| The literature review section focuses on the research progress of modern medicine and traditional Chinese medicine on malignant tumors and the application of scoping review and qualitative research in traditional Chinese medicine.The main body of this study is divided into two parts,the first part is to use scoping review to sort out the current status and trend of the application of fire acupuncture(FA)in the field of malignant tumors,and the second part is to use qualitative research to explore the knowledge,attitude and practice of doctors and patients on the application of FA in the field of malignant tumors.Study 1:Scoping ReviewOBJECTIVE:To explore the current research status and trends of using FA for the treatment of cancers.METHODS:Eight electronic databases(PubMed,EMBASE,Cochrane CENTRAL,Web of Science,China National Knowledge Infrastructure,Wanfang Database,Chinese Biomedical Database,and VIP Database)were systematically searched for relevant published studies of FA in the treatment of cancers from inception to February 14th,2023.A scoping review of relevant systematic reviews(SRs),randomized controlled trials(RCTs),case series,case reports,and animal experiments were performed.RESULTS:A total of 47 articles published from 1989 to 2023 met the eligible criteria,encompassing 48 studies(including 1 SR,27 RCTs,16 case reports,3 case series studies,and 1 animal experiment).The 48 studies covered cancer types including non-small cell lung cancer(10,20.8%),breast cancer(10,20.8%),etc.Types of clinical problems mainly include cancer pain(14,29.2%).A total of 11 interventions were included in this scoping review,of which the most commonly used intervention was FA combined with chemotherapy(13,27.1%).The outcomes shown that the primary outcome is quality of life(15,31.3%).The results of the quality/risk of bias assessment revealed that:the only one SR was of critically low quality,all included RCTs had a high risk of bias(RoB).CONCLUSION:This study shows that FA plays an important role in the treatment of cancers and related clinical problems.But most of the current research evidence is not convincing,and the evaluation of outcomes is not standardized,which still needs subsequent improvement.Study2:Qualitative ResearchOBJECTIVE:To apply qualitative interviews to deeply explore the knowledge,attitude and practice of both doctors and patients regarding the application of FA in the field of malignant tumors,and to provide comprehensive evidence for the application of FA in the field of malignant tumors,with the aim of providing references for future clinical treatment as well as further research.METHODS:Semi-structured interviews were conducted with individual in-depth interviews with both doctors and patients;qualitative data analysis was performed using thematic analysis;and data analysis was performed using the qualitative data analysis software Nvivo 12.0.RESULTS:The physicians and patients had more consistent knowledge about the principles,indications,adverse effects,and characteristics of the application of FA in the field of malignant tumors.They believed that FA can be used locally to treat and reach the lesion;change the peritumor environment to prevent tumor spread;mobilize the body’s immunity to stimulate the local potential;warm and raise Wei-Yang to destroy the tumor at high temperatures;and combine with chemotherapy to increase the concentration of drugs.It is believed that FA is suitable for the treatment of abdominal and pelvic tumors,body surface tumors,and cancer pain,and there are few malignant adverse events in terms of adverse reactions,except for the pain caused during the process of FA.In addition,FA has the characteristics of "warmth","ventilation","elimination" and "tonicity",and has a fast onset,obvious effect,large range of action,long duration,and good results.It has advantages of fast onset,obvious effect,large range of action,long duration,and increase the effectiveness of other Chinese medicine therapy.Most of the doctors and patients had confidence and expressed a high degree of approval in the attitude of FA for tumor application,and among them,the interviewed physicians emphasized the non-negligible role of FA in tumor suppression.The focus of the doctors and patients on FA was different.The patients interviewed were mainly concerned about the clinical efficacy of FA,but the interviewed physicians were more concerned with the operational specifications of FA and the design of clinical trials,in addition to clinical efficacy.CONCLUSION:There is a high degree of overlap between physicians and patients in terms of their the knowledge,attitude and practice regarding the application of FA in the field of malignant tumors,but with different emphases.However,the current immature system,poor reproducibility,low popularity and mainstream acceptance of FA application in the field of oncology,and the fact that FA therapy is not yet standardized,all limit the development of FA,and more investment in high-quality clinical trials and mechanism research is needed in the future. |
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