Effects of Acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five Element Music Therapy on Symptom Management and Quality of Life for Cancer Patients: A Meta-Analysis

Abstract Context Most cancer patients suffer from both the disease itself and symptoms induced by conventional treatment. Available literature on the clinical effects on cancer patients of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five Element Music Therapy (TCM FEMT) rep...

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Published in:Journal of pain and symptom management 2016-04, Vol.51 (4), p.728-747
Main Authors: Tao, Wei-Wei, MD, Jiang, Hua, Tao, Xiao-Mei, Jiang, Ping, Sha, Li-Yan, Sun, Xian-Ce
Format: Article
Language:English
Subjects:
Acupuncture
Acupuncture Therapy
Anesthesia & Perioperative Care
cancer
Disease Management
Humans
massage
Medicine, Chinese Traditional - methods
meta-analysis
Music Therapy - methods
Neoplasms - physiopathology
Neoplasms - psychology
Neoplasms - therapy
Pain Medicine
Qigong
Quality of Life
Randomized Controlled Trials as Topic
symptom management
Tai Chi
Tai Ji
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Summary:Abstract Context Most cancer patients suffer from both the disease itself and symptoms induced by conventional treatment. Available literature on the clinical effects on cancer patients of acupuncture, Tuina, Tai Chi, Qigong, and Traditional Chinese Medicine Five Element Music Therapy (TCM FEMT) reports controversial results. Objectives The primary objective of this meta-analysis was to evaluate the effect of acupuncture, Tuina, Tai Chi, Qigong, and TCM FEMT on various symptoms and quality of life (QOL) in patients with cancer; risk of bias for the selected trials also was assessed. Methods Studies were identified by searching electronic databases (MEDLINE via both PubMed and Ovid, Cochrane Central, China National Knowledge Infrastructure, Chinese Scientific Journal Database, China Biology Medicine, and Wanfang Database). All randomized controlled trials (RCTs) using acupuncture, Tuina, Tai Chi, Qigong, or TCM FEMT published prior to October 2, 2014 were selected, regardless of whether the paper was published in Chinese or English. Results We identified 67 RCTs (5465 patients) that met our inclusion criteria to perform this meta-analysis. Analysis results showed that a significant combined effect was observed for QOL change in patients with terminal cancer in favor of acupuncture and Tuina (Cohen’s d : 0.21-4.55, P 0.05). The meta-analysis also demonstrated that acupuncture produced small-to-large effects on adverse symptoms including pain, fatigue, sleep disturbance, and some gastrointestinal discomfort; however, no significant effect was found on the frequency of hot flashes (Cohen’s d =-0.02; 95% confidence interval [CI] -1.49, 1.45; P =0.97; I 2 = 36%) and mood distress ( P >0.05). Tuina relieved gastrointestinal discomfort. TCM FEMT lowered depression level. Tai Chi improved vital capacity of breast cancer patients. High risk of bias was present in 74.63% of the selected RCTs. Major sources of risk of bias were lack of blinding, allocation concealment and incomplete outcome data. Conclusion Taken together, although there are some clear limitations regarding the body of research reviewed in this study, a tentative conclusion can be reached that acupuncture, Tuina, Tai Chi, Qigong, or TCM FEMT represent beneficial adjunctive therapies. Future study reporting in this field should be improved regarding both method and content of interventions and research methods.
ISSN:0885-3924
1873-6513
DOI:10.1016/j.jpainsymman.2015.11.027