The Rules Of Acupoint Selection And Efficacy Evaluation On Cancer Pain Treated By Acupuncture

Objectives To summarize the rules of acupoints selection and evaluate the clinical efficacy on cancer pain treated by acupuncture by collecting relevant clinical randomized controlled trials,and provide clinical reference program.Methods The clinical randomized controlled trials on cancer pain treated by acupuncture which published until August 2018 were collected from China National Knowledge Infrastructure(CNKI),Chinese Biomedical Literature Database(CBM),Wanfang Academic Journal Full-text Database,VIP Database(VIP),Pubmed and Cochrane Library.The common acupoint,acupoint istribution and acupoint meridian tropism were made descriptive analysis,the high frequency acupoints were made association rules analysis and cluster analysis with IBM SPSS Modeler 18.0 and IBM SPSS Statistics 25.0 software.The clinical efficacy on cancer pain treated by acupuncture was evaluated with meta-analysis and network meta-analysis by using R 3.5.1 software.Results 1 Acupoints Analysis: There are 106 kinds acupoints used on cancer pain treated by acupuncture in modern journal literature,and the top five are Ashi acupoint,Zusanli(ST36),Hegu(LI4),Neiguan(PC6)and Zhongwan(CV12).They mainly distribute in the lower limbs and back,which belong the Bladder Meridian and the meridian related cancer,and most of them belong to five Shu point and back Shu point.The well-related acupoints are Zusanli(ST36)and Hegu(LI4),Zhongwan(CV12)and Zusanli(ST36),Zusanli(ST36)and Ashi points,which are good at supporting qi,activating meridians to stop pain,and smoothing the blood of the corresponding meridians.The acupoints clustering are based on Ashi acupoint,Zusanli(ST36),Hegu(LI4),Neiguan(PC6),and adds others acupoints according to the type of cancer on this basis.2 Efficacy Analysis:(1)effectiveness: Acupuncture therapy are more effective than three-step analgesics in treating cancer pain [RR=1.16,95% CI(1.13,1.20)],and ‘the acupoint injection plus three-step analgesics' is the best;(2)pain score: After acupuncture treatment for cancer pain,the pain score are lower than three-step analgesics [MD=-0.95,95% CI(-1.14,-0.77)],and ‘the fire needle plus three-step analgesics' is the best;(3)life quality score: Acupuncture treatment for cancer pain have higher life quality score than three-step analgesics [MD= 6.98,95% CI(5.07,8.89)],and ‘the electroacupuncture plus three-step analgesics' is the best;(4)analgesia onset time: The onset time of analgesic effect of acupuncture therapy for cancer pain are earlier than three-step analgesics [SMD=-1.99,95% CI(-2.38,-1.61)];(5)analgesia duration: The duration of analgesic effect of acupuncture therapy for cancer pain are longer than three-step analgesics [SMD=2.17,95% CI(1.58,2.77)];(6)burst pain times: The frequency of outbreak pain of acupuncture therapy for cancer pain are less than three-step analgesics [MD=-1.17,95% CI(-1.64,-0.69)];(7)morphine dose: Acupuncture therapy use less morphine than three-step analgesics [SMD=-1.50,95% CI(-1.97,-1.03)];(8)adverse reactions: Acupuncture therapy have fewer adverse reactions to cancer pain than three-step analgesics [RR=0.41,95% CI(0.32,0.53)],and ‘the acupoint injection plus three-step analgesics' is the best.Conclusions 1 We summarize the new prescriptions for acupuncture treatment of cancer pain based on the rules of acupoints selectionn in modern journal literature,and provide reference for modern clinical.Cancer pain: Ashi points,Zusanli(ST36),Zhongwan(CV12),Hegu(LI4),Neiguan(PC6),Sanyinjiao(SP6),lung cancer: Feishu(BL13),Danzhong(CV17),Kongzui(LU6),Taiyuan(LU9);breast cancer: Geshu(BL17),Rugen(ST18),Zhigou(TE6),Daling(PC7),Lieque(LU7);stomach cancer: Weishu(BL21),Liangqiu(ST34),Chongyang(ST42),Gongsun(SP4);liver cancer: Ganshu(BL18),Qimen(LR14),Yanglingquan(GB34),Danshu(BL19);pancreatic cancer: Yishu,Zhigou(TE6);bone cancer: Xuanzhong(GB39),Shenshu(BL23),Shuiquan(KI5),Taixi(KI3).2 The acupuncture therapy are effective in treating cancer pain,especially when combine with three-step analgesics,which have earlier analgesia onset time,longer duration time,better effectiveness,better pain and quality of life improvement,fewer burst pain times,morphine dose and adverse reactions than three-step analgesics.To benefit the cancer patients,‘acupoint injection + three-step' combination therapy and ‘fire needle + threestep' combination therapy are worth popularizing in the clinical treatment of cancer pain.Figure 55;Table 28;Reference 219...