电针治疗化疗所致周围神经病变的Meta分析

Meta-analysis of electroacupuncture for chemotherapy-induced peripheral neuropathy

关键词:  化疗所致周围神经病变  电针  系统评价  Meta分析

Key words:  chemotherapy-induced peripheral neuropathy  electroacupuncture  systematic review  Meta analysis

摘要:

[目的] 系统评价电针治疗化疗所致周围神经病变（CIPN）的临床疗效。[方法] 电子检索中国知网、维普、万方、PubMed、EMbase和Cochrane图书馆数据库，时间从2018年12月追溯至建库，对纳入文献按相关标准进行质量评估，并分别使用 RevMan 5.2 统计软件、TSA v0.9软件进行Meta 分析及试验序贯分析。[结果] 纳入的11篇文献Meta 分析结果示：电针能降低CIPN患者Levi或NCI周围神经毒性分级[SMD=-0.69，95%CI（-1.03，-0.35）]、[SMD=-0.67，95%CI（-0.94，-0.41）]、视觉模拟评分（VAS疼痛评分）[SMD=-2.14，95%CI（-3.27，-1.01）]，提高功能状态（KPS）评分[SMD=12.20，95%CI（8.44，15.96）]、四肢感觉神经传导速度[SMD=2.30，95%CI（1.33，3.26）]、四肢运动神经传导速度[SMD=1.37，95%CI（0.62，2.12）]，与对照组比较差异均有统计学意义。[结论] 电针治疗有利于缓解CIPN患者疼痛症状，控制化疗患者神经毒性的进展，改善神经传导速度，提高生活质量，但上述结论尚需更多高质量临床研究加以证实。

Abstract:

[Objective] To systematically review the clinical efficacy of electroacupunc-ture in treating chemotherapy-induced peripheral neuropathy. [Methods] The databases of CNKI,VIP,WANFANG,PubMed,EMbase and The Cochrane Library were searched in order to collect relevant literatures with the deadline to December 2018. The quality of the included literatures was evaluated,while Meta analysis and TSA analysis were conducted using RevMan 5.2 statistical software and TSA v0.9 software. [Results] 11 literatures were included eventually.The analysis suggested that:Electroacupuncture can reduce Levi's and NCI's score in patients with CIPN[SMD=-0.69,95%CI(-1.03,-0.35)]、[SMD=-0.67,95%CI(-0.94,-0.41)] as well as VAS pain score[SMD=-2.14,95%CI(-3.27,-1.01)],and improve the KPS score[SMD=12.20,95%CI(8.44,15.96)],as well as SNCV[SMD=2.30,95%CI (1.33,3.26)],MNCV[(SMD=1.37,95%CI (0.62, 2.12)],the differences were statistically significant. [Conclusion] Electroacupuncture therapy may help relieve pain and control the progress and severity of CIPN,improving nerve conduction speed,as well as patients' the quality of life.The above conclusions need to be confirmed by more high-quality clinical studies.