肿瘤化疗后骨髓抑制针灸诊疗特点文献分析

Literature Analysis of the Diagnosis and Treatment of Acupuncture and Moxibustion for Chemotherapy-induced Myelosuppression

目的:回顾性分析肿瘤化疗后骨髓抑制的针灸诊疗特点。方法:电子检索CNKI、WanFang data、VIP、SinoMed、PubMed、Cochrane Library和Clinical trials.gov数据库中针灸治疗肿瘤化疗后骨髓抑制的相关文献,对纳入文献进行分析,总结针灸治疗该病的不同干预措施、辨治方案、治疗频次及疗程、疗效评价、随访情况和安全性。结果:共纳入40篇文献,针灸治疗肿瘤化疗后骨髓抑制常用干预措施以艾灸为主(40.00%,16/40);常用取穴方式为辨病选穴(87.50%,35/40),出现频次最高的穴位为足三里穴(80.00%,32/40);针灸频次和疗程因针灸方式不同而有差别,以1次/d,10次1疗程多见(32.50%,13/40);疗效评价标准以白细胞计数多见(67.50%,27/40),有效率在66.40%~100%之间;实施随访的文献占7.50%(3/40);仅有3篇文献提及针灸不良反应。结论:化疗后骨髓抑制针灸治疗以艾灸最常见;多为辨病选穴,常取足三里穴;治疗频次及疗程以1次/d,10次1疗程多见;近期疗效较好,有一定远期疗效,且疗法安全,不良反应少见。

Objective:To retrospectively analyze diagnostic and therapeutic characteristics of acupuncture and moxibustion for chemotherapy-induced myelosuppression(CIM).Methods:The related literature about acupuncture and moxibustion in the treatment of chemotherapy-induced bone marrow suppression was searched from CNKI,WFPD,VIP,SinoMed,PubMed,Cochrane Library and Clinical trials.gov,and the included literature was analyzed to sum up different intervention measures,the plan of syndrome differentiation and treatment,therapeutic frequency and the course of the treatment,clinical evaluation,follow-up conditions and the safety of the acupuncture and moxibustion in the treatment of different diseases.Results:All 40 papers were included,the common intervention measure for acupuncture and moxibustion in the treatment of CIM was moxa-moxibustion mainly(40.00%,16/40);the common way of selecting acupoint was disease differentiation and acupoint selection(87.50%,35/40),the most frequently-used acupoint was Zusanli(ST36)(80.00%,32/40);differences could been found in the frequency and the course of acupuncture and moxibustion due to different methods of acupuncture,once each day and ten times as one course of the treatment were common(32.50%,13/40);among the standard of clinical evaluation,WBC counting was common(67.50%,27/40),and the effective rate was between 66.40%and 100%;the literature with the implementation of follow-up holds 7.5%(3/40);side effects of acupuncture were mentioned only in three papers.Conclusion:Among the acupuncture therapy for CIM,it’s common to choose moxa-moxibustion,disease differentiation and acupoints selection,selecting Zusanli frequently,therapeutic frequency once each day,ten days as one course of the treatment mostly;which demonstrates better short-term clinical effects and certain long-term clinical effects,with good safety and minor adverse reaction.