针灸治疗乳腺癌淋巴水肿的系统评价和Meta分析OA北大核心CSTPCDMEDLINE

Objective To evaluate the efficacy of acupuncture in treating breast cancer-related lymphedema(BCRL)by using systematic review and Meta analysis method.Methods Searching CNKI,Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform,Chinese Biomedical Literature Database,PubMed,Cochrane Library,Embase and Web of Science,the randomized controlled trials(RCTs)literature of acupuncture for BCRL was collected from the establishment of the databases to October 1st,2023.After data extraction and risk of bias evaluation of the included literature,Meta-analysis was performed using RevMan5.4 software.Results A total of 14 RCTs with 952 patients were included.The Meta-analysis results showed that compared with comprehensive decongestive therapy(CDT),CDT-associated methods and other interventions of the contro group,acupuncture was able to decrease the circumference of the proximal 10 cm to elbow crease(MD=-1.95,P=0.000 5),reduce the difference in arm circumference(MD=-1.30,P<0.000 01),and increase the effective index(MD=27.47,P<0.000 01;RR=1.23,P=0.000 5);acupuncture improves the range of motion(ROM)scores of shoulder joint in four areas:anteflexion(SMD=0.47,P=0.04),posterior extension(SMD=0.87,P<0.000 01),abduction(SMD=0.48,P=0.03),and adduction(SMD=0.72,P=0.000 5);acupuncture also could alleviate pain and improve visual analog scale(VAS)scores(MD=-1.15,P<0.000 01).No serious adverse reactions were reported in the literatures.Conclusion Acupuncture can effectively improve the degree of limb edema and subjective symptoms in BCRL patients.