国内近五年针刺对癌症患者生存质量影响研究的评价

Assessment about domestic trials of acupuncture for cancer patients' quality of life in the past five years

目的了解国内针刺对癌症患者生存质量的影响及相关文献质量。方法检索2012年1月1日—2017年10月18日间CNKI、WANFANG及VIP数据库内发表的针刺治疗癌症及其相关并发症并以生存质量评分作为结局指标的随机对照试验。使用Cochrane偏倚风险评价标准及STRICTA标准评价文献质量。结果纳入32篇随机对照试验,涉及1878名患者。绝大多数的文献在方法学上都是中等到高偏倚风险,证据质量低。由于各研究间异质性较大,不能对结果数据进行定量合并。68. 75%的研究报告了针刺可以改善癌症患者的生存质量,9. 38%研究不支持这一结论。文献的方法学及针刺干预的报告质量仍存在报告不完善、不明确等问题。结论针刺能在一定程度上改善癌症患者的生存质量,但是由于研究证据质量低且样本量小,结论的可信度不高,国内尚需要更多高质量、多中心、大样本的随机对照临床试验来证明。

Objective Objective To know the effect of acupuncture for cancer patients'quality of life and the quality of related literatures.Methods The randomized controlled trials(RCTs)studies involving the effect of acupuncture for cancer patients'quality of life,related complications with scores of quality of life as the onset criteria published from January 2012 to October 2017 were searched on CNKI,WANFANG and.VIP databases.Cochrane Risk of Bias Criteria and STRICTA Criteria were used to assess the quality of trials.Results 32 RCTs were included,involving 1878 patients.A majority of the included trials were of moderate to high risk of bias in methodological quality,and the quality of evidence was low.Due to the large heterogeneity among the studies,the outcome data could not be pooled quantitatively.68.75% of trials reported that acupuncture could improve the cancer patients'quality of life,but 9.38% trials didn't support this viewpoint.There were still many problems in the quality of the methodology and acupuncture intervention in this field,such as imperfection and inaccuracy.Conclusion The Results show that acupuncture can improve the quality of life of cancer patients to a certain extent.But because of the low quality evidences of studies and small sample size,the credibility is not high.High quality,multi-centered prospective RCTs with bigger sample size are needed to certify the effect of acupuncture.