针灸治疗乳腺癌芳香化酶抑制剂所致肌肉关节疼痛疗效的Meta分析

Therapeutic Effect of Acupuncture and Moxibustion in the Treatment of Aromatase Inhibitors-associated Muscular Joint Pain of Breast Cancer:A Meta-analysis

【目的】系统评价针灸治疗乳腺癌芳香化酶抑制剂所致的肌肉关节疼痛的疗效,为临床提供循证参考。【方法】计算机检索中国期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、美国医学在线(PubMed)、荷兰医学文献数据库(Embase)及国际循证医学图书馆(Cochrane Library)等数据库。检索针灸治疗乳腺癌芳香化酶抑制剂所致肌肉关节疼痛的随机对照试验(RCT)文献。采用Cochrane手册5.3推荐的偏倚风险评估工具评价纳入研究质量。由2名研究者各自独立严格按照纳入和排除标准进行纳入研究的质量评价和资料提取。运用Stata 15.0软件进行Meta分析。【结果】最终纳入5篇文献,共462例患者。Meta分析结果显示:试验组患者在简要疼痛量表评估(BPI)[SMD=-0.56,95%CI(-0.71,-0.41),P<0.01]、WOMAC评分表[SMD=-0.58,95%CI(-0.81,-0.35),P<0.01]方面均低于对照组,同时,BPI[SMD=-0.73,95%CI(-0.90,-0.55),P<0.01]也低于空白组,差异有统计学意义。【结论】针灸治疗能够显著降低乳腺癌芳香化酶抑制剂所致的肌肉关节疼痛患者的BPI评分和WOMAC评分,但仍需纳入更多高质量的研究进一步证实。

Objective To systematically evaluate the efficacy of acupuncture and moxibustion in the treatment of aromatase inhibitors-associated muscular joint pain of breast cancer,and to provide an evidence-based clinical reference.Methods Databases such as China National Knowledge Internet(CNKI),Wanfang Data Knowledge Service Platform(Wanfang),China Science and Technology Journal Database(VIP),China Biology Medicine disc(CBM),PubMed,The Exerpta Medical Database(Embase)and Cochrane Library were searched through the computer.The literatures on randomized controlled trials(RCTs)of acupuncture for the treatment of aromatase inhibitors-associated muscular joint pain of breast cancer were screened.The quality of the included studies was evaluated using the bias risk assessment tool recommended by Cochrane Manual 5.3.The quality evaluation and data extraction of the included studies were carried out by two researchers independently and strictly according to the inclusion and exclusion criteria.Stata15.0 software was used for meta-analysis.Results A total of 462 patients were included in 5 literatures.Meta-analysis showed that the Brief Pain Inventory(BPI)being[SMD=-0.56,95%CI(-0.71,-0.41),P<0.01]and the WOMAC score being[SMD=-0.58,95%CI(-0.81,-0.35),P<0.01]in trial group was lower than those in the control group,and BPI being[SMD=-0.73,95%CI(-0.90,-0.55),P<0.01]was also lower than that of the blank group,the difference being statistically significant.Conclusion Acupuncture treatment exerts significant effect in reducing BPI scores and WOMAC scores in patients with aromatase inhibitors-associated muscular joint pain of breast cancer,but further confirmation is needed by including more high-quality studies.