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Background: Although acupuncture is a well-established treatment for cancer pain and its effects have been widely reported in recent two decades, there is still controversy over whether its efficacy is better than placebo.
Objective: To evaluate the efficacy of acupuncture therapy on cancer pain.
Search strategy: Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2008), EMBASE, PubMed, ScienceDirect database, Current Controlled Trials, Chongqin VIP database and CNKI database were searched, and the search date ended in June 2008. The authors also hand-searched six Chinese Journals related to the question.
Inclusion criteria: All randomized controlled trials (RCTs) comparing acupuncture therapy with placebo, Western drugs, Chinese herbal medicines, or comparing acupuncture therapy plus drug treatment with drug treatment.
Data extraction and analysis: Two separate evaluators assessed the quality of the included reports and extracted the useful information. Disagreements were resolved through discussion. Meta-analysis of the included trials was done with RevMan 5.0, and qualitative analysis was employed when meta-analysis was not appropriate.
Results: Seven published RCTs with a total of 634 patients met the inclusion criteria, and the quality of one of the included trials was high. Due to flaws in design and reporting, meta-analysis was precluded, and only qualitative analysis was done on the majority of the reports. The high-quality trial showed that auricular acupuncture therapy was significantly superior to placebo in pain alleviation. The other six low-quality trials with non-placebo showed that acupuncture therapy had some positive effects.
Conclusion: Acupuncture is effective for pain relief. However, the poor quality of the majority of the trials reduces the reliability of the conclusion. More high-quality RCTs are needed to verify the
effects.
Autors
Peng H, Peng HD, Xu L, Lao LX. Efficacy of acupuncture in treatment of cancer pain: a systematic review. J Chin Integr Med / Zhong Xi Yi Jie He Xue Bao. 2010; 8(6): 501-509.
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针刺治疗癌痛疗效的系统综述
References:
1 Zhang J. Analgesia mechanism and clinical application of acupuncture[M]. Beijing: People's Medical Publishing House, 2007. 522. Chinese.
2 Li QS, Qian H. Cancer complications and its management. In: Tang ZY. Modern oncology[M]. Shanghai: Shanghai Medical University Press, 2000. 556. Chinese.
3 He XZ, Lu LP, Yin FM. Evidence-based research on drug treatment of cancer pain[J].Zhongguo Lin Chuang Kang Fu, 2002, 6(16): 2446-2447. Chinese.
4 Reid CM, Martin RM, Sterne JAC, Davies AN, Hanks GW. Oxycodone for cancer-related pain: meta-analysis of randomized controlled trials[J].Arch Intern Med, 2006, 166(8): 837-843. .
5 Lee H, Schmidt K, Ernst E. Acupuncture for the relief of cancer-related pain: a systematic review[J].Eur J Pain, 2005, 9(4): 437-444. .
6 Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials: is blinding necessary?[J].Control Clin Trials, 1996, 17(1): 1-12. .
7 Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M, Tugwell P, Klassen TP. Does quality of reports of randomized trials affect estimates of intervention efficacy reported in meta-analyses?[J].Lancet, 1998, 352(9128): 609-613. .
8 Kjaergard LL, Villumsen J, Gluud C. Randomized clinical trials in HEPATOLOGY: predictors of quality[J].Hepatology, 1999, 30(5): 1134-1138. .
9 Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials[J].Control Clin Trials, 1998, 19(2): 159-166. .
10 Egger M, Smith GD, Schneider M. Bias in meta-analysis detected by a simple, graphical test[J].BMJ, 1997, 315(7109): 629-634. .
11 Hu X, Gu W, Zhou QH, Ling CQ. Analgesic efficacy and mechanism of wrist-ankle acupuncture on pain caused by liver cancer[J].Zhong Xi Yi Jie He Gan Bing Za Zhi, 2005, 15(3): 131-133. Chinese with abstract in English.
12 Hu X, Ling CQ, Zhou QH. Clinical observation on wrist-ankle acupuncture for treatment of pain of middle-late liver cancer[J].Zhongguo Zhen Jiu, 2004, 24(3): 149-151. Chinese with abstract in English.
13 Chen H, Liu Y. Effective observations on treating cancerous pain by acupuncture and moxibustion and three levels analgesia[J].Zhonghua Shi Yong Zhong Xi Yi Za Zhi, 2002, 2(9): 1125-1126. Chinese with abstract in English.
14 Liu XY. Acupuncture and point injection in treating thirty cases of liver cancer pain[J].Shaanxi Zhong Yi, 2007, 28(9): 1225-1226. Chinese.
15 Liu XY, Dong RP. Acupuncture and point injection in treating fifty-one cases of liver cancer pain[J].Shaanxi Zhong Yi, 2008, 29(3): 347-348. Chinese.
16 Chen LL, Hu HQ, Shen AX, Wang JL. Therapeutic effects of electric stimulation on patients with cancer pain[J].Zhejiang Zhong Xi Yi Jie He Za Zhi, 2002, 12(8): 516. Chinese.
17 Dou ZP, Lei YH, Zheng GA, Hong B. Observation on the abirritation of Zusanli point injection on late gastric carcinoma[J].Zhejiang Zhong Xi Yi Jie He Za Zhi, 2004, 19(9): 538-539. Chinese with abstract in English.
18 Shen SE. Clinical observation of wrist-ankle acupuncture in relieving pain of cancer patients[J].Zhongguo Zhen Jiu, 2000, 20(3): 143-144. Chinese.
19 McDonough SM, Liddle SD, Hunter R, Walsh DM, Glasgow P, Gormley G, Hurley D, Delitto A, Park J, Bradbury I, Baxter GD. Exercise and manual auricular acupuncture: a pilot assessor-blind randomised controlled trial[J].BMC Musculoskelet Disord, 2008, 9: 31. .
20 Jin ZX. Clinical analysis of two-phase acupuncture-moxibustion therapy for large intestine cancer in 27 cases[J].Shanghai Zhong Yi Yao Za Zhi, 2003, 37(5): 48-49. Chinese with abstract in English.
21 Mehling WE, Jacobs B, Acree M, Wilson L, Bostrom A, West J, Acquah J, Burns B, Chapman J, Hecht FM. Symptom management with massage and acupuncture in postoperative cancer patients: a randomized controlled trial[J].J Pain Symptom Manage, 2007, 33(3): 258-266. .
22 Bian D, Zhang NS, Cheng ZD, Chen YG. Effect of point injection plus moxibustion on peripheral blood β-endorphin in patients with cancer pain[J].Liaoning Zhong Yi Za Zhi, 2004, 31(3): 246-247. Chinese.
23 Bian D, Cheng ZD, Zhang NS, Chen YG. Effects of acupoint-injection plus moxibustion on IL-2/IL-2R expression in peripheral blood in the patient with carcinous pain[J].Zhongguo Zhen Jiu, 2004, 24(9): 641-644. Chinese with abstract in English.
24 Bian D, Cheng ZD, Zhang NS, Chen YG. Regulation of immunologic mechanism of acupuncture on patients with cancer pain[J].Liaoning Zhong Yi Za Zhi, 2004, 31(4): 334-335. Chinese.
25 Chen ZJ, Guo YP, Wu ZC. Observation on the therapeutic effect of acupuncture at pain points on cancer pain[J].Zhongguo Zhen Jiu, 2008, 28(4): 251-253. Chinese with abstract in English.
26 Xiao JH, Li LJ. Observation of 50 cases of cancer pain relieved by acupuncture[J].Zhen Ci Yan Jiu, 1994, 19(3): 139-140. Chinese with abstract in English.
27 Dang W, Yang JB. Clinical research of acupuncture on gastric cancer pain[J].Zhong Yi Za Zhi, 1995, 36(5): 277-280. Chinese.
28 Dan Y, Liang YB, Tao Y. Clinical reseach of analgesic effect of acupuncture on cancer pain[J].Zhongguo Zhen Jiu, 1998, 18(1): 17-18. Chinese.
29 Bian RH. Observation on analgesic effect of acupuncture on cancer pain[J].Shi Yong Zhong Yi Yao Za Zhi, 1999, 15(7): 28. Chinese.
30 Sun YL, Yu LR. Therapeutic effect observation of needle-retaining method of triple puncture in treating 80 cases of liver cancer pain[J].Zhongguo Zhen Jiu, 2000, 20(4): 211-212. Chinese.
31 Zhang M, Xia T, Wu SH, Zhang ZH, Zhang YJ. Analgesic effects of Chinese herbs and acupuncture in treating cancer patients[J].Zhen Ci Yan Jiu, 2000, 25(1): 64-66. Chinese.
32 Alimi D, Rubino C, Pichard-Léandri E, Fermand-Brulé S, Dubreuil-Lemaire ML, Hill C. Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial[J].J Clin Oncol, 2003, 21(22): 4120-4126. .
33 Su XD, Wang L. Therapeutic effect observation of three-step analgesic ladder in treating 80 cases of medium and advanced cancer pain[J].Sichuan Zhong Liu Fang Zhi, 1998, 11(3): 18-20. Chinese.
34 Guo ZR, Zhou CJ, Chen DL, Wang MJ. Therapeutic effect observation of sustained-release morphine tablets in treating medium to advanced cancer pain[J].Zhongguo Zhong Liu Lin Chuang Yu Kang Fu, 2001, 8(4): 114-115. Chinese.
35 Guan TJ, Jin G, Li DW. Clinical observation of morphine hydrochloride sustained-release tablets in treating medium to advanced cancer pain[J].Shi Yong Zhong Liu Xue Za Zhi, 2001, 15(4): 285. Chinese.
36 Ding L. Clinical observation of morphine in treating medium to advanced cancer pain[J].Zhonghua Yi Xue Yan Jiu Yu Shi Jian, 2005, 3(1): 48-49. Chinese.
37 Zhao SL, Wei Y, Gong JZ. Clinical observation of morphine in treating 70 cases of terminal cancer pain[J].Youjiang Min Zu Yi Xue Yuan Xue Bao, 2007, 29(4): 537-538. Chinese.
38 Institute of Physiology, Chinese Academy of Sciences. Influence of different parameters on clinical effect of acupuncture anaesthesia[J].Zhen Ci Ma Zui, 1978, 1: 109. Chinese.
39 Wang JY. Evidence-based medicine and clinical practice[M]. Beijing: Science Press, 2002. 58. Chinese.
40 Liu P, Tong Y. Thought and method of traditional Chinese medicine scientific research[M]. Shanghai: Shanghai University of Traditional Chinese Medicine Press, 2003. 56. Chinese.
41 Wang Y, Li W, Cheng XR, Jia X. Sample size calculation in noninferiority trial by monte carlo method[J].Zhongguo Wei Sheng Tong Ji, 2008, 25(1): 26-28. Chinese with abstract in English.
42 Xu L, Wei PK, Sun DZ, Lao LX. Quality of reporting in 41 randomized controlled clinical trials of Chinese medicine for cancer pain[J].Shi Jie Hua Ren Xiao Hua Za Zhi, 2007, 15(35): 3764-3769. Chinese with abstract in English.
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