Xingyue Wu, Chun Sing Lam, Yau Shing Chu, Weishang Deng, Carmen Wing Han Chan, Kwok Yin Au, Sze Shun Man, Chi Kong Li, Chenwen Zhong, Leonard Ho, Yin Ting Cheung
{"title":"传统、补充和结合医学在儿童姑息治疗患者疼痛和心理困扰管理中的疗效：随机对照试验的系统回顾和荟萃分析。","authors":"Xingyue Wu, Chun Sing Lam, Yau Shing Chu, Weishang Deng, Carmen Wing Han Chan, Kwok Yin Au, Sze Shun Man, Chi Kong Li, Chenwen Zhong, Leonard Ho, Yin Ting Cheung","doi":"10.1016/j.jpainsymman.2025.01.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Context: </strong>Traditional, complementary, and integrative medicine (TCIM) is being increasingly used to manage symptoms in patients with palliative needs. However, there is a lack of evidence to guide its use in the pediatric palliative care (PPC) setting.</p><p><strong>Objectives: </strong>This study aimed to synthesize and evaluate the current evidence on the effectiveness of TCIM in reducing pain and psychological distress in PPC.</p><p><strong>Methods: </strong>Four English electronic databases were searched for randomized controlled trials (RCTs) published between January 2000 and August 2023. The standardized mean difference (SMD) was used to report the pooled magnitude of the treatment effect. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the evidence for each treatment outcome.</p><p><strong>Results: </strong>Thirty RCTs were included. The interventions were massage (n = 9), music therapy (n = 6), hypnosis (n = 3), acupuncture, aromatherapy, and other TCIM modalities. Compared with the control interventions, music therapy significantly decreased pain (SMD: -1.07; 95% CI: -1.64 to -0.50; P < 0.05; I<sup>2</sup> = 72%) and relieved anxiety (SMD: -0.75; 95% CI: -1.35 to -0.15; P < 0.05; I<sup>2</sup> = 74%); massage significantly decreased pain (SMD: -0.74; 95% CI: -1.46 to -0.02; P < 0.05; I<sup>2</sup> = 83%) and relieved anxiety (SMD: -0.61; 95% CI: -1.21 to -0.01; P < 0.05; I<sup>2</sup> = 71%). Hypnosis had significant effects on procedure-related anxiety, pain, and behavioral distress management (P < 0.05). The quality of evidence was rated as \"moderate\" for the efficacy of music therapy in alleviating pain and anxiety and \"low\" for the efficacy of all of the other interventions.</p><p><strong>Conclusions: </strong>Existing evidence supports the therapeutic benefits of music therapy, massage, and hypnosis on relieving pain and anxiety symptoms in the PPC setting, though the evidence is of low-to-moderate quality.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of Traditional, Complementary, and Integrative Medicine in Pain and Psychological Distress Management for Pediatric Palliative Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.\",\"authors\":\"Xingyue Wu, Chun Sing Lam, Yau Shing Chu, Weishang Deng, Carmen Wing Han Chan, Kwok Yin Au, Sze Shun Man, Chi Kong Li, Chenwen Zhong, Leonard Ho, Yin Ting Cheung\",\"doi\":\"10.1016/j.jpainsymman.2025.01.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context: </strong>Traditional, complementary, and integrative medicine (TCIM) is being increasingly used to manage symptoms in patients with palliative needs. However, there is a lack of evidence to guide its use in the pediatric palliative care (PPC) setting.</p><p><strong>Objectives: </strong>This study aimed to synthesize and evaluate the current evidence on the effectiveness of TCIM in reducing pain and psychological distress in PPC.</p><p><strong>Methods: </strong>Four English electronic databases were searched for randomized controlled trials (RCTs) published between January 2000 and August 2023. The standardized mean difference (SMD) was used to report the pooled magnitude of the treatment effect. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the evidence for each treatment outcome.</p><p><strong>Results: </strong>Thirty RCTs were included. The interventions were massage (n = 9), music therapy (n = 6), hypnosis (n = 3), acupuncture, aromatherapy, and other TCIM modalities. Compared with the control interventions, music therapy significantly decreased pain (SMD: -1.07; 95% CI: -1.64 to -0.50; P < 0.05; I<sup>2</sup> = 72%) and relieved anxiety (SMD: -0.75; 95% CI: -1.35 to -0.15; P < 0.05; I<sup>2</sup> = 74%); massage significantly decreased pain (SMD: -0.74; 95% CI: -1.46 to -0.02; P < 0.05; I<sup>2</sup> = 83%) and relieved anxiety (SMD: -0.61; 95% CI: -1.21 to -0.01; P < 0.05; I<sup>2</sup> = 71%). Hypnosis had significant effects on procedure-related anxiety, pain, and behavioral distress management (P < 0.05). The quality of evidence was rated as \\\"moderate\\\" for the efficacy of music therapy in alleviating pain and anxiety and \\\"low\\\" for the efficacy of all of the other interventions.</p><p><strong>Conclusions: </strong>Existing evidence supports the therapeutic benefits of music therapy, massage, and hypnosis on relieving pain and anxiety symptoms in the PPC setting, though the evidence is of low-to-moderate quality.</p>\",\"PeriodicalId\":16634,\"journal\":{\"name\":\"Journal of pain and symptom management\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-01-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of pain and symptom management\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jpainsymman.2025.01.002\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of pain and symptom management","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpainsymman.2025.01.002","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Efficacy of Traditional, Complementary, and Integrative Medicine in Pain and Psychological Distress Management for Pediatric Palliative Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Context: Traditional, complementary, and integrative medicine (TCIM) is being increasingly used to manage symptoms in patients with palliative needs. However, there is a lack of evidence to guide its use in the pediatric palliative care (PPC) setting.
Objectives: This study aimed to synthesize and evaluate the current evidence on the effectiveness of TCIM in reducing pain and psychological distress in PPC.
Methods: Four English electronic databases were searched for randomized controlled trials (RCTs) published between January 2000 and August 2023. The standardized mean difference (SMD) was used to report the pooled magnitude of the treatment effect. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the evidence for each treatment outcome.
Results: Thirty RCTs were included. The interventions were massage (n = 9), music therapy (n = 6), hypnosis (n = 3), acupuncture, aromatherapy, and other TCIM modalities. Compared with the control interventions, music therapy significantly decreased pain (SMD: -1.07; 95% CI: -1.64 to -0.50; P < 0.05; I2 = 72%) and relieved anxiety (SMD: -0.75; 95% CI: -1.35 to -0.15; P < 0.05; I2 = 74%); massage significantly decreased pain (SMD: -0.74; 95% CI: -1.46 to -0.02; P < 0.05; I2 = 83%) and relieved anxiety (SMD: -0.61; 95% CI: -1.21 to -0.01; P < 0.05; I2 = 71%). Hypnosis had significant effects on procedure-related anxiety, pain, and behavioral distress management (P < 0.05). The quality of evidence was rated as "moderate" for the efficacy of music therapy in alleviating pain and anxiety and "low" for the efficacy of all of the other interventions.
Conclusions: Existing evidence supports the therapeutic benefits of music therapy, massage, and hypnosis on relieving pain and anxiety symptoms in the PPC setting, though the evidence is of low-to-moderate quality.
期刊介绍：
The Journal of Pain and Symptom Management is an internationally respected, peer-reviewed journal and serves an interdisciplinary audience of professionals by providing a forum for the publication of the latest clinical research and best practices related to the relief of illness burden among patients afflicted with serious or life-threatening illness.
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