、PEDro、Cochrane Library、PROSPERO建库至2022年7月1日穴位刺激治疗成人癌因性疲乏系统评价/Meta分析相关文献。使用AMSTAR-2工具评价纳入系统评价的方法学质量,ROBIS工具评价偏倚风险,PRISMA清单评价报告完整度,GRADE系统评价证据可信度。结果最终纳入9项系统评价/Meta分析,干预措施包括针灸、艾灸、指压和耳穴。8项系统评价为极低质量,另1项为低质量。4项系统评价为高偏倚风险,另外5项为低偏倚风险。没有系统评价报告了所有条目,只有4项报告了70%以上的条目。34个汇总结果中,有高质量证据2个、中等质量证据12个。大部分研究结果显示,穴位刺激干预能够显著改善成人癌因性疲乏及生活质量,针灸还能改善癌因性疲乏患者的焦虑和睡眠质量。结论虽然穴位刺激治疗成人癌因性疲乏的系统评价/Meta分析方法学质量、报告完整度及证据可信度较低,但总结目前证据显示,针灸能显著改善癌因性疲乏,艾灸、耳穴及指压具有极大潜力,值得进一步研究。Objective To evaluate and summarize the quality and results of systematic reviews on acupoint stimulation in the treatment of cancer-related fatigue in adults.Methods Systematic review/Meta analysis of relevant literature about acupoint stimulation in the treatment of cancer-related fatigue in adults was retrieved from CNKI,Wanfang Data,CBM,VIP,PubMed,Web of Science,CINAHL,Scopus,OVID,Embase,PEDro,Cochrane Library,and PROSPERO from the establishment of the databases to July 1,2022.AMSTAR-2 was used to evaluate the methodological quality of the included systematic reviews.ROBIS was used to evaluate the risk of bias.PRISMA checklist was used to evaluate the completeness of the report.GRADE was used to evaluate the credibility of the evidence.Results Nine systematic reviews/Meta-analyses were finally included,and the interventions included acupuncture,moxibustion,acupressure,and auricular points.Eight systematic reviews were rated“very low quality”and another one was rated“low quality”.Four systematic reviews were rated as high risk of bias and another five as low risk of bias.No systematic review reported all items and only four reported more than 70%of them.Among the 34 pooled results,there were 2 pieces of high quality evidence and 12 pieces of medium quality evidence.Most of the results showed that acupoint stimulation could significantly improve cancer-related fatigue in adults and quality of life,and acupuncture could also improve anxiety and sleep quality of the patients.Conclusion The methodological quality,report integrity and evidence credibility of systematic reviews/Meta-analyses on acupoint stimulation in the treatment of cancer-related fatigue in adults are low.Current evidence shows that acupuncture can significantly improve cancer-related fatigue.Moxibustion,auricular point and acupressure have great potential in the treatment of cancer-related fatigue,which is worth further research.

关 键 词：癌因性疲乏 针灸 艾灸 穴位刺激 系统评价再评价 

分 类 号：R2-05[医药卫生—中医学] R273