中药外敷阿是穴对肿瘤患者疼痛影响的Meta分析
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摘要
目的:评价中药穴位外敷阿是穴对肿瘤患者疼痛症状的影响。方法:计算机检索The Cochrane Library、Web of Science、PubMed、CNKI、维普网和万方数据库中对出现疼痛症状肿瘤患者采用中药穴位贴敷干预的随机对照试验。采用RevMan5.2软件对数据进行Meta分析。结果:共纳入16项研究,1421例患者。Meta分析结果显示,中药外敷阿是穴对癌性疼痛具有缓解作用[RR=1.18(1.13,1.24),P<0.01];VAS评分差异具有统计学意义[SMD=-0.80(-1.01,-0.59),P<0.01];2组不良反应发生情况差异无统计学意义[OR=1.38(0.55,3.47),P=0.49];中药外敷阿是穴对癌症患者生活质量具有改善作用[SMD=-0.89(0.71,1.07),P<0.01]。结论:中药外敷阿是穴对肿瘤患者疼痛症状控制安全有效,但受研究纳入文献质量影响,尚不能得出肯定结论。
Objective: To evaluate the effectiveness of acupoint application on Ashi points with herbs in patients with cancer-related cancer. Methods: We searched The Cochrane Library(Issue 10 October 2015), Web of Science, CNKI, VIP, PubMed and Wanfang Datebase to collect randomized controlled trails(RCTs). Meta-analysis was conducted by using RevMan 5.2 software. Results: Sixteen RCTs were included 1421 patients. The results of meta-analysis showed that Ashi points application therapy significantly improved cancer patients with pain [RR=1.18(1.13, 1.24), P<0.01]; the score of VAS between the two groups was significant [SMD=-0.80(-1.01,-0.59), P<0.01]; and there was no difference of adverse reaction[OR=1.38(0.55, 3.47), P=0.49]; Meanwhile, Ashi points application therapy acted a role in improving quality of life [SMD=-0.89(0.71, 1.07), P<0.01]. Conclusion: Ashi points application therapy is effective to management of cancer pain, This study has not gained a reliable conclusion due to the limiting of literature quality.
Objective: To evaluate the effectiveness of acupoint application on Ashi points with herbs in patients with cancer-related cancer. Methods: We searched The Cochrane Library(Issue 10 October 2015), Web of Science, CNKI, VIP, PubMed and Wanfang Datebase to collect randomized controlled trails(RCTs). Meta-analysis was conducted by using RevMan 5.2 software. Results: Sixteen RCTs were included 1421 patients. The results of meta-analysis showed that Ashi points application therapy significantly improved cancer patients with pain [RR=1.18(1.13, 1.24), P<0.01]; the score of VAS between the two groups was significant [SMD=-0.80(-1.01,-0.59), P<0.01]; and there was no difference of adverse reaction[OR=1.38(0.55, 3.47), P=0.49]; Meanwhile, Ashi points application therapy acted a role in improving quality of life [SMD=-0.89(0.71, 1.07), P<0.01]. Conclusion: Ashi points application therapy is effective to management of cancer pain, This study has not gained a reliable conclusion due to the limiting of literature quality.
引文
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[25]蒋晓芳,宋彦,刘婷婷,等.止痛方外敷在晚期癌痛护理中的应用[J].中华现代护理杂志,2013,19(4):431-432.
[26]周晓艳.止痛散结膏联合盐酸布桂嗪片治疗癌性疼痛疗效观察[J].中国医药指南,2013(20):679-679,680.
[27]陈宏,刘书红,孙晓蕾,等.中药贴敷局部治疗癌性疼痛的效果观察[J].护理学报,2012(24):55-56.
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[29]路守萍.中药贴剂穴位符治疗癌痛临床疗效观察[J].基层医学论坛,2013(25):3358-3359.
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[31]Han ZY,Zhou YQ.Advanced research of acupoint application in cancerous pain[J].Zhong Yi Yao Guan Li Za Zhi,2007,15(2):142-146.
[32]Jost L,Roila F,ESMO guidelines working group.Management of cancer pain:EMSO clinical recommendations[J].Ann Oncol,2009,20(s2):170-173.
[2]Kurita GP,Ulrich A,Jensen TS,et al.How is neuropathic cancer pain assessed in randomised controlled trials[J].Pain,2012,153(1):13-17.
[3]Portenoy RK.Treatment of cancer pain[J].Lancet,2011,377(9784):2236-2247.
[4]van den Beuken-van Everdingen MH,de Rijke JM,Kessels AG,et al.Prevalence of pain in patients with cancer:a systematic review of the past 40 years[J].Ann Oncol,2007,18(9):1437-1449.
[5]Cassileth BR,Vickers AJ.Massage therapy for symptom control:outcome study at a major cancer center[J].J Pain Symptom Manage,2004,28(3):244-249.
[6]Ferreira KA,Kimura M,Teixeira MJ,et al.Impact of cancerrelated symptom synergisms on health-related quality of life and performance status[J].J Pain Symptom Manage,2008,35(6):604-616.
[7]Kroenke K,Theobald D,Wu J,et al.The association of depression and pain with healthrelated quality of life,disability,and health care use in cancer patients[J].J Pain Symptom Manage,2010,40(3):327-341.
[8]Sepulveda C,Marlin A,Yoshida T,et al.Palliative Care:the World Health Organization’s global perspective[J].J Pain Symptom Manage,2002,24(2):91-96.
[9]Susman E.Cancer pain management guidelines issued for children;adult guideli-nes updated[J].J Natl Cancer Inst,2005,97(10):711-712.
[10]Pargeon KL,Hailey BJ.Barriers to effective cancer pain management:a review of the literature[J].J Pain Symptom Manage,1999,18(5):358-368.
[11]Management of Cancer Pain.Clinical practice guideline No.9AHCPR Pub.No.94-0592[J].Agency for Health,Rockville,1994:1.
[12]Gunnarsdottir S,Donovan HS,Serlin RC,et al.Patient-related barriers to pain management:the Barriers Questionnaire II(BQ-II)[J].Pain,2002,99(3):385-396.
[13]夏克春,张梅.中药贴敷治疗癌性疼痛研究进展[J].山东中医药大学学报,2012,36(2):170-173.
[14]Higgins JP,Green S.Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0.The Cochrane Collaboration,2011[J/OL].Available from:http://handbook.cochrane.org/.
[15]Bao YBWHXGX.Alleviation of cancerous pain by external compress with Xiaozheng Zhitong Paste[J].Chin J Integr Med,2010,16(4):309-314.
[16]Wang C,Tan W,Huang X,et al.Curative effect of Dingqi analgesic patch on cancer pain:a single-blind randomized controlled trail[J].JOURNAL OF TRADITIONAL CHINESEMEDICINE,2013,33(2):176-180.
[17]蔡永敏,李根林.阿麒贴治疗癌症疼痛178例临床研究[J].中医杂志,2002,43(3):200-201.
[18]王芳,冯利,张平,等.补肾化瘀中药外敷联合帕米膦酸二钠改善骨转移癌痛[J].中国实验方剂学杂志,2013,19(17):327-329.
[19]巫桁锞,熊慧生,文军.攻癌镇痛散外敷治疗癌性疼痛临床观察[J].中国中医急症,2012,21(7):1128-1129.
[20]景年财,郭环宇,王军,等.加减身痛逐瘀膏外敷联合强阿片类药物治疗肺癌骨转移中、重度疼痛的疗效[J].中国老年学杂志,2014(19):5428-5430.
[21]吴迪,冯肖卿,李卫东,等.四黄散外敷治疗原发性肝癌疼痛临床观察[J].中药材,2010,33(7):1197-1199.
[22]尚学彬,张喜峰,李文虎,等.温阳止痛散合奥施康定治疗中、重度癌性疼痛35例[J].中医临床研究,2013(13):68-69.
[23]沈丽贤,王明波,张红宇.消痛散联合吗啡缓释片治疗晚期肝癌癌痛的临床研究[J].中西医结合肝病杂志,2014(5):265-267.
[24]罗兰,罗秀丽.消肿Ⅰ号外敷治疗癌性疼痛的临床观察[J].湖北中医杂志,2010,32(5):48.
[25]蒋晓芳,宋彦,刘婷婷,等.止痛方外敷在晚期癌痛护理中的应用[J].中华现代护理杂志,2013,19(4):431-432.
[26]周晓艳.止痛散结膏联合盐酸布桂嗪片治疗癌性疼痛疗效观察[J].中国医药指南,2013(20):679-679,680.
[27]陈宏,刘书红,孙晓蕾,等.中药贴敷局部治疗癌性疼痛的效果观察[J].护理学报,2012(24):55-56.
[28]苏超,张翠玲,崔玉芬.中药贴敷治疗肝癌疼痛临床观察[J].山西中医,2013,29(8):36.
[29]路守萍.中药贴剂穴位符治疗癌痛临床疗效观察[J].基层医学论坛,2013(25):3358-3359.
[30]刘新平.中药外敷联合硫酸吗啡缓释片治疗转移性骨肿瘤癌性疼痛临床研究[J].中国医药导报,2011,08(32):107-108.
[31]Han ZY,Zhou YQ.Advanced research of acupoint application in cancerous pain[J].Zhong Yi Yao Guan Li Za Zhi,2007,15(2):142-146.
[32]Jost L,Roila F,ESMO guidelines working group.Management of cancer pain:EMSO clinical recommendations[J].Ann Oncol,2009,20(s2):170-173.