基于德尔菲法中医治疗癌因性疲乏的共识

Consensus on Traditional Chinese Medicine Treatment of Cancer-Related Fatigue Based on Delphi Method

目的为探索更优的癌因性疲乏治疗方案、充分发挥中医优势,世界中医药学会联合会(世中联)癌症姑息治疗研究专业委员会成立中医治疗癌因性疲乏专题小组,对中医药治疗癌因性疲乏的现状进行系统的评述,形成共识。方法通过检索国内外数据库,筛选、收集中医药治疗癌因性疲乏的文献,采用国际认可的证据级别判定标准GRADE进行评价,并由中医肿瘤学、针灸学、统计学等多学科教授形成专家组,经过两轮德尔菲法调查,达成本共识。结果本共识形成以下推荐意见:①中药能缓解癌因性疲乏(1B,证据级别中,强推荐);②针刺能改善癌因性疲乏(2B,证据等级中,弱推荐);③艾灸能缓解癌因性疲乏(1B,证据等级中,强推荐);④耳穴治疗能改善癌因性疲乏(2C,证据等级低,弱推荐);⑤中国传统养生功法(太极、气功等)可改善癌因性疲乏(太极:2C,证据等级低,弱推荐;气功:2D,证据等级极低,弱推荐)。结论中医药治疗癌因性疲乏有一定的疗效,安全性较好,本共识可为临床医生提供切实可行、有效的癌因性疲乏中医治疗方法。

Objective To explore a better therapeutic regimen for cancer-related fatigue(CRF)and adequately take advantage of traditional Chinese medicine(TCM),the Professional Committee of Cancer Palliative Care Research of World Federation of Chinese Medicine Societies set up a special topic group to systematically review the current status of TCM treatment of CRF and form a consensus.Methods Literature on TCM treatment of CRF was screened and collected by searching domestic and foreign databases,then it was evaluated based on the internationally accreditated GRADE standard.Next,a multi-disciplinary expert group consisting of professors who majored in such as TCM oncology,acupuncture,and statistics was formed.After two rounds of Delphi method survey,the consensus was formed.Results The following recommendations are formed in this consensus:①Chinese herbal medicine can alleviate CRF(1B,moderate evidence level,strongly recommended);②Acupuncture can relieve CRF(2B,moderate evidence level,weakly recommended);③Moxibustion can mitigate CRF(1B,moderate evidence level,strongly recommended);④Auricular acupoint therapy can alleviate CRF(2C,low evidence level,weakly recommended);⑤Traditional Chinese exercise(tai chi,qigong,etc)can relieve CRF(tai chi:2C,low evidence level,weakly recommended;qigong:2D,extremely low evidence level,weakly recommended).Conclusion TCM has a certain therapeutic effect and good safety in treating CRF.This consensus can provide clinicians with practical and effective TCM treatments for CRF.