耳针治疗癌痛随机对照研究的Meta分析

目的：运用循证医学方法评价耳针治疗癌痛的有效性和安全性。方法：计算机检索Cochrane Library、EMBASE、PUBMED、中国生物医学文献数据库、中国知网、重庆维普、万方数据库,检索所需的随机对照试验（RCT）文献进行Meta分析。结果：共纳入8个研究,合计853例癌痛病例,分析发现耳针联合药物治疗癌痛有效率对比常规药物无统计学差异（95%Cl 1.0～1.25,P=0.05）;耳针联合药物可以减轻患者疼痛评分（95%Cl-3.08～-0.17,P=0.03）;比较两组患者阿片类药物不良反应发生率,恶心呕吐发生率两组比较无统计学差异（95%Cl 0.17～1.16,P=0.1）,治疗组对于减少便秘发生优于对照组（95%Cl 0.12～0.93,P=0.04）。结论：耳针联合药物治疗癌痛有效,在减轻疼痛、减少便秘的发生有一定优势,但不能减少恶心呕吐的发生。由于纳入文献数量过少,特别是高质量、多中心的文献极少,因此上述结果还需进入深入研究。

Meta-analysis on Randomized Controlled Clinical Trials of Auricular Acupuncture on Cancer Pain

Objective：To assess the efficacy and security of auricular acupuncture for cancer pain with evidence-based medicine method. Methods：A retrieval on literatures concerning treatment of cancer pain with auricular acupuncture was carried out in databases of Cochrane Library,EMBASE,Pubmed,CMB,CNKI,VIP and WANFANG. And Meta- analyses were conducted on randomized controlled trials（RCT） which met the enrolling requirements. Results：A total number of 8 papers involving 853 patients were included. The result indicated that auricular acupuncture plus routine medication treatment showed no effect on curative rate（95% Cl 1. 0 ～ 1. 25,P = 0. 05）. Pain scores were lower in the auricular acupuncture plus medication group than in routine medicine group（95% Cl- 3. 08 ～- 0. 17,P = 0. 03）. In the comparison of side effect of opium,statistical significance cannot be found on nausea and vomiting occurrence rate（95% Cl 0. 17 ～1. 16,P = 0. 1）. And auricular acupuncture plus medication treatment was better than routine medication on constipation occurrence rate（95% Cl 0. 12 ～ 0. 93,P = 0. 04）. Conclusion：Auricular acupuncture plus medication is effective to treat cancer pain. It has advantage on alleviate pain level and reduce the occurrence of constipation when compared with routine medication treatment. Auricular acupuncture cannot reduce the occurrence of nausea and vomiting. However,since the number of RCT literatures was less,especially high- quality,large samples and multi- center reports were not enough.Further studies are still necessary for approving the conclusions.