Evidence mapping of traditional Chinese medicine interventions for cancer-related fatigue_Chinese Journal of Evidence-Based Medicine

Authors：

XU Ling ¹ , DAI Lingyun ¹ , REN Ying ¹ , LI Qingqing ¹ , LIU Baoyu ¹ , SUN Yumei ¹ , SU Tao ¹ , CHEN Yu ¹ ,  PANG Xiaoli ² , LI Huhu ³

1. Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China;
2. School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China;
3. School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, P. R. China;

Corresponding author：

PANG Xiaoli, Email: 403033115@qq.com

Keywords：

Traditional Chinese medicine; Cancer-related fatigue; Randomized controlled trial; Systematic review; Meta-analysis; Clinical research; Evidence mapping

DOI：

10.7507/1672-2531.202407125

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To identify, describe, and evaluate the evidence of traditional Chinese medicine (TCM) interventions for cancer-related fatigue (CRF) using an evidence mapping approach. Methods The CNKI, WanFang Data, VIP, SinoMed, PubMed, Web of Science and Embase databases were electronically searched to collect studies on TCM interventions for CRF from inception to June 4, 2024. Evidence mapping was employed to present the characteristics of study populations, interventions, studies included in systematic review/meta-analysis (SR/MA), and conclusions. Results A total of 94 randomized controlled trials (RCT) and 17 SR/MA/network MA were included. The number of publications has shown an overall fluctuating upward trend in the past 15 years. The RCT included literature with a high focus on mixed cancers, involving a total of 51 TCM therapeutic measures, including 40 herbal treatments, 5 external TCM treatments, and 5 TCM integrative therapies. The outcome indicators were classified into 14 categories, with the most frequent ones being CRF scores, TCM syndrome scores, clinical efficacy, quality of life scores, immune function indicators, adverse event rates, and serum indicators. The SR/MA included 7-81 original studies with sample sizes of 551-7 547 cases, involving 5 intervention measures: herbal medicine (9 studies), moxibustion (3 studies), TCM injection (2 studies), moxibustion (2 studies), and acupuncture (1 study). The quality of RCT and SR/MA was generally low, and the evidence quality was low. Most studies showed that TCM interventions for CRF had potential efficacy, but there was still a lack of definitive clinical evidence. Conclusion The results suggest that TCM interventions for CRF have advantages but also problems. There is still a lack of high-quality research. More large-sample, multicenter RCT and high-quality SR/MA are needed to further explore the advantages of TCM interventions for CRF and provide strong support for the effectiveness and safety of TCM interventions for CRF.

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30.	陈柳茵, 林桂娇, 杨柳, 等. 灸法对癌因性疲乏患者干预效果的网状Meta分析. 中国医药指南, 2023, 21(8): 1-5.
31.	许可依, 胡凯文, 孙健豪, 等. 中药注射液治疗癌因性疲乏的网状Meta分析. 世界科学技术-中医药现代化, 2023, 25(12): 4017-4031.
32.	Wang Z, Wu Z, Xiang Q, et al. Effects of botanical drugs in the treatment of cancer-related fatigue in patients with gastric cancer: a meta-analysis and prediction of potential pharmacological mechanisms. Front Pharmacol, 2022, 13: 979504.
33.	曾悦, 罗秀丽, 李成银, 等. 中药治疗胃癌患者癌因性疲乏疗效的Meta分析. 医学信息, 2022, 35(5): 63-68,79.
34.	胡静温, 杨柳, 陈锦秀, 等. 健脾类方剂治疗癌因牲疲乏的Meta分析. 湖南中医杂志, 2021, 37(2): 115-121.
35.	韩金钱, 张宜佳, 蒋恩社. 艾灸对癌症病人癌因性疲乏干预效果的Meta分析. 循证护理, 2021, 7(6): 719-726.
36.	胡月, 蒋运兰, 李征, 等. 灸法治疗癌因性疲乏的临床有效性和安全性的系统评价. 成都中医药大学学报, 2020, 43(3): 65-72.
37.	余婷, 刘杰, 杨兵, 等. 灸法治疗癌因性疲乏临床疗效的荟萃分析. 世界科学技术-中医药现代化, 2020, 22(12): 4175-4184.
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1. NCCN Guidelines. Cancer-related fatigue: NCCN clinical practice guidelines in oncology (version 2). 2023.
2. Fabi A, Bhargava R, Fatigoni S, et al. Cancer-related fatigue: ESMO clinical practice guidelines for diagnosis and treatment. Ann Oncol, 2020, 31(6): 713-723.
3. Bower JE. Cancer-related fatigue--mechanisms, risk factors, and treatments. Nat Rev Clin Oncol, 2014, 11(10): 597-609.
4. 生金, 潘宏铭. 2023年第2版NCCN癌因性疲乏诊治指南述评. 实用肿瘤杂志, 2023, 38(5): 416-420.
5. Cella D, Davis K, Breitbart W, et al. Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol, 2001, 19(14): 3385-3391.
6. 曹莹, 陈湘玉, 陈玉华. 宫颈癌同步放化疗患者治疗后癌因性疲乏症状体验的质性研究. 解放军护理杂志, 2017, 34(2): 18-22.
7. 李娟, 杨柱, 龙奉玺, 等. 国医大师刘尚义治疗癌性疲乏用药数据挖掘. 辽宁中医杂志, 2018, 45(4): 703-706.
8. 韩金凤. 癌因性疲乏的中医药治疗研究概况. 光明中医, 2018, 33(6): 902-904.
9. Strebkova R. Cancer-related fatigue in patients with oncological diseases: causes, prevalence, guidelines for assessment and management. Folia Med (Plovdiv), 2020, 62(4): 679-689.
10. Thong MSY, van Noorden CJF, Steindorf K, et al. Cancer-related fatigue: causes and current treatment options. Curr Treat Options Oncol, 2020, 21(2): 17.
11. Mao JJ, Pillai GG, Andrade CJ, et al. Integrative oncology: addressing the global challenges of cancer prevention and treatment. CA Cancer J Clin, 2022, 72(2): 144-164.
12. 许博文, 吴静远, 李杰, 等. 肿瘤中成药上市后生存获益评价的探索与实践. 中国中药杂志, 2021, 46(8): 1980-1987.
13. Zuo S, Cheng H, Wang Z, et al. Nonpharmacological interventions for cancer-related fatigue: a literature review. Asia Pac J Oncol Nurs, 2023, 10(5): 100230.
14. Mustian KM, Alfano CM, Heckler C, et al. Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: a meta-analysis. JAMA Oncol, 2017, 3(7): 961-968.
15. Finnegan-John J, Molassiotis A, Richardson A, et al. A systematic review of complementary and alternative medicine interventions for the management of cancer-related fatigue. Integr Cancer Ther, 2013, 12(4): 276-290.
16. 高亚, 李沐阳, 孙月, 等. 证据图研究合作能力与研究主题分析. 中国药物评价, 2019, 36(3): 165-168.
17. Miake-Lye IM, Hempel S, Shanman R, et al. What is an evidence map. A systematic review of published evidence maps and their definitions, methods, and products. Syst Rev, 2016, 5: 28.
18. Katz DL, Williams AL, Girard C, et al. The evidence base for complementary and alternative medicine: methods of evidence mapping with application to CAM. Altern Ther Health Med, 2003, 9(4): 22-30.
19. 李沐阳, 张福利, 蔡润津, 等. 证据图研究现状分析. 中国药物评价, 2019, 36(3): 161-164.
20. 北京DRGs-PPS项目组. 国际疾病分类第十次修订本(ICD-10)BJ-临床版. 2012.
21. Higgins JPT, Chandler J, Cumpston M, et al. Cochrane handbook for systematic reviews of interventions version 6.0. 2019.
22. 李佳璐, 李玲玲, 马新萍, 等. Cochrane偏倚风险评估工具(RoB 2. 0)的介绍及示范性应用. 中华现代护理杂志, 2023, 29(22): 2951-2956.
23. 陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
24. 张方圆, 沈傲梅, 曾宪涛, 等. 系统评价方法学质量评价工具AMSTAR2解读. 中国循证心血管医学杂志, 2018, 10(1): 14-18.
25. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358: j4008.
26. Li Y, Wei Z, Zhang J, et al. Wearing masks to reduce the spread of respiratory viruses: a systematic evidence mapping. Ann Transl Med, 2021, 9(9): 811.
27. 陈琳俪, 张阿润, 卜文璐, 等. 中药治疗化疗后癌因性疲乏有效性及安全性的Meta分析. 云南中医中药杂志, 2024, 45(5): 31-39.
28. 何思颖, 云洁, 周子淇, 等. 雷火灸治疗癌因性疲乏临床疗效与安全性的Meta分析. 中国民族民间医药, 2024, 33(1): 106-111.
29. Yang J, Li Y, Chau CI, et al. Efficacy and safety of traditional Chinese medicine for cancer-related fatigue: a systematic literature review of randomized controlled trials. Chin Med, 2023, 18(1): 142.
30. 陈柳茵, 林桂娇, 杨柳, 等. 灸法对癌因性疲乏患者干预效果的网状Meta分析. 中国医药指南, 2023, 21(8): 1-5.
31. 许可依, 胡凯文, 孙健豪, 等. 中药注射液治疗癌因性疲乏的网状Meta分析. 世界科学技术-中医药现代化, 2023, 25(12): 4017-4031.
32. Wang Z, Wu Z, Xiang Q, et al. Effects of botanical drugs in the treatment of cancer-related fatigue in patients with gastric cancer: a meta-analysis and prediction of potential pharmacological mechanisms. Front Pharmacol, 2022, 13: 979504.
33. 曾悦, 罗秀丽, 李成银, 等. 中药治疗胃癌患者癌因性疲乏疗效的Meta分析. 医学信息, 2022, 35(5): 63-68,79.
34. 胡静温, 杨柳, 陈锦秀, 等. 健脾类方剂治疗癌因牲疲乏的Meta分析. 湖南中医杂志, 2021, 37(2): 115-121.
35. 韩金钱, 张宜佳, 蒋恩社. 艾灸对癌症病人癌因性疲乏干预效果的Meta分析. 循证护理, 2021, 7(6): 719-726.
36. 胡月, 蒋运兰, 李征, 等. 灸法治疗癌因性疲乏的临床有效性和安全性的系统评价. 成都中医药大学学报, 2020, 43(3): 65-72.
37. 余婷, 刘杰, 杨兵, 等. 灸法治疗癌因性疲乏临床疗效的荟萃分析. 世界科学技术-中医药现代化, 2020, 22(12): 4175-4184.
38. Huang Z, Zhang Q, Fan Y, et al. Effect of traditional Chinese medicine injection on cancer-related fatigue: a meta-analysis based on existing evidence. Evid Based Complement Alternat Med, 2020, 2020: 2456873.
39. Zhao Y, Wang S, Li J, et al. Effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue: a systematic review and Meta-analysis of randomized controlled trials. J Tradit Chin Med, 2020, 40(5): 738-748.
40. 张洲姬, 郭毅峻, 蔡霄月, 等. 中药治疗Ⅲ~Ⅳ期肺癌含铂两药化疗患者癌因性疲乏的Meta分析. 河北中医, 2019, 41(10): 1462-1469.
41. 李娟, 杨柱, 龙奉玺, 等. 基于益气法治疗癌因性疲乏的Meta分析. 成都中医药大学学报, 2017, 40(3): 117-122.
42. 朱琦, 唐文富, 张颖. 补气中药治疗癌性疲劳随机对照临床研究文献Meta分析. 海军医学杂志, 2015, 36(4): 302-307.
43. Ling WM, Lui LY, So WK, et al. Effects of acupuncture and acupressure on cancer-related fatigue: a systematic review. Oncol Nurs Forum, 2014, 41(6): 581-592.
44. Bower JE. Cancer-related fatigue--mechanisms, risk factors, and treatments. Nat Rev Clin Oncol, 2014, 11(10): 597-609.
45. 凡全女. 中药合理应用常见问题及应对措施. 临床合理用药杂志, 2017, 10(29): 84-85.
46. 庄铭, 安佳丽, 钟梦媛, 等. 中医药临床疗效评价方法研究进展. 中国中药杂志, 2023, 48(12): 3263-3268.
47. 邱瑞瑾, 魏旭煦, 关之玥, 等. 中医药领域核心指标集研究现状及展望. 中国循证医学杂志, 2023, 23(2): 211-220.
48. Schulz KF, Chalmers I, Hayes RJ, et al. Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA, 1995, 273(5): 408-412.
49. 姜俊杰, 井媛媛, 黎元元, 等. 近5年常用中成药治疗2型糖尿病的随机对照试验证据图分析. 中国中药杂志, 2024, 49(4): 1102-1112.

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