Systematic Review of the Clinical Efficacy and Safety of Acupuncture Treatment for Multiple Myeloma Peripheral Neuropathy

Author：TIAN Yingjie1,2, SU Liang1, CHEN Xiaohan1, YUAN Guoxing1, GUO Zhijiang1, CHANG An1, WU Jie1

Unit：1.Guanganmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; 2.Beijing University of Chinese Medicine, Beijing 100028, China

Quote：引用：田英洁，苏亮，陈晓涵，袁国兴，郭志江，苌安，吴洁.针刺治疗多发性骨髓瘤周围神经病变的临床疗效及安全性的系统评价[J].中医药导报,2025,31(1):143-152.

DOI：10.13862/j.cn43-1446/r.2025.01.026

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Abstract：

Objectives: To evaluate the efficacy and safety of acupuncture treatment for multiple myeloma peripheral neuropathy (MMPN). Methods: The databases including CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Web of Science, and the Cochrane Library from the establish of database to October 2023 were retrieved for clinical studies on acupuncture treatment for MMPN. Studies that reported Functional Assessment of Cancer Therapy/GOG—Neurotoxicity (FACT/GOG-Ntx) scale scores, nerve conduction velocity, Clinical Total Neuropathy score(TNSc), and pain scale scores were included. Safety was assessed based on the incidence of adverse events. Two researchers independently conducted literature screening, data extraction, and quality assessment. The RevMan5.3 and Stata16.0 software was used to analyze the data. Results: A total fo 9 studies were included, comprising 5 randomized controlled trials (RCTs) and 4 single-arm studies, with a total of 381 patients. Acupuncture combined with drug treatment could reduce the FACT/GOG-Ntx scores of patients, and the difference was statistically significant [MD=-4.79, 95% CI (-6.59, -2.99), P<0.000 1]. The FACT/GOG-Ntx scores in the treatment group were significantly lower than those in the control group [MD=-2.70, 95% CI  (-3.75, -1.64), P<0.000 1]. The median nerve motor conduction velocity [MD=1.99, 95% CI (1.23, 2.75), P<0.000 1], common peroneal nerve motor conduction velocity [MD=2.43, 95% CI (1.68, 3.17), P<0.000 1], median nerve sensory conduction velocity [MD=1.91, 95% CI (1.11, 2.70), P<0.000 1], and sural nerve sensory conduction velocity [MD=2.81, 95% CI (2.14, 3.47), P<0.000 1] in the treatment group were all higher than those in the control group, and the differences were statistically significant. The TNSc scores in the treatment group were significantly lower than those in the control group [MD=-2.62, 95% CI (-3.49, -1.76), P<0.000 01)]. The pain scores of patients in the treatment group were lower than those in the control group, and the difference was statistically significant [SMD=-1.20, 95% CI (-1.87, -0.53), P<0.000 01]. There was no statistically significant difference (P>0.05) between simple acupuncture treatment and medication treatment in increasing nerve conduction velocity and reducing neurotoxicity score. There have been no reports of adverse reactions to acupuncture treatment of MMPN in the included studies. The treatment mainly focuses on the Yangming meridian points on the hands and feet, with Hegu (LI4) and Zusanli (ST36) being the most commonly selected points. Conclusion: Acupuncture combined with drug treatment for MMPN is beneficial for reducing neurotoxicity, promoting the recovery of nerve conduction velocity, improving the degree of neuropathy, alleviating pain symptoms, without observing any adverse events. However, more clinical trials are still needed to confirm the conclusions.

Key words：multiple myeloma; peripheral nervous system diseases; acupuncture; efficacy; safety; Meta-analysis

摘要：目的：评估针刺治疗多发性骨髓瘤周围神经病变（MMPN）的疗效及安全性。方法：检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Embase、Web of Science、Cochrane Library等数据库建库至2023年10月19日有关针刺治MMPN的临床研究，纳入报告癌症治疗相关神经毒性功能评估量表（FACT/GOG-Ntx）评分、神经传导速度、临床总神经病变评分（TNSc）、疼痛评分的研究，安全性评价通过不良事件的发生率进行判断。两名研究者独立进行文献筛选、资料提取及质量评价，通过RevMan 5.3和Stata 16软件进行数据分析。结果：纳入9项研究，包括5项RCT和4项单臂研究，共381例患者。针刺联合西药治疗后患者FACT/GOG-Ntx评分下降，差异有统计学意义[MD=-4.79，95%CI（-6.59，-2.99），P<0.000 01]。试验组患者FACT/GOG-Ntx评分低于对照组，差异有统计学意义[MD=-2.70，95%CI（-3.75，-1.64），P<0.000 01]。试验组患者正中神经运动传导速度[MD=1.99，95%CI（1.23，2.75），P<0.000 01]、腓总神经运动传导速度[MD=2.43，95%CI（1.68，3.17），P<0.000 01]、正中神经感觉传导速度[MD=1.91，95%CI（1.11，2.70），P<0.000 01]、腓肠神经感觉传导速度[MD=2.81，95%CI（2.14，3.47），P<0.000 01]均高于对照组，差异均有统计学意义。试验组患者TNSc评分低于对照组，差异有统计学意义[MD=-2.62，95%CI（-3.49，-1.76），P<0.000 01）]。试验组患者疼痛评分低于对照组，差异有统计学意义[SMD=-1.20，95%CI（-1.87，-0.53），P＜0.000 01]。单纯针刺治疗与药物治疗在增加神经传导速度和降低神经毒性评分方面，差异无统计学意义（P＞0.05）。纳入研究中未见有针刺治疗MMPN发生不良反应的报告，治疗选穴以手足阳明经穴为主，最常选穴为合谷、足三里。结论：针刺联合西药治疗MMPN有利于减轻神经毒性，促进神经传导速度的恢复，改善神经病变程度，减轻疼痛症状，且未见不良事件发生，但仍需更多临床研究证实上述结论。

关键词：多发性骨髓瘤；周围神经病变；针刺；疗效；安全性；Meta分析

Release time：2025-11-28

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