针刺治疗癌症化疗后恶心呕吐疗效的Meta分析＊

目的 系统评价针刺治疗癌症化疗后恶心呕吐的有效性和安全性。方法 采用计算机检索PubMed、荷兰医学文献数据库（Embase）、Cochrane图书馆（Cochrane Library）、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普中文科技期刊全文数据库（VIP）、万方学术期刊全文数据库（Wan fang）建库至2021年02月28日针刺治疗化疗后恶心呕吐的随机对照试验。采用RevMan5.4软件进行Meta分析。结果 本研究共纳入18篇文献,涉及1538名患者。Meta分析结果显示,针刺治疗化疗后的恶心呕吐在有效率（P<0.01,RR=1.17,95%CI=［1.09,1.26］）、症状完全缓解率（恶心：P<0.01,RR=1.42,95%CI=［1.14,1.76］;呕吐：P=0.01,RR=1.18,95%CI=［1.04,1.34］）及Karnofsky功能状态评分（KPS）（P<0.01,MD=3.97,95%CI=［1.55,6.39］］）等方面均优于对照组。亚组分析显示,消化道肿瘤试验组与对照组治疗有效率相当（P=0.45,RR=1.07,95%CI=［0.89,1.29］）;非消化道肿瘤试验组有效率优于对照组（P<0.01,RR=1.29,95%CI=［1.10,1.52］）。同时,试验组药物不良事件发生数远低于对照组,且针刺不良事件发生数较少。结论 针刺治疗癌症化疗后恶心呕吐是安全的,并可以提高有效率、症状完全缓解率,改善化疗后KPS评分,提高患者生活质量。

Efficacy of Acupuncture in the Treatment of Chemotherapy-induced Nausea and Vomiting: A Meta-analysis

Objective To systematically review the efficacy of acupuncture in the treatment of chemotherapy-induced nausea and vomiting.Methods PubMed, Excerpt Medica Database (Embase), Cochrane Library, China national Knowledge Infrastructure Database (CNKI), Chinese Biomedical Literature Database (CBM), Chinese Scientific Journal Database (VIP) and Wan Fang Data database (Wan fang) were searched to collect randomized controlled trials (RCTs) of acupuncture in the treatment of chemotherapy-induced nausea and vomiting from the date of database establishment to on February 28, 2021. Meta-analysis was performed by RevMan5.4 software.Results Totally 18 literatures involving 1538 patients were included in this study. The results of meta-analysis showed that acupuncture treatment of nausea and vomiting after chemotherapy was superior to the control group in the effective rate (P<0.01, RR=1.17, 95%CI=[1.09, 1.26]) and complete remission rate of symptoms (Nausea: P<0.01, RR=1.42, 95%CI=[1.14, 1.76]; Vomiting: P=0.01, RR=1.18, 95%CI=[1.04, 1.34]) and KPS score (P<0.01, MD=3.97, 95%CI=[1.55, 6.39]). Subgroup analysis showed that the effective rate of gastrointestinal tumors were similar between the experimental group and the control group (P=0.45, RR=1.07, 95%CI=[0.89, 1.29]). The effective rate of other tumors in the experimental group were better than that in the control group (P<0.01, RR=1.29, 95%CI=[1.10, 1.52]). At the same time, the number of adverse drug events in the experimental group was much lower than that in the control group, and there were fewer adverse events in acupuncture.Conclusion Acupuncture is safe to treat chemotherapy-induced nausea and vomiting, and can improve the effective rate and complete remission rate of symptoms in the treatment of nausea and vomiting after chemotherapy, improve KPS score after chemotherapy, and improve patients'' quality of life.