Acupuncture Therapy For Preventing Chemotherapy-Induced Nausea And Vomiting:A Network Meta-Analysis

Objective:To systematically evaluate the prevention effect of the treatment on chemotherapy-induced nausea and vomiting(CINV),and compares the difference in the incidence rate between different treatments,in order to provide evidence-based medicine basis for acupuncture therapy.Methods Authors searched Pub Med/Medline,Cochrane library,Web of Science,Ebsco,Ovid/Embase,China National Knowledge Infrastructure(CNKI),Wanfang database,VIP database and China Biology Medicine(CBM)from setup time to August 2020.All randomized control trails meet the standard were included.The two researchers used the JADAD evaluation table and ROB2.0 to evaluate the quality evaluation and risk bias of the literature.STATA 14.0was employed to perform pairwise meta-analysis.STATA 14.0 and Open BUGS 3.2.3 were used to conduct network meta-analysis.Results:A total of 61 articles containing 13 treatments and 5260 patients were included in the literature,among 2482 in the 5-HT3RA group,103 patients in the placebo group,30 in the Acupoint Application group,136 in the Acupoint injection group,81 in the5-HT3 RA and Acupoint injection combination group,116 in the 5-HT3 RA and Acupoint injection combination group,293 in the 5-HT3 RA and acupuncture combination group,464 in the 5-HT3 RA and moxibustion combination group,697 in the 5-HT3 RA and Acupoint Application combination group,255 in the 5-HT3 RA and combined therapy,423 in the 5-HT3 RA and Acupoint injection combination group,80 in the 5-HT3 RA and Acupoint ligat thread embed combination group.(1)Effects of the Early Process The first three of the most effective acupuncture treatments for acute nausea are 5-HT3 RA combined Electroacupuncture,5-HT3 RA combined Moxibustion,5-HT3 RA combined the Acupoint ligat thread embed.The first three of the most effective acupuncture treatments for acute vomiting are 5-HT3 RA and combined therapy,5-HT3 RA combined Electroacupuncture,5-HT3 RA combined acupuncture.Among them,5-HT3 RA and combined therapy 、 5-HT3 RA combined Electroacupuncture 、 5-HT3 RA combined acupuncture 、 5-HT3 RA combined Acupoint Application were more effective than 5-HT3 RA only,and the difference was statistically significant.(2)Effects of the Whole Process The first three of the most effective acupuncture treatments for whole process nausea were 5-HT3 RA combined Acupoint Application,5-HT3 RA and combined therapy,5-HT3 RA and Acupoint injection.Among them,5-HT3 RA combined Acupoint Application,5-HT3 RA combined Acupoint injection were more effective than 5-HT3RA only,and the difference was statistically significant.The first three of the most effective acupuncture treatments for whole process vomiting are 5-HT3 RA and combined therapy,5-HT3 RA combined Acupoint Application,5-HT3 RA combined 5-HT3 RA and Acupressure.Besides the three treatments,5-HT3 RA combined Acupoint injection,5-HT3 RA combined moxibustion were more effective than 5-HT3 RA only,and the difference was statistically significant.Conclusion:Acupuncture therapy can effectively prevent chemotherapy-induced nausea and vomiting.The adjuvant therapy that prevents acute nausea is the Electroacupuncture therapy,The adjuvant therapy that prevents acute vomiting is the combination therapy,the most effective adjuvant therapy for preventing the whole process nausea is the Acupoint Application,and the most effective adjuvant therapy for the prevention of the whole process vomiting is the combination therapy.Further clinical validation of the results of this study is required if heterogeneity and risk of bias are taken into account.