The preferences and values of patients treated with acupuncture for cancer pain:a qualitative systematic review

Background:Understanding values and preferences in the context of personal,physical,emotional,relational,and social factors is important in optimizing cancer patient counselling,facilitating treatment decision-making,and improving guideline recommendations in treating cancer pain patients.Objective:To systematically review the available evidence regarding the values,preferences,and expectations of acupuncture for patients with cancer pain.Methods:A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)statement was conducted.Eight databases were searched without time limits for eligible studies up to April 26,2021.Reference lists of included articles were also searched manually and authors were contacted to inquire about other relevant papers.The quality of the studies was appraised using the Critical Appraisal Skill Program Qualitative Appraisal Checklist(CASP)for studies.This research was registered on PROSPERO with number CRD42020213396.Results:A total of eight studies published in period from 2002 to 2020 were identified from 8 studies involving 2,835 patients.The number of participants in each study ranged from 76 to 706.The quality of the eight included studies was considered high as judged by the CASP tool.Safety is the main factor influencing patients'willingness and preference to accept acupuncture treatment.Human race,education,gender,and knowledge of acupuncture were potentially correlated with patients'preferences.Patients with moderate to severe pain were more likely to use acupuncture than those with mild pain.Conclusion:The preferences and values of patients with cancer pain to receive acupuncture treatment are mainly related to the safety of acupuncture,the degree of cancer pain and demographic characteristics.It is hoped that future high-quality studies could further confirm our conclusions.

Study on the technical specification of Miao doctor's medicinal acupuncture therapy for interventional cancer pain

Objective: Under the guidance of the theory of Miao medicine, the technical norm scheme for intervention of acupuncture and moxibustion for the treatment of cancer pain is proposed. Methods: The standard operation procedure of the intervention of the acupuncture and moxibustion acupuncture therapy for cancer pain was formulated according to the selection of acupoints in the Miao medicine Tianying acupoint, sputum manipulation method, and the routine operations such as medicine, acupuncture and canning. Results: A set of technical specifications for the treatment of cancer pain in a mobilized Miao doctor was sorted out. Conclusion: The sputum acupuncture treatment technique specification for cancer pain is easy to operate and easy to be applied in clinical application.

Efficacy of acupuncture on cancer pain:A systematic review and meta-analysis

Background:Pain associated with cancer is one of the greatest causes of reduced quality of life in patients.Acupuncture is one of the treatments used to address this issue,with the great advantage of having little or no side effects,especially when compared with pharmacological pain-killers.Objective:The aim of this systematic review and meta-analysis was to evaluate the current evidence regarding the efficacy of acupuncture for cancer pain.Search strategy:Six electronic databases(PubMed,EBSCO,Cochrane Library,Scielo,b-On and Scopus)were searched for relevant articles about pain relief in cancer patients from their beginning until 2022using MeSH terms such as“acupuncture,”“electroacupuncture,”“ear acupuncture,”“acupuncture analgesia,”“oncological pain,”and“cancer pain.”Inclusion criteria:Studies included were randomized controlled trials(RCTs)where acupuncture was compared with no treatment,placebo acupuncture or usual care.Data extraction and analysis:Three independent reviewers participated in data extraction and evaluation of risk of bias,and a meta-analysis was conducted.The primary outcome was pain intensity,measured with the visual analog scale,numeric rating scale,or brief pain inventory.Secondary outcomes also assessed were quality of life,functionality,xerostomia,pain interference,and analgesic consumption.Results were expressed as standardized mean difference(SMD)with 95%confidence interval(CI).Results:Sixteen RCTs with a total of 1124 participants were included in the meta-analysis,with the majority of the studies presenting a low or unclear risk of bias.Acupuncture was more effective in reducing pain than no treatment(SMD=–0.90,95%CI[–1.68,–0.12]),sham acupuncture(SMD=–1.10,95%CI[–1.59,–0.61])or usual care(SMD=–1.16,95%CI[–1.38,–0.93]).Conclusion:The results of this study suggest that acupuncture may be an effective intervention to reduce pain associated with cancer.Despite some limitations due to the low quality and small sample size of some included studies,as well as the different types and stages of cancer,acupuncture might provide an effective and safe treatment to reduce cancer pain.

Traditional Chinese non-drug therapies for cancer pain treatment

Cancer pain is the most common and serious symptom of cancer, which seriously affects the quality of life of cancer patients. the most widely used three-step analgesia has received good effects, but the toxic side effects at the same time can be ignored. As a complementary therapy increasingly accepted around the world, traditional Chinese medicine (TCM) also plays an important role in cancer pain treatment. Traditional Chinese non-drug therapy has a good effect for cancer pain. In this mini-review, the commonly used traditional Chinese non-drug therapies such as acupuncture, moxibustion, acupoint catgut embedding and injection, massage, ear point pressing with coxherb seeds therapy, traditional music therapy were introduced.

Systematic Review and Meta-Analysis of Acupuncture for Pain Caused by Liver Cancer

Objective:The objective of this study is to systematically review and analyze the efficacy of acupuncture for pain caused by primary liver cancer(PLC).Materials and Methods:We searched databases,including PubMed,Medline,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,Chinese Science and Technology Periodicals Database(VIP),Wanfang,and SinoMed/Chinese Biomedical Database(CBM),and retrieved randomized controlled trials(RCTs)that used acupuncture as the primary intervention to treat pain caused by PLC.Two investigators then screened the articles,extracted and pooled data,and evaluated the risk of bias of the included articles according to the Cochrane Handbook.RevMan5.3 was used for the meta-analysis of eligible RCTs.Results:A total of 145 articles were retrieved;after screening,8 RCTs involving 496 patients were eventually included in this meta-analysis.The results showed that acupuncture effectively improved cancer pain and was superior to Western medicine.Moreover,acupuncture was fast-acting for pain relief,prolonged the relief,and prevented relapse.Its adverse reaction rate was also significantly lower than that of Western medicine.No significant difference was observed in Visual Analog Scale score between acupuncture and Western medicine.Conclusion:Acupuncture relieves pain caused by liver cancer and can be used as an adjunct and alternative therapy for drug treatment.The existing research evidence is not yet objective or comprehensive,and more rigorous clinical trials are needed to validate the results.

Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain: a systematic review and meta-analysis

BACKGROUND：Shoulder pain is a common complication of stroke.Bee venom acupuncture（BVA）is increasingly used in the treatment of post-stroke shoulder pain.OBJECTIVE：To summarize and evaluate evidence on the effectiveness of BVA in relieving shoulder pain after stroke.SEARCH STRATEGY：Nine databases,namely MEDLINE,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure（CNKI）,the Japan Science and Technology Information Aggregator,Electronic（J-STAGE）,and four Korean medical databases,namely,the National Assembly Library,the Research Information Service System,the National Discovery for Science Leaders,and OASIS,were searched from their inception through August 2014 without language restrictions.INCLUSION CRITERIA：Randomized controlled trials（RCTs）were included if BVA was used at acupoints as the sole treatment,or as an adjunct to other treatments,for shoulder pain after stroke.DATA EXTRACTION AND ANALYSIS：Two review authors independently selected trials for inclusion,assessed methodological quality and extracted data.RESULTS：A total of 138 potentially relevant articles were identifi ed,4 of which were RCTs that met our inclusion criteria.The quality of studies included was generally low,and a preponderance of positive results was demonstrated.All four trials reported favorable effects of BVA on shoulder pain after stroke.Two RCTs assessing the effects of BVA on post-stroke shoulder pain,as opposed to saline injections,were included in the meta-analysis.Pain was signifi cantly lower for BVA than for saline injections（standardized mean difference on 10-cm visual analog scale：1.46 cm,95%CI=0.30–2.62,P=0.02,n=86）CONCLUSION：This review provided evidence suggesting that BVA is effective in relieving shoulder pain after stroke.However,further studies are needed to confi rm the role of BVA in alleviating post-stroke shoulder pain.Future studies should be conducted with large samples and rigorous study designs.

Endoscopic pancreatic duct stenting for pain palliation in selected pancreatic cancer patients:a systematic review and meta-analysis

Background Abdominal pain is a debilitating symptom affecting-80%of pancreatic cancer(PC)patients.Pancreatic duct(PD)decompression has been reported to alleviate this pain,although this practice has not been widely adopted.We aimed to evaluate the role,efficacy,and safety of endoscopic PD decompression for palliation of PC post-prandial obstructive-type pain.Methods A systematic review until 7 October 2020 was performed.Two independent reviewers selected studies,extracted data,and assessed the methodological quality.Results We identified 12 publications with a total of 192 patients with PC presenting with abdominal pain,in whom PD decompression was attempted,and was successful in 167 patients(mean age 62.5 years,58.7%males).The use of plastic stents was reported in 159 patients(95.2%).All included studies reported partial or complete improvement in pain levels after PD stenting,with an improvement rate of 93%(95%confidence interval,79%-100%).The mean duration of pain improvement was 94616 days.Endoscopic retrograde cholangiopancreatography(ERCP)-related adverse events(AEs)were postsphincterotomy bleeding(1.8%),post-ERCP pancreatitis(0.6%),and hemosuccus pancreaticus(0.6%).AEs were not reported in two patients who underwent endoscopic ultrasound-guided PD decompression.In the 167 patients with technical success,the stent-migration and stent-occlusion rates were 3.6%and 3.0%,respectively.No AE-related mortality was reported.The methodological quality assessment showed the majority of the studies having low or unclear quality.Conclusion In this exploratory analysis,endoscopic PD drainage may be an effective and safe option in selected patients for the management of obstructive-type PC pain.However,a randomized–controlled trial is needed to delineate the role of this invasive practice.

Clinical regularities in acupuncture-moxibustion treatment of cancer pain in recent 30 years

Objective: To explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the re leva nt studies published betwee n 1985 and 2017. Methods: Based on the Chinese Medicine Acupuncture-moxibustion Information Database, quantitative analysis, correlation an alysis and Chi-square test were applied to an a lyze the comm only used acupoi nts, meridia n affiliatio ns and body regi on distributi ons, comm only used methods and acupoi nt correlati ons, treatme nt method correlati ons, the efficacy of acupuncture- moxibusti on plus the three-step an algesic ladder for can cer pain, and in dicators. Results: Zusanli (ST 36), Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency;points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used;points from the lower limbs and back had high frequencies. The most commonly used treatment method was acupuncture-moxibustion plus medication. Acupuncture-moxibusti on plus the three-step an algesic ladder showed certai n adva ntage compared with the two methods used separately, and among the integrated methods, acupoint application plus the three-step analgesic ladder produced the most significant efficacy. It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h. Numerical rati ng scale (NRS), visual an alog scale (VAS) and Kar nofsky performa nee status (KPS) scores all showed sign ifica nt changes after interventions (all P<0.01);there was no significant change in the score of quality of life (QOL) after interventions (P>0.05). Conclusion: Zusa nli (ST 36), Ashi point and Sanyin jiao (SP 6) are comm only selected in acup un cture-moxibusti on treatment of cancer pain;acupuncture and acupoint application are often used;acupuncture-moxibustion plus the three-step an algesic ladder can boost the treatme nt efficacy.

Efficacy and safety of acupuncture for the treatment of knee osteoarthritis:a systematic review and meta-analysis

Objective:To evaluate the efficacy and safety of acupuncture for the treatment of knee osteoarthritis and to provide evidence for its use in clinical practice.Methods:Eight databases were extensively searched up to March 2018.Randomized controlled trials(RCTs)comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included.Study selection,data extraction and quality assessment were independently conducted by two reviewers.The Cochrane Collaboration's tool was used for assessing the risk of bias.Results:A total of 18 RCTs were included,involving a total of 3522 participants.The results showed that acupuncture was superior to sham acupuncture in relieving pain(SMD=-0.34,95%CI:-0.57 to-0.11,I^2=85%,P=0.003)and improving physical function(SMD=-0.34,95%CI:-0.57 to-0.11,I^2=85%,P=0.003).In comparison to the no-acupuncture group,the acupuncture group also showed significant advantages in relieving pain(SMD=-0.79,95%CI:-1.15 to-0.43,I^2=87%,P<0.0001)and improving physical function(SMD=-0.75,95%CI:-1.19 to-0.31,I^2=91%,P=0.0008).Sensitivity analyses suggested that the results were robust,and Egger's test found no potential publication bias.Conclusion:In the treatment of knee osteoarthritis,the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.

Annual advances of acupuncture research in 2022

This article reviews the major advances in acupuncture research in 2022,including clinical reports,basic research,and reviews.In terms of the type of literature,most of them are systematic reviews and clinical trials,while high-quality basic studies can also be found.The innovative inventions and researches in this field are of increasing quality and in a wide range of fields,acupuncture is attracting more and more attention in the international arena.In particular,some acupuncture combined sensors such as H2-EC/SD co-therapy,precise positioning,and vivo monitoring of neurotransmitter has been used for oncological diseases and neuropathic pain.Acupuncture has been shown to be beneficial in the treatment of pain,stroke,psychiatric disorders,cancer,COVID-19 and others.Most of the studies show that acupuncture can play a positive role in various diseases and provide evidence for clinical applications and mechanism research.

阿片类药物联合眼针疗法对癌性疼痛临床观察

目的 研究阿片类药物联合眼针疗法对癌性疼痛患者数字分级法(NRS)评分、生活质量量表(QOL)评分及总有效率的影响。方法 将60例癌性疼痛患者随机分成针药并用组和单纯西药组,各30例。单纯西药组遵医嘱服用盐酸羟考酮缓释片。针药并用组在此基础上联合眼针疗法,根据其脏腑、三焦、循经取穴原则选穴,配阿是穴,每日1次,治疗2周。观察2组治疗前后NRS评分、QOL评分变化情况,计算总有效率。结果 治疗2周后,2组NRS评分均下降、QOL评分均提高(P<0.01),且针药并用组NRS评分下降更为明显、QOL评分提高更为明显(P<0.01);针药并用组总有效率优于单纯西药组(P<0.05)。结论 阿片类药物联合眼针疗法可明显减轻癌痛患者的疼痛,提升生活质量水平,总有效率更高,值得推广。

第三腰椎横突综合征针灸治疗进展

第三腰椎横突综合征(TLTPS)是一种多发病,属于中医学“腰痛”范畴,以第三腰椎横突明显压痛为特征。临床此病多发且易反复发作,患病人群分布广泛。在治疗上,现代医学主要依靠封闭疗法、手术,但结合患者自身情况以及手术风险,均不易被接受;而针灸疗法具有安全、有效等明显优势。文章对近30年来关于TLTPS的认识、机制、疗效的研究进行概述,发现各治疗方法独具特色,均具有良好效果;但目前还缺乏对各疗法适用范围的足够关注,日后尚需高质量的研究设计以全面评价针灸疗法与TLTPS的联系。

辨证论治癌痛的研究进展

癌痛是晚期癌症患者最常见、最严重的症状之一,它给患者带来了巨大的痛苦,严重影响了患者的生活质量。文章分析了近几年治疗癌痛的有关文献,从病因病机到辨证论治的相关内容,阐述了中医辨证论治癌痛的进展。中西医结合治疗癌痛能提高临床效果,减少不良作用,但目前还没有客观统一的癌痛辨证标准。

针灸联合耳穴疗法治疗癌性疼痛的临床研究

目的:观察针灸联合耳穴疗法治疗癌性疼痛的临床疗效。方法:47例临床或病理诊断为恶性肿瘤伴有癌性疼痛的患者随机分为治疗组(针灸联合耳穴治疗)24例、对照组(假针灸联合假耳穴治疗)23例,治疗组接受针灸(体针+电针)7 d+耳穴14 d治疗,对照组接受假针灸(假体针+电针)7 d+假耳穴14 d治疗,21 d为1疗程。结果:治疗组采用针灸联合耳穴疗法可显著减轻癌性疼痛,减少止痛药的用量,减轻止痛药的不良反应,同时能改善患者免疫功能,提高生存质量,与对照组相比有显著性差异。结论:针灸联合耳穴疗法是中医治疗癌性疼痛有效的外治方法之一。

骨转移癌疼痛的治疗进展

骨转移癌是肿瘤患者常见并发症,其发病率占全身转移癌的15%~20%,仅次于肺及肝转移癌的发病率。易发生骨转移癌的恶性肿瘤包括肺癌、乳腺癌、前列腺癌等,而疼痛是骨转移癌最常见的临床症状,早期症状隐匿,随着病情进展,症状逐渐加重,晚期疼痛剧烈,给肿瘤患者的生存质量带来严重威胁。因此,本研究通过检索国内外文献,系统介绍了西医及中医治疗骨转移癌疼痛的现状,以期为骨转移癌疼痛的临床治疗提供建议和参考。

癌性疼痛非药物治疗方法

癌痛是影响癌症患者生存质量的一个重要的因素,现在常用的三阶梯药物止痛疗法虽然取得了一定疗效,但是仍然存在问题。而非药物疗法,比如针灸推拿疗法、音乐疗法、身心疗法等对于缓解癌痛都有不错的疗效。文章就近年来癌痛非药物疗法的应用现状做一综述。

针灸联合耳穴疗法配合三阶梯止痛药对癌性疼痛影响的临床观察

目的观察针灸联合耳穴疗法配合三阶梯止痛药治疗癌性疼痛的临床疗效。方法将120例癌性疼痛患者随机分为治疗组与对照组,每组60例。两者均予基础三阶梯止痛药物,治疗组加用针灸联合耳穴疗法,对照组加用假针灸联合假耳穴疗法。两组疗程均为21日,观察三阶梯止痛药的使用情况与副反应情况,比较疼痛强度视觉模拟评分(VAS)、生存质量评分(ZPS)及自然杀伤细胞(NK)、T细胞(CD3^+、CD4^+、CD8^+、CD4^+/CD8^+)水平的变化情况。结果 (1)最终完成试验者114例,治疗组58例,对照组56例。(2)组间治疗后比较,VAS评分差异有统计学意义,治疗组明显低于对照组(P<0.05)。(3)疗程结束时,治疗组有58.62%的患者有效减用或降阶梯使用止痛药,对照组有17.86%的患者有效减用或降阶梯使用止痛药;组间减药有效率比较,差异有统计学意义(P<0.05)。(4)疗程结束时,治疗组34.48%的患者止痛药副反应减少,对照组21.43%的患者止痛药副反应减少;组间减副反应有效率比较,差异有统计学意义,治疗组明显高于对照组(P<0.05)。(5)组间治疗后比较,ZPS评分差异有统计学意义,治疗组明显低于对照组(P<0.05)。(6)组间治疗后比较,CD3^+、CD4^+、CD4^+/CD8^+水平差异有统计学意义,治疗组改善程度明显优于对照组(P<0.05)。结论针灸联合耳穴疗法配合三阶梯常规止痛药治疗癌性疼痛,可明显减轻癌性疼痛,提高患者的生存质量与细胞免疫功能,还可一定程度减少止痛药的使用及止痛药所致的副反应。

针灸治疗肠道疾病内脏痛的实验研究进展

国内外大量研究表明,针灸对包括内脏痛在内的各类疼痛具有显著的镇痛作用。该文以肠道疾病为切入点,从疼痛评估方法、镇痛效应和镇痛机制3个方面,对近15年针灸治疗内脏痛的实验研究进行述评,以期为针灸治疗内脏痛的深入研究提供科学资料。

针灸在恶性肿瘤治疗中的应用概况

就近年来有关针灸在恶性肿瘤治疗中的应用的文献进行总结,分析针灸在缓解癌性疼痛、改善放化疗不良反应、提高机体免疫力等方面的疗效,探讨针灸在恶性肿瘤治疗中的作用,为临床研究提供参考依据。通过对文献中的针灸方法、疗效判断、试验方法、实验结果等资料的分析,认为针灸在缓解癌性疼痛、改善放化疗后不良反应、提高机体免疫力等方面有一定效果,但针灸治疗恶性肿瘤在介入时机、相关疗法的综合应用、刺激强度、留针时间及作用机理等方面有待进一步研究。

针刺联合盐酸羟考酮控释片治疗椎体转移所致重度癌性疼痛的临床观察

目的观察针刺联合盐酸羟考酮缓释片治疗椎体转移所致重度癌性疼痛患者的临床疗效及对患者疼痛程度的影响。方法将纳入的108例椎体转移所致重度癌性疼痛患者按照随机数字表法分为研究组和对照组,每组54例。对照组采用口服盐酸羟考酮缓释片治疗,研究组在对照组治疗基础上联合针刺治疗。比较两组疼痛缓解情况;采用抑郁自评量表(SDS)和焦虑自评量表(SAS)评估患者抑郁和焦虑情况;用生活质量量表(QOL)评价两组患者治疗前后生活质量。观察两组消化系统毒副反应发生情况。结果研究组疼痛总缓解率明显高于对照组,两组差异具有统计学意义(P<0.05)。治疗后,两组SAS、SDS和NRS评分均较治疗前降低(P<0.05),且研究组均低于对照组(P<0.05);研究组生活质量良好率和QOL总分均明显高于对照组,两组比较差异具有统计学意义(P<0.05)。两组消化系统不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合盐酸羟考酮缓释片治疗椎体转移所致重度癌性疼痛患者可有效缓解疼痛,改善抑郁和焦虑状态,提升生活质量。