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Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review

Cancer pain is a common problem in clinical cancer therapy. Opioid analgesia is one of the most effective drugs for pain relief with satisfying performance besides the side effect of opioid-induced constipation (OIC). Acupuncture, as a Chinese traditional non-invasive intervention, has been applied...

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Autores principales: Han, Changhui, Liu, Yingjuan, Fan, Huanfang, Li, Dehui, Guo, Na
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495145/
https://www.ncbi.nlm.nih.gov/pubmed/34629905
http://dx.doi.org/10.2147/CLEP.S324193
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author Han, Changhui
Liu, Yingjuan
Fan, Huanfang
Li, Dehui
Guo, Na
author_facet Han, Changhui
Liu, Yingjuan
Fan, Huanfang
Li, Dehui
Guo, Na
author_sort Han, Changhui
collection PubMed
description Cancer pain is a common problem in clinical cancer therapy. Opioid analgesia is one of the most effective drugs for pain relief with satisfying performance besides the side effect of opioid-induced constipation (OIC). Acupuncture, as a Chinese traditional non-invasive intervention, has been applied to clinical cancer pain management and functional constipation therapy. However, only a few studies have adopted this treatment for OIC patients. Due to limited numbers of investigated subjects and variability of application methods, including treatment apparatus, acupoints, durations, and sessions, the interpretation of acupuncture’s therapy effects from single-site randomized clinical trials (RCT) is limited. Therefore, we conducted a meta-analysis by collecting published data from Pubmed, Embase, Cochrane library, and Web of Science. Five RCTs focusing on the application of acupuncture with or without medication in OIC patients were included. An overall remission rate of 86.8% in the acupuncture-treated group was achieved, higher than the control group (78.9%; RR, 1.10, 95% CI [1.03, 1.18]). The symptom scores, reporting on defecation frequency, defecation straining, abdominal pain, defection time, and stool property, in acupuncture groups were lower than control groups with a standardized mean difference (SMD) of −2.21 [−4.15, −0.27]. The quality of life (QOL) for patients in the acupuncture treated group increased compared to the control group with reduced PAC-QOL scores (SMD, −1.02 [−1.78, −0.26]). Referring to the effects from pure acupuncture treatment (SMD, −0.43 [−0.83, −0.03]), the co-intervention of acupuncture and drugs (SMD, −1.77 [−2.51, −1.02]) improved the life quality of patients more remarkably (P < 0.05). Overall, our data confirmed the therapeutic effects of acupuncture in the treatment of OIC. The co-intervention of acupuncture with drugs improves the outcomes of OIC patients better than a single strategy. Combined therapy with both medicine and acupuncture has insightful potential for future clinical cancer patient management on constipation problems.
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spelling pubmed-84951452021-10-07 Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review Han, Changhui Liu, Yingjuan Fan, Huanfang Li, Dehui Guo, Na Clin Epidemiol Review Cancer pain is a common problem in clinical cancer therapy. Opioid analgesia is one of the most effective drugs for pain relief with satisfying performance besides the side effect of opioid-induced constipation (OIC). Acupuncture, as a Chinese traditional non-invasive intervention, has been applied to clinical cancer pain management and functional constipation therapy. However, only a few studies have adopted this treatment for OIC patients. Due to limited numbers of investigated subjects and variability of application methods, including treatment apparatus, acupoints, durations, and sessions, the interpretation of acupuncture’s therapy effects from single-site randomized clinical trials (RCT) is limited. Therefore, we conducted a meta-analysis by collecting published data from Pubmed, Embase, Cochrane library, and Web of Science. Five RCTs focusing on the application of acupuncture with or without medication in OIC patients were included. An overall remission rate of 86.8% in the acupuncture-treated group was achieved, higher than the control group (78.9%; RR, 1.10, 95% CI [1.03, 1.18]). The symptom scores, reporting on defecation frequency, defecation straining, abdominal pain, defection time, and stool property, in acupuncture groups were lower than control groups with a standardized mean difference (SMD) of −2.21 [−4.15, −0.27]. The quality of life (QOL) for patients in the acupuncture treated group increased compared to the control group with reduced PAC-QOL scores (SMD, −1.02 [−1.78, −0.26]). Referring to the effects from pure acupuncture treatment (SMD, −0.43 [−0.83, −0.03]), the co-intervention of acupuncture and drugs (SMD, −1.77 [−2.51, −1.02]) improved the life quality of patients more remarkably (P < 0.05). Overall, our data confirmed the therapeutic effects of acupuncture in the treatment of OIC. The co-intervention of acupuncture with drugs improves the outcomes of OIC patients better than a single strategy. Combined therapy with both medicine and acupuncture has insightful potential for future clinical cancer patient management on constipation problems. Dove 2021-10-02 /pmc/articles/PMC8495145/ /pubmed/34629905 http://dx.doi.org/10.2147/CLEP.S324193 Text en © 2021 Han et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Han, Changhui
Liu, Yingjuan
Fan, Huanfang
Li, Dehui
Guo, Na
Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review
title Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review
title_full Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review
title_fullStr Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review
title_full_unstemmed Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review
title_short Acupuncture Relieves Opioid-Induced Constipation in Clinical Cancer Therapy – A Meta-Analysis and Systematic Review
title_sort acupuncture relieves opioid-induced constipation in clinical cancer therapy – a meta-analysis and systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8495145/
https://www.ncbi.nlm.nih.gov/pubmed/34629905
http://dx.doi.org/10.2147/CLEP.S324193
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