Acupuncture for cancer pain: an evidence-based clinical practice guideline

Chinese Medicine

Linpeng Wang¹  Ka-Kit Hui²  Fanrong Liang³  Anthony Lin Zhang⁴  Weimin Zhang⁵  Yufei Yang⁶  Qi Wang⁷  Long Ge⁸  Kehu Yang⁹  Qi Zhou^1,10  Haibo Zhang^1,11  Darong Wu^1,11  Yihan He^1,11  Xinfeng Guo^1,11  Charlie Changli Xue^1,12  Bing Zhu^1,13  Bin Xu^1,14  Haiqing Hua^1,15  Baixiao Zhao^1,16  Nenggui Xu^1,17  Jinchang Huang^1,18  Yaolong Chen^1,19 

[1] Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China;Center for East-West Medicine, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Santa Monica, USA;Chengdu University of Traditional Chinese Medicine, Chengdu, China;China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia;Department of Oncology, Southern Theater Command General Hospital of PLA, Guangzhou, China;Department of Oncology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China;Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China;Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China;Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China;Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China;WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China;Chinese GRADE Centre, Lanzhou University, Lanzhou, China;Evidence Based Social Science Research Centre, School of Public Health, Lanzhou University, Lanzhou, China;WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China;Chinese GRADE Centre, Lanzhou University, Lanzhou, China;Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China;Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China;Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China;Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China;Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China;The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China;Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China;China-Australia International Research Centre for Chinese Medicine, School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia;Institute of Acupuncture and Moxibustion, China Academy of Chinese Medicine Sciences, Beijing, China;Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing, China;Oncology Department of Bayi Hospital, Nanjing University of Chinese Medicine, Nanjing, China;School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China;South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China;The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China;WHO Collaborating Center for Guideline Implementation and Knowledge Translation, Lanzhou, China;Chinese GRADE Centre, Lanzhou University, Lanzhou, China;Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China;Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou, China;

关键词: Acupuncture;    Cancer pain;    Practice guideline;    Evidence-based practice;   

DOI  :  10.1186/s13020-021-00558-4

来源: Springer

【 摘 要 】

BackgroundThis study aims to develop an evidence-based clinical practice guideline of acupuncture in the treatment of patients with moderate and severe cancer pain.MethodsThe development of this guideline was triggered by a systematic review published in JAMA Oncology in 2020. We searched databases and websites for evidence on patient preferences and values, and other resources of using acupuncture for treatment of cancer pain. Recommendations were developed through a Delphi consensus of an international multidisciplinary panel including 13 western medicine oncologists, Chinese medicine/acupuncture clinical practitioners, and two patient representatives. The certainty of evidence, patient preferences and values, resources, and other factors were fully considered in formulating the recommendations. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to rate the certainty of evidence and the strength of recommendations.ResultsThe guideline proposed three recommendations: (1) a strong recommendation for the treatment of acupuncture rather than no treatment to relieve pain in patients with moderate to severe cancer pain; (2) a weak recommendation for the combination treatments with acupuncture/acupressure to reduce pain intensity, decrease the opioid dose, and alleviate opioid-related side effects in moderate to severe cancer pain patients who are using analgesics; and (3) a strong recommendation for acupuncture in breast cancer patients to relieve their aromatase inhibitor-induced arthralgia.ConclusionThis proposed guideline provides recommendations for the management of patients with cancer pain. The small sample sizes of evidence limit the strength of the recommendations and highlights the need for additional research.

【 授权许可】

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