非药物干预对化疗所致恶心呕吐影响的系统评价再评价

An overview of systematic reviews on efficacy of non-pharmacological intervention for chemotherapy induced nausea and vomiting

目的对化疗所致恶心呕吐的非药物干预措施进行系统评价再评价。方法检索有关非药物干预防治化疗所致恶心呕吐的系统评价或Meta分析文献。检索数据库包括中国知网、万方全文数据库、维普全文数据库、中国生物医学文献数据库、Cochrane Library、卫生保健及护理学数据库(CINAHL)、Embase、Pubmed,检索时间为建库至2022年6月30日。筛选文献后,提取纳入文献的相关资料,并评价分析其方法学质量和证据质量。结果共纳入19篇系统评价文献,其中中质量等级4篇,低质量等级8篇,极低质量等级7篇。文献共评价8种非药物措施的证据,其中穴位刺激对化疗所致恶心呕吐的积极影响最为显著。结论通过对目前已发表的系统评价再评价发现,非药物干预可尝试作为临床或居家管理化疗所致恶心呕吐的辅助手段,其中穴位刺激可优先考虑。但纳入文献的方法学质量不高、证据等级偏低,其效果仍需进一步验证。

Objective To overview the systematic reviews on efficacy of non-pharmacological interventions of chemotherapy induced nausea and vomiting in cancer patients.Methods Databases were searched for systematic reviews or meta-analyses of non-pharmacological interventions for chemotherapy induced nausea and vomiting.The databases included CNKI,WanFang Database,VIP,Chinese Biomedical Literature Database,Cochrane Library,Cumulative Index to Nursing and Allied Health Literature(CINAHL),Embase and Pubmed.The retrieval time was from the establishment of the database to June 30,2022.After screening,data were extracted from the included systematic reviews,and the quality of methodology and evidence was evaluated and analyzed.Results A total of 19 systematic evaluations were included,among which 4 were of medium quality grade,8 were of low quality grade,and 7 were of very low quality grade.Eight non-pharmacological interventions were evaluated and the results showed that acupoint stimulation had a positive effect on chemotherapy induced nausea and vomiting.Conclusion The result of overview of the published systematic reviews so far shows that non-pharmacological intervention can be attempted as a clinical aid for the management of chemotherapy induced nausea and vomiting,but acupoint stimulation can be given priority.However,the methodological quality and evidence quality are low,so the effect still needs to be further validated.