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Acupuncture and Moxibustion for Cancer-related Fatigue: a Systematic Review and Meta-analysis

  • He, Xi-Ran (Department of Integration of Traditional Chinese and Western Medicine, Perking University Cancer Hospital & Institute, The School of Clinical Oncology of Peking University, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University) ;
  • Wang, Quan (The School of Clinical Oncology of Peking University) ;
  • Li, Ping-Ping (Department of Integration of Traditional Chinese and Western Medicine, Perking University Cancer Hospital & Institute, The School of Clinical Oncology of Peking University, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University)
  • Published : 2013.05.30

Abstract

Background: Faced with highly prevalent and recalcitrant cancer-related fatigue (CRF), together with the absence of any official guidelines on management, numerous groups have been striving to seek and test alternative therapies including acupuncture and moxibustion. However, different patients have various feedbacks, and the many clinical trials have given rise to varied conclusions. In terms of the therapeutic effect of acupuncture and moxibustion, there exist vast inconsistencies. Objective: The aim of the study was to evaluate the auxiliary effectiveness of acupuncture and moxibustion in the treatment of CRF, and to provide more reliable evidence to guide clinical practice. Methods: Randomized controlled trials (RCTs) published before December 2012 were all aggregated, focusing on evaluation of acupuncture or moxibustion for CRF. The quality of the included studies was assessed basing on Cochrane handbook 5.1.0, and the available data were analyzed with RevMan software (version 5.2.0). Descriptive techniques were performed when no available data could be used. Results: A total of 7 studies involving 804 participants were eligible. With real acupuncture versus sham acupuncture, subjects receiving true acupuncture benefited more in the reduction of fatigue. With real acupuncture versus acupressure or sham acupressure, fatigue level appeared 36% improved in the acupuncture group, but 19% in the acupressure group and only 0.6% with sham acupressure. When real acupuncture plus enhanced routine care was compared with enhanced routine care, the combination group improved mean scores for general fatigue, together with physical and mental fatigue. With real acupuncture versus sham acupuncture or wait list controls, the real acupuncture group displayed significant advantages over the wait list controls at 2 weeks for fatigue improvement and better well-being effects at 6 weeks. When moxibustion plus routine care was compared with routine care alone, the meta-analyses demonstrated the combination had a relatively significant benefit in improving severe fatigue and QLQ-C30. Conclusion: Up to the search date, there exist few high quality RCTs to evaluate the effect of acupuncture and moxibustion, especially moxibustion in English. Yet acupuncture and moxibustion still appeared to be efficacious auxiliary therapeutic methods for CRF, in spite of several inherent defects of the included studies. Much more high-quality studies are urgently needed.

Keywords

Acupuncture;moxibustion;cancer;fatigue;systematic review;meta-analysis

References

  1. Arthur K, Belliard JC, Hardin SB, et al (2012). Practices, attitudes, and beliefs associated with complementary and alternative medicine (CAM) use among cancer patients. Integr Cancer Ther, 11, 232-42. https://doi.org/10.1177/1534735411433832
  2. Balk J, Day R, Rosenzweig M, Beriwal S (2009). Pilot, randomized, modified, double-blind, placebo-controlled trial of acupuncture for cancer-related fatigue. J Soc Integr Oncol, 7, 4-11.
  3. Berger AM, Gerber LH, Mayer DK (2012). Cancer-related fatigue, implications for breast cancer survivors. Cancer, 118, 2261-69. https://doi.org/10.1002/cncr.27475
  4. Cheng XR, Cheng K (2008). Survey of studies on the mechanism of acupuncture and moxibustion treating diseases abroad. Zhongguo Zhen Jiu, 28, 463-67.
  5. Chen FR, Wang M, Xue J, Xu J (2011). Study on influence of ginger seperated moxibustion on quality of life of elderly patients with advanced cancer. Chin Nurs Res, 2951-2.
  6. Hou SW, Li YC (2009). Discussion on the treatment amount of acupuncture and moxibustion. Zhongguo Zhen Jiu, 29, 670-4.
  7. Huntley AL, de Valois B, Low Dog T, Borrelli F (2012). Complementary and alternative medicine and cancer survivorship. Evid Based Complement Alternat Med, 2012,850429.
  8. Ip PS, Tsim KW, Chan K, Bauer R (2012). Application of complementary and alternative medicine on neurodegenerative disorders, current status and future prospects. Evid Based Complement Alternat Med, 2012, 930908.
  9. Jia CS, Xu J, Li XF, Wang JL (2011). Specificity of acupuncturemoxibustion effect and its research value. Zhongguo Zhen Jiu, 31, 577-9.
  10. Lehmann H (2013). Acupuncture in ancient China, How important was it really? J Integr Med, 11, 45-53. https://doi.org/10.3736/jintegrmed2013008
  11. Liu WH (2009). Thinking about standard and standardization of acupuncture and moxibustion. Zhongguo Zhen Jiu, 29, 40-3.
  12. Lyons Z, van der Watt G, Shen Z, Janca A (2012). Acupuncture and Chinese herbs as treatments for depression, an Australian pilot study. Complement Ther Clin Pract, 18, 216-20. https://doi.org/10.1016/j.ctcp.2012.06.003
  13. MacPherson H, White A, Cummings M, et al (2002). Standards for reporting interventions in controlled trials of acupuncture, The STRICTA recommendations. STandards for Reporting Interventions in Controlled Trails of Acupuncture. Acupunct Med, 20, 22-5. https://doi.org/10.1136/aim.20.1.22
  14. Mitchell SA (2010). Cancer-related fatigue, state of the science. PM R, 2, 364-83. https://doi.org/10.1016/j.pmrj.2010.03.024
  15. Mock V, Atkinson A, Barsevick A, et al (2000). NCCN Practice Guidelines for Cancer-Related Fatigue. Oncology (Williston Park), 14, 151-61.
  16. Moher D (2010). Corrigendum to: Preferred Reporting Items For Systematic Reviews And Meta-Analyses: The PRISMA Statement International Journal of Surgery 2010; 8: 336-341. Int J Surg. https://doi.org/10.1016/j.ijsu.2010.02.007
  17. Molassiotis A, Bardy J, Finnegan-John J, et al (2012). Acupuncture for cancer-related fatigue in patients with breast cancer, a pragmatic randomized controlled trial. J Clin Oncol, 30, 4470-6. https://doi.org/10.1200/JCO.2012.41.6222
  18. Molassiotis A, Sylt P, Diggins H (2007). The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure, a randomised controlled trial. Complement Ther Med, 15, 228-37. https://doi.org/10.1016/j.ctim.2006.09.009
  19. Qin XY, Liu ZH (2012). Clinical observation of wen moxibustion therapy of cancer-related fatigue of advanced cancer. China J Chin Med, 27, 273-4.
  20. Saibul N, Shariff ZM, Rahmat A, Sulaiman S, Yaw YH (2012). Use of complementary and alternative medicine among breast cancer survivors. Asian Pac J Cancer Prev, 13, 4081-6. https://doi.org/10.7314/APJCP.2012.13.8.4081
  21. Scott JA, Lasch KE, Barsevick AM, Piault-Louis E (2011). Patients' experiences with cancer-related fatigue, a review and synthesis of qualitative research. Oncol Nurs Forum, 38, E191-203. https://doi.org/10.1188/11.ONF.E191-E203
  22. Shi XM (2011). Indications and prospects of acupuncturemoxibustion. Zhongguo Zhen Jiu, 31, 961-4.
  23. Siegel R, Naishadham D, Jemal A (2013). Cancer statistics, 2013. CA Cancer J Clin, 63, 11-30. https://doi.org/10.3322/caac.21166
  24. Smith C, Carmady B, Thornton C, Perz J, Ussher JM (2013). The effect of acupuncture on post-cancer fatigue and well-being for women recovering from breast cancer, a pilot randomised controlled trial. Acupunct Med, 31, 9-15. https://doi.org/10.1136/acupmed-2012-010228
  25. Wang H, Wu XP, Huang W (2011). Elucidation of the national standard for Standardized Manipulation of Acupuncture and Moxibustion, Part VII, Skin needle. Zhongguo Zhen Jiu, 31, 657-9.
  26. Weis J (2011). Cancer-related fatigue, prevalence, assessment and treatment strategies. Expert Rev Pharmacoecon Outcomes Res, 11, 441-6. https://doi.org/10.1586/erp.11.44
  27. Wen BL, Jia CS, Liu WH, et al (2009). Thinking about academic development of acupuncture and moxibustion in recent ten years. Zhongguo Zhen Jiu, 29, 949-54.
  28. Wu HG (2012). Acupoint and therapeutic efficacy of acupuncturemoxibustion. Zhongguo Zhong Xi Yi Jie He Za Zhi, 32, 1452-7.
  29. Yang JL, Yu L, Xu L, et al (2012). The effect observation of moxibustion for cancer-related fatigue in elderly patients suffered from advanced cancer. Chin J Gerontol, 32, 4408-10.
  30. Zhang N, Wu Y (2010). Discussion on the therapeutic method of acupuncture and moxibustion. Zhongguo Zhen Jiu, 30, 431-3.

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