BACKGROUND Pain in the liver is a common symptom of liver cancer in late stages,and the pain incidence rate exceeds 50%[1].In serious cancer pain,morphine and other major analgesics have been commonly administrated fo...BACKGROUND Pain in the liver is a common symptom of liver cancer in late stages,and the pain incidence rate exceeds 50%[1].In serious cancer pain,morphine and other major analgesics have been commonly administrated for clinical treatments,and their effects are accurate,but with a high incidence of side effects,such as nausea,vomiting,constipation,and other conditions.Acupuncture is a traditional Chinese medicine therapy.There have been many randomized controlled trials addressing the safety and usefulness of different methods of acupuncture in alleviating liver cancer pain.However,which of these methods is the most effective method is still unclear.AIM To compare the effectiveness of different acupuncture methods for alleviating pain due to liver cancer.METHODS Eligible studies were retrieved from eight databases(the Cochrane Library,PubMed,EMBASE,Medline,CNKI,CBM,Chongqing VIP,and Wan Fang Database)up to March 31,2021 and screened based on the established inclusion and exclusion criteria.The quality of the include studies was evaluated.Stata software was applied for statistical analyses.Publication bias of the included studies was also determined.Finally,the network meta-analysis was carried out to evaluate the efficacy of acupuncture methods for relief of pain due to liver cancer.RESULTS A total of eight randomized controlled trials were included in the network metaanalysis.Eight trials(covering 5 treatments and 734 patients)provided data suitable for analysis.Most trials focused on short-term effects and many were classed as being of poor quality with a high risk of bias,commonly associated with lack of blinding(which was sometimes impossible to achieve).End of treatment results showed that four interventions,including wrist-ankle acupuncture,triple puncture and remaining needle acupuncture,Tian Yuan acupuncture,and block acupuncture,produced a statistically significant reduction in pain when compared with the three-step analgesic ladder therapy.The surface under the cumulative ranking sorting results showed that triple puncture and remaining needle acupuncture had a relatively high effective rate.CONCLUSION The network meta-analysis results indicate that the overall effectiveness of triple puncture and remaining needle acupuncture is better than the other therapies.展开更多
目的观察枳术汤合补中益气汤加味联合三阶梯止痛疗法对中晚期恶性肿瘤患者癌性疼痛程度及生存质量的影响。方法选取2018年6月—2020年12月该院收治的45例恶性肿瘤患者作为研究对象,随机分为观察组23例,对照组22例,对照组使用三阶梯止痛...目的观察枳术汤合补中益气汤加味联合三阶梯止痛疗法对中晚期恶性肿瘤患者癌性疼痛程度及生存质量的影响。方法选取2018年6月—2020年12月该院收治的45例恶性肿瘤患者作为研究对象,随机分为观察组23例,对照组22例,对照组使用三阶梯止痛疗法,观察组在对照组基础上增加枳术汤合补中益气汤加味,中药每天服用1剂,连续服用1周;之后隔天服用1剂,连续服用1周,总疗程2周。比较两组患者治疗前与治疗后2周的癌性疼痛程度、生存质量和疼痛相关血清因子水平,比较两组患者在治疗过程中发生的不良反应。结果观察组癌性疼痛的治疗有效率高于对照组(P<0.05),两组患者的视觉模拟评分法(Visual Analogue Scale,VAS)评分的组间和时间差异有统计学意义(P<0.05),无交互效应(P>0.05),治疗后观察组的癌症患者生活质量量表(Quality of Life Questionnare-Core 30,QLQ-C30)评分均高于对照组(P<0.05),观察组患者治疗后血清C反应蛋白(C-reactive protein,CRP)、5-羟色胺(5-hydroxytryptamine,5-HT)与前列腺素E2(prostaglandin E2,PGE2)水平均低于对照组(P<0.05),观察组的不良反应发生率低于对照组(P<0.05)。结论枳术汤合补中益气汤加味联合三阶梯止痛疗法可有效缓解中晚期恶性肿瘤患者的癌性疼痛程度,提高患者的生存质量。展开更多
文摘BACKGROUND Pain in the liver is a common symptom of liver cancer in late stages,and the pain incidence rate exceeds 50%[1].In serious cancer pain,morphine and other major analgesics have been commonly administrated for clinical treatments,and their effects are accurate,but with a high incidence of side effects,such as nausea,vomiting,constipation,and other conditions.Acupuncture is a traditional Chinese medicine therapy.There have been many randomized controlled trials addressing the safety and usefulness of different methods of acupuncture in alleviating liver cancer pain.However,which of these methods is the most effective method is still unclear.AIM To compare the effectiveness of different acupuncture methods for alleviating pain due to liver cancer.METHODS Eligible studies were retrieved from eight databases(the Cochrane Library,PubMed,EMBASE,Medline,CNKI,CBM,Chongqing VIP,and Wan Fang Database)up to March 31,2021 and screened based on the established inclusion and exclusion criteria.The quality of the include studies was evaluated.Stata software was applied for statistical analyses.Publication bias of the included studies was also determined.Finally,the network meta-analysis was carried out to evaluate the efficacy of acupuncture methods for relief of pain due to liver cancer.RESULTS A total of eight randomized controlled trials were included in the network metaanalysis.Eight trials(covering 5 treatments and 734 patients)provided data suitable for analysis.Most trials focused on short-term effects and many were classed as being of poor quality with a high risk of bias,commonly associated with lack of blinding(which was sometimes impossible to achieve).End of treatment results showed that four interventions,including wrist-ankle acupuncture,triple puncture and remaining needle acupuncture,Tian Yuan acupuncture,and block acupuncture,produced a statistically significant reduction in pain when compared with the three-step analgesic ladder therapy.The surface under the cumulative ranking sorting results showed that triple puncture and remaining needle acupuncture had a relatively high effective rate.CONCLUSION The network meta-analysis results indicate that the overall effectiveness of triple puncture and remaining needle acupuncture is better than the other therapies.
文摘目的观察枳术汤合补中益气汤加味联合三阶梯止痛疗法对中晚期恶性肿瘤患者癌性疼痛程度及生存质量的影响。方法选取2018年6月—2020年12月该院收治的45例恶性肿瘤患者作为研究对象,随机分为观察组23例,对照组22例,对照组使用三阶梯止痛疗法,观察组在对照组基础上增加枳术汤合补中益气汤加味,中药每天服用1剂,连续服用1周;之后隔天服用1剂,连续服用1周,总疗程2周。比较两组患者治疗前与治疗后2周的癌性疼痛程度、生存质量和疼痛相关血清因子水平,比较两组患者在治疗过程中发生的不良反应。结果观察组癌性疼痛的治疗有效率高于对照组(P<0.05),两组患者的视觉模拟评分法(Visual Analogue Scale,VAS)评分的组间和时间差异有统计学意义(P<0.05),无交互效应(P>0.05),治疗后观察组的癌症患者生活质量量表(Quality of Life Questionnare-Core 30,QLQ-C30)评分均高于对照组(P<0.05),观察组患者治疗后血清C反应蛋白(C-reactive protein,CRP)、5-羟色胺(5-hydroxytryptamine,5-HT)与前列腺素E2(prostaglandin E2,PGE2)水平均低于对照组(P<0.05),观察组的不良反应发生率低于对照组(P<0.05)。结论枳术汤合补中益气汤加味联合三阶梯止痛疗法可有效缓解中晚期恶性肿瘤患者的癌性疼痛程度,提高患者的生存质量。
