Efficacy of complementary and alternative medicine therapies in relieving cancer pain: A systematic review
Efficacy of complementary and alternative medicine therapies in relieving cancer pain: A systematic review
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DOI：
10.1200/jco.2006.08.3725
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发表时间：
2006-12-01
影响因子：
45.3
通讯作者：
Moynihan, Timothy J.
中科院分区：
文献类型：
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作者：
Bardia, Aditya;Barton, Debra L.;Moynihan, Timothy J.
尽管补充和替代医学（CAM）疗法广泛流行，但缺乏关于其对癌症相关疼痛疗效的严格证据基础。这是一个系统的评价随机对照试验（RCT）评估CAM治疗癌症相关pain. MethodsRCT使用CAM干预癌症相关pain. MethodsRCT抽象使用Medline，EMBASE，CINAHL，AMED，和科克伦database.Results18试验确定（8个穷人，3个中间，7个高质量的基础上Jadad评分），共有1,499例患者。中位样本量为53例患者，中位干预持续时间为45天。所有研究均来自单一机构，其中4项研究有样本量合理性证明，没有报告任何不良反应。7项试验报告了以下CAM疗法的显著益处：针灸（n = 1），支持团体（n = 2），催眠（n = 1），放松/想象（n = 2）和草药补充剂/HESA-A（n = 1，但研究质量低，没有对照数据）。7项研究报告了以下CAM干预的即时干预后或短期获益：针灸（n = 2）、音乐（n = 1）、草药补充/艾通平（n = 1）、按摩（n = 1）和愈合触摸（n = 2）。四项研究报告CAM干预措施（音乐，n = 2;按摩，n = 2）在减少癌症pain compared with a control arm.ConclusionThere是缺乏多机构随机对照试验评估CAM干预癌症疼痛与足够的权力，持续时间，和假对照。催眠、意象、支持小组、针灸和治疗触摸似乎很有希望，特别是在短期内，但由于缺乏严格的试验，没有一种可以推荐。未来的研究应该集中在方法学上强有力的随机对照试验，以确定这些CAM干预措施的潜在疗效。
PurposeDespite widespread popular use of complementary and alternative medicine (CAM) therapies, a rigorous evidence base about their efficacy for cancer-related pain is lacking. This is a systematic review of randomized controlled trials (RCTs) evaluating CAM therapies for cancer-related pain.MethodsRCTs using CAM interventions for cancer-related pain were abstracted using Medline, EMBASE, CINAHL, AMED, and Cochrane database.ResultsEighteen trials were identified (eight poor, three intermediate, and seven high quality based on Jadad score), with a total of 1,499 patients. Median sample size was 53 patients, and median intervention duration was 45 days. All studies were from single institutions, four had sample size justification, and none reported any adverse effects. Seven trials reported significant benefit for the following CAM therapies: acupuncture (n = 1), support groups (n = 2), hypnosis (n = 1), relaxation/imagery (n = 2), and herbal supplement/HESA-A (n = 1, but study was of low quality without control data). Seven studies reported immediate postintervention or short-term benefit of the following CAM interventions: acupuncture (n = 2), music (n = 1), herbal supplement/Ai-Tong-Ping (n = 1), massage (n = 1), and healing touch (n = 2). Four studies reported no benefit of CAM interventions (music, n = 2; massage, n = 2) in reducing cancer pain compared with a control arm.ConclusionThere is paucity of multi-institutional RCTs evaluating CAM interventions for cancer pain with adequate power, duration, and sham control. Hypnosis, imagery, support groups, acupuncture, and healing touch seem promising, particularly in the short term, but none can be recommended because of a paucity of rigorous trials. Future research should focus on methodologically strong RCTs to determine potential efficacy of these CAM interventions.