LAUSR

ObjectiveTo explore the clinical regularities in acupuncture-moxibustion treatment of cancer pain by reviewing the relevant studies published between 1985 and 2017.MethodsBased on the Chinese Medicine Acupuncture-moxibustion Information Database, quantitative analysis, correlation analysis and Chi-square test were applied to analyze the commonly used acupoints, meridian affiliations and body region distributions, commonly used methods and acupoint correlations, treatment method correlations, the efficacy of acupuncture- moxibustion plus the three-step analgesic ladder for cancer pain, and indicators.ResultsZusanli (ST 36), Ashi point and Sanyinjiao (SP 6) ranked the top on the list of frequency; points from Bladder Meridian of Foot Taiyang and Stomach Meridian of Foot Yangming were often used; points from the lower limbs and back had high frequencies. The most commonly used treatment method was acupuncture-moxibustion plus medication. Acupuncture-moxibustion plus the three-step analgesic ladder showed certain advantage compared with the two methods used separately, and among the integrated methods, acupoint application plus the three-step analgesic ladder produced the most significant efficacy. It took (44.77±55.54) min for the analgesic effect to act and the effect lasted for (12.81±14.59) h. Numerical rating scale (NRS), visual analog scale (VAS) and Karnofsky performance status (KPS) scores all showed significant changes after interventions (all P<0.01); there was no significant change in the score of quality of life (QOL) after interventions (P>0.05).ConclusionZusanli (ST 36), Ashi point and Sanyinjiao (SP 6) are commonly selected in acupuncture-moxibustion treatment of cancer pain; acupuncture and acupoint application are often used; acupuncture-moxibustion plus the three-step analgesic ladder can boost the treatment efficacy.概要目的回顾 1985 年至 2017 年有关针灸治疗癌性疼痛文献, 探索针灸治疗癌性疼痛的临床规律。方法根据 《中医针灸信息库》, 采用计量分析、 关联性分析和卡方检验对针灸治疗癌性疼痛的常用穴位、 腧穴归经和部位分布、 常用治疗方法及穴位关联性、 治疗方法关联性、 针灸结合三阶梯治疗癌性疼痛的疗效及效应指标进行分析。结果足三里、 阿是穴和三阴交应用频次最高; 多用足太阳膀胱经和足阳明胃经穴; 下肢穴位和背部穴位使用频次最高。 治疗方法以针药并用为主, 针灸结合三阶梯疗法优于单纯三阶梯疗法和单纯针灸疗法, 其中穴位贴敷结合三阶梯疗效更明显。 癌性疼痛缓解起效时间为(44.77±55.54) min; 缓解持续时间为(12.81±14.59) h。 治疗前后疼痛数字评价量表(NRS)、 视觉模拟量表(VAS)和卡氏行为状态量表(KPS)评分比较, 差异均有统计学意义(均 P<0.01); 生活质量(QOL)评分治疗前后比较, 差异无统计学意义(P>0.05)。结论针灸治疗癌性疼痛常取足三里、 阿是穴和三阴交; 多用针刺和穴位贴敷法; 针灸结合三阶梯止痛法可提高疗效。