Whether acupuncture could be used to manage limb oedema in women after breast cancer surgery

Effects of acupuncture on breast cancer-related lymphoedema: a systematic review and meta-analysis of randomized controlled trials

https://doi.org/10.1136/acupmed-2018-011668

Article Information

Volume: 37 issue: 1, page(s): 16-24

Article first published online: March 8, 2019; Issue published: February 1, 2019

Xinyan Zhang¹, Xiuli Wang², Bingyan Zhang¹, Sa Yang¹, Dongling Liu¹

¹School of Nursing, Jilin University,Changchun, Jilin, China

²Hospital of Stomatology, Jilin University, Changchun, Jilin, China

Corresponding Author:

Dongling Liu, School of Nursing, Jilin University, Changchun 130021, China. Email: ldongling69@126.com

Abstract

Objective:

Breast cancer-related lymphoedema (BCRL) is a common complication after breast cancer treatment. We investigated whether acupuncture could be used to manage limb oedema in women after breast cancer surgery.

Methods:

The Cochrane Library, PubMed, Embase, Web of Science, CINAHL, and four Chinese databases were electronically searched for papers published through November 2017. Randomised controlled trials (RCTs) of acupuncture for BCRL were included.

Results:

In total, six RCTs with 318 patients were identified. The main analysis revealed a positive overall effect of acupuncture intervention on pre/post-treatment differences in the diameter of the elbow joint, reductions in upper limb lymphoedema and effectiveness index based on arm measurement data in patients with breast cancer. Two studies evaluating the outcome of acupuncture on the diameter of the elbow joint found a significant reduction in diameter between the acupuncture and control groups (weighted mean difference (WMD) 6 cm, 95% CI 5.11 to 6.89 cm; P<0.001). The same two studies investigated the effect of acupuncture on upper limb lymphoedema reduction and found a significant difference between the acupuncture and control groups (risk ratio 1.4, 95% CI 1.17 to 1.67; P<0.001). Two other studies used the effectiveness index to assess the arm and found a significant difference between the acupuncture and control groups (WMD 23.34, 95% CI 10.74 to 35.94; P<0.001). The fifth study used bioelectrical impedance spectroscopy to assess lymphoedema at several points on the arm before and after acupuncture; this study also reported a significant reduction in lymphoedema. The sixth study reported no significant difference in bioimpedance between the groups.

Conclusions:

The present meta-analysis and systematic review suggests that acupuncture is effective at reducing BCRL in patients after breast cancer treatment.

Electro-acupuncture Therapy

Electro-acupuncture means the stimulation of points, meridians, channels, collaterals, and ah-shi points with or without needles with: the administration and/or prescription of percutaneous and transcutaneous electrical nerve and tissue stimulation; and/or the use of microcurrent; low volt; high volt; interferential current; galvanic current; and acupunctoscope.

HERBAL THERAPY

Herbal therapy means the use, prescription, recommendation, and administration of herbal therapy/phyto-therapy which consists of plant, or mineral substances and shall include all homeopathic preparations to promote, maintain and restore health and to prevent disease.