Acupuncture and moxibustion for malignant tumor patients with psychological symptoms of insomnia, anxiety and depression: a systematic review and Meta-analysis

M A Fangfang; Zhang Hewei; L I Bingxue; Cheng Peiyu; Y U Mingwei; Wang Xiaomin

doi:10.19852/j.cnki.jtcm.20230313.001

Acupuncture and moxibustion for malignant tumor patients with psychological symptoms of insomnia, anxiety and depression: a systematic review and Meta-analysis

J Tradit Chin Med. 2023 Jun;43(3):441-456. doi: 10.19852/j.cnki.jtcm.20230313.001.

Authors

M A Fangfang¹, Zhang Hewei², L I Bingxue³, Cheng Peiyu⁴, Y U Mingwei⁴, Wang Xiaomin⁴

Affiliations

¹ Department of Acupuncture-Moxibustion, Tuina and Rehabilitation, Kunshan Hospital of Traditional Chinese Medicine, Kunshan 215300, China.
² Traditional Chinese Medicine Department, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
³ Department of General Surgery, Pancreatic Disease Center, Research Institute of Pancreatic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
⁴ Oncology Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China.

Abstract

Objective: To evaluate the efficacy and safety of acupuncture and moxibustion therapy (AMT) for cancer-related psychological symptoms (CRPS) of insomnia, depression and anxiety.

Methods: Seven databases were searched for randomized controlled trials (RCT) comparing AMT to routine care or conventional drug for alleviating CRPS of insomnia, depression, and anxiety before April 2020. Two independent reviewers performed the data extraction and assessed the risk of bias.

Results: A total of 30 RCTs involving 2483 cancer patients were enrolled. The pooled analysis indicated that the treatment group was significantly better than the control group in improving the depression effective rate [= 1.29, 95% (1.12, 1.49), 0.0004], the quality of life (QOL) [1.11, 95% (0.80, 1.42), 0.000 01], and reducing Self-rating Anxiety Scale (SAS) [﹣7.75, 95% (﹣10.44, ﹣5.05), 0.000 01]. But there was no statistically significant difference between two groups in improving the insomnia effective rate [= 1.18, 95% (0.93, 1.51), 0.18]. The subgroup analysis showed the effectiveness of different intervention on CRPS. Compared with routine care, AMT helps relieve CRPS better evaluated by Pittsburgh Sleep Quality Index (PSQI), Hamilton Depression Scale (HAMD), and Self-rating Depression Scale (SDS), and depression effective rate. Compared with conventional drug, AMT performs better evaluated by SDS, depression effective rate and QOL. Moreover, the conventional drug showed higher treatment efficacy on improving insomnia effective rate compared with AMT. Compared to conventional drug, AMT plus conventional drug resulted in a significant reduction on CRPS such as PSQI, HAMD, SDS, and SAS, and also had a meaningful improvement on insomnia effective rate, depression effective rate and QOL. Fewer published reports were found on the adverse events of AMT than the conventional drug.

Conclusion: The results suggested that AMT might be effective in improving CPRI; however, a definite conclusion could not be drawn because the quality of trials are low. Further large-scale and high-quality RCTs to verify the efficacy and safety of AMT on CRPS are still warranted.

Keywords: acupuncture; anxiety; depression; moxibustion; neoplasms; review; sleep initiation and maintenance disorders.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Acupuncture Therapy* / methods
Anxiety / therapy
Depression / drug therapy
Humans
Moxibustion*
Neoplasms* / complications
Neoplasms* / therapy
Sleep Initiation and Maintenance Disorders* / therapy