Numerous acupuncture studies have been conducted on cancer-related pain; however, its efficacy compared to sham acupuncture remains controversial. We confirmed whether the outcome of acupuncture differs according to the needling points of sham acupuncture for cancer-related pain. We searched 10 databases on 23 May 2023 to screen acupuncture trials using sham acupuncture or waiting list as controls for cancer-related pain. Sham acupuncture was classified into two types, depending on whether the needling was applied at the same locations as verum acupuncture (SATV) or not (SATS). A network meta-analysis (NMA) was performed on the basis of a frequentist approach to assess pain severity. Eight studies (n= 574 participants) were included in the review, seven of which (n= 527 participants) were included in the NMA. The pain severity was not significantly different between SATV and verum acupuncture, but verum acupuncture significantly improved pain severity compared to SATS. The risk of bias affecting the comparisons between the verum and sham acupuncture was generally low. Previous acupuncture trials for cancer-related pain showed differing outcomes of sham and verum acupuncture, depending on the needling points of sham acupuncture. The application of SATV cannot be considered a true placebo, which leads to an underestimation of the efficacy of verum acupuncture.
针对癌症相关疼痛已开展了大量针灸研究，但其相较于假针灸的疗效仍存争议。本研究旨在验证针灸治疗癌症相关疼痛的效果是否会因假针灸的针刺点选择而产生差异。我们于2023年5月23日检索了10个数据库，筛选出以假针灸或等待名单作为对照的癌症相关疼痛针灸临床试验。根据是否在与真针灸相同部位施针，将假针灸分为同部位假针灸（SATV）与异部位假针灸（SATS）两类。基于频率学派方法进行网状Meta分析（NMA）以评估疼痛程度。共纳入8项研究（574名参与者），其中7项（527名参与者）纳入NMA。分析显示：SATV与真针灸在疼痛缓解程度上无显著差异，但真针灸较SATS能显著改善疼痛程度。真针灸与假针灸比较的偏倚风险总体较低。既往针对癌症相关疼痛的针灸研究表明，假针灸与真针灸的疗效差异取决于假针灸的针刺点选择。SATV不能被视为真正的安慰剂，这可能导致真针灸疗效被低估。
肿瘤(癌症)患者之家