灸法对肿瘤患者生活质量影响的网状Meta分析

Effect of moxibustion on quality of life in tumor patients:network Meta-analysis

目的:将多种灸法对肿瘤患者生活质量的影响进行有效性排序,从循证医学角度探讨艾灸改善肿瘤患者生活质量的最佳方案。方法:计算机检索PubMed、EMbase、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(SinoMed)、万方数据知识服务平台(Wanfang)、维普资讯中文期刊服务平台(VIP)中灸法对肿瘤患者生活质量影响的随机对照试验(RCT)中、英文文献,检索时间为从建库至2020年10月31日。运用R3.6.2和Stata15.0软件进行基于贝叶斯模型的网状Meta分析。结果:共纳入30个RCT中文文献,2169例患者,涉及16种干预措施。对生活质量改善效果的排序,前3位依次为特殊灸法+其他疗法1(经筋刺法、穴位按压、穴位注射等其中一种)、麦粒灸、温和灸。特殊灸法为火龙灸、雷火灸、扶阳火灸、艾盐包热熨的合并,这4种灸法文献数量较少,结合灸法临床应用实际,得出排在首位的是麦粒灸。结论:麦粒灸辅助治疗在改善肿瘤患者生活质量方面相对其他灸法疗效好,但因本研究纳入的原始RCT文献偏倚风险较高且样本量较小,尚需进一步验证。

Objective To rank the effectiveness of various moxibustion methods on the quality of life in tumor patients,and explore the best treatment plan of moxibustion for improving the quality of life in tumor patients from the perspective of evidence-based medicine.Methods The Chinese and English literature of randomized controlled trial(RCT)of the effect of moxibustion on the quality of life in tumor patients were searched in PubMed,EMbase,Cochrane Library,CNKI,SinoMed,Wanfang and VIP.The retrieval time was from the establishment of the databases to October 31,2020.The R3.6.2 and Stata15.0 software were used for network Meta-analysis based on Bayesian model.Results A total of 30 Chinese RCTs were included,including 2169 patients,involving 16 interventions.In terms of the effectiveness of improving quality of life,the top three treatments were special moxibustion plus other therapies 1(either of tendon acupuncture,acupoint pressing,acupoint injection,etc.),wheat-grain moxibustion and mild moxibustion.The special moxibustion methods were the combination of fire-dragon moxibustion,thunder-fire moxibustion,fuyang fire moxibustion and moxa salt-bag moxibustion.The number of literature of these four moxibustion methods was small.Considering the clinical application of moxibustion,it was concluded that wheat-grain moxibustion ranked first.Conclusion The adjuvant treatment of wheat-grain moxibustion is more effective than other moxibustion methods on improving the quality of life in tumor patients,but the results needed to be further verified because the bias risk of RCT included in this study is high and the sample size is small.