Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Apr 28, 2022; 10(2): 52-62
Published online Apr 28, 2022. doi: 10.13105/wjma.v10.i2.52
Different methods of acupuncture for relief of pain due to liver cancer: A network meta-analysis
Hong-Yuan Mou, Jing Chen, Zuo-Yun Chen, Hong Du
Hong-Yuan Mou, Jing Chen, Zuo-Yun Chen, Department of Traditional Chinese Medicine, People’s Hospital of Lichuan, Lichuan 445400, Hubei Province, China
Hong Du, Preventive Treatment Center, Central Hospital of Enshi Prefecture, Enshi 445000, Hubei Province, China
Author contributions: Mou HY and Chen ZY contributed to the conception and design of the study, acquisition, analysis, and interpretation of the data, and drafting the article; Chen J and Du H interpreted the data and revised the article; All authors read and issued final approval of the submitted version.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zuo-Yun Chen, BM BCh, Chief Doctor, Department of Traditional Chinese Medicine, People’s Hospital of Lichuan, No. 12 Longchuan Road, Lichuan 445400, Hubei Province, China. 1513588676@qq.com
Received: August 12, 2021
Peer-review started: August 12, 2021
First decision: October 2, 2021
Revised: October 15, 2021
Accepted: March 5, 2022
Article in press: March 5, 2022
Published online: April 28, 2022
Processing time: 258 Days and 21.7 Hours
Abstract
BACKGROUND

Pain in the liver is a common symptom of liver cancer in late stages, and the pain incidence rate exceeds 50%[1]. In serious cancer pain, morphine and other major analgesics have been commonly administrated for clinical treatments, and their effects are accurate, but with a high incidence of side effects, such as nausea, vomiting, constipation, and other conditions. Acupuncture is a traditional Chinese medicine therapy. There have been many randomized controlled trials addressing the safety and usefulness of different methods of acupuncture in alleviating liver cancer pain. However, which of these methods is the most effective method is still unclear.

AIM

To compare the effectiveness of different acupuncture methods for alleviating pain due to liver cancer.

METHODS

Eligible studies were retrieved from eight databases (the Cochrane Library, PubMed, EMBASE, Medline, CNKI, CBM, Chongqing VIP, and Wan Fang Database) up to March 31, 2021 and screened based on the established inclusion and exclusion criteria. The quality of the include studies was evaluated. Stata software was applied for statistical analyses. Publication bias of the included studies was also determined. Finally, the network meta-analysis was carried out to evaluate the efficacy of acupuncture methods for relief of pain due to liver cancer.

RESULTS

A total of eight randomized controlled trials were included in the network meta-analysis. Eight trials (covering 5 treatments and 734 patients) provided data suitable for analysis. Most trials focused on short-term effects and many were classed as being of poor quality with a high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that four interventions, including wrist-ankle acupuncture, triple puncture and remaining needle acupuncture, Tian Yuan acupuncture, and block acupuncture, produced a statistically significant reduction in pain when compared with the three-step analgesic ladder therapy. The surface under the cumulative ranking sorting results showed that triple puncture and remaining needle acupuncture had a relatively high effective rate.

CONCLUSION

The network meta-analysis results indicate that the overall effectiveness of triple puncture and remaining needle acupuncture is better than the other therapies.

Keywords: Pain; Liver cancer; Acupuncture; Network meta-analysis; Effectiveness; Three-step analgesic ladder

Core Tip: Seventy-five percent of patients with liver cancer suffer varying degrees of pain. Pain is widely perceived as the fifth vital sign in cancer patients, which seriously affects the quality of their life and threatens their survival. Acupuncture, part of traditional Chinese medicine, involves the application of needles, heat, pressure, and other treatments at specific sites of the body known as acupoints to affect the physical functions of the body. Numerous studies have concluded that acupuncture may be efficacious in relieving cancer-related pain. However, there is still no direct evidence on which method of acupuncture is more effective. The present study aimed to identify the best method of acupuncture for liver cancer-related pain.