Effects of Qigong, Tai Chi, acupuncture, and Tuina on cancer-related fatigue for breast cancer patients: A protocol of systematic review and meta-analysis

A bibliometric analysis of the development trend of Tuina research: Based on the Web of Science (WOS) platform

BACKGROUND

Tuina has been proven to significantly relieve symptoms, demonstrating its clinical value. With the growth of related research, a comprehensive review is urgently needed to promote its development. This study aims to clarify the collaboration and current research status in the field of Tuina research using bibliometric analysis, and to discuss future directions.

METHODS

On February 4, 2023, the Web of Science Core Collection (WoSCC) database was searched using the keywords "tuina," "tui-na," "tui na," and "Chinese massage" to collect literature related to Tuina from its inception until December 31, 2022. The collected literature included all types of research articles and reviews. VOSviewer, CiteSpace, Pajek, and Scimago Graphica were utilized to perform a visual analysis of annual publication volume, as well as publication volume and collaboration networks of different countries, institutions, and authors, along with journal publication volume and keyword network analysis.

RESULTS

A total of 761 publications were included in the analysis, with the total number of papers showed an increasing trend over time. The countries and institutions with the most publications were China and Shanghai University of Traditional Chinese Medicine, respectively. The authors who contributed the most were Min Fang, Qingguang Zhu, Zhiwei Wu, Lingjun Kong and Yufeng Wang. The most widely published journal in the field was the Journal of Acupuncture and Tuina Science. The clinical efficacy evaluation of Tuina therapy for musculoskeletal and spinal diseases, apoplexy sequelae, chronic diseases, and pediatric diseases were research hotspots and developing trends in this field.

CONCLUSION

The research on Tuina has been increasing year by year. Currently, the focus of Tuina research lies in clinical studies, including the treatment of skeletal muscle and spinal diseases, stroke sequelae, chronic diseases, and pediatric illnesses, with pediatric Tuina emerging as a hot topic of research. Basic research in this field is relatively scarce, and the mechanisms of action of this therapy have not yet been fully elucidated. Future efforts in this area should aim to strengthen basic research and promote cooperation among international institutions.

Attitude, knowledge, and barriers of Chinese clinical and nursing students in implementing complementary and alternative medicine for COVID-19：a cross-sectional study

Background

Complementary and alternative medicine (CAM) has emerged to combat the global COVID-19 pandemic. However, no studies have been conducted to evaluate the attitudes, knowledge, and barriers of Chinese clinical and nursing students in implementing CAM during this period.

Objective

The aim of this study was to investigate the attitude, knowledge, and barriers of Chinese clinical and nursing students in using CAM in the context of COVID-19.

Methods

An online-based cross-sectional survey was carried out among Chinese medical students, majoring in clinical medicine or nursing, in Nanjing, Jiangsu Province, and Zhengzhou, Henan Province from May to July 2022. A total of 402 clinical and 644 nursing students responded to a self-administered questionnaire through the Questionnaire Star and WeChat APPs. SPSS 25 (version 25) was used for data analysis. Proportions were compared by Chi-square test. Level of significance between groups was analyzed using independent student t-test and Mann-Whitney U test.

Results

The average score of attitude was 46.63 (SD: 7.38) in clinical students and 49.84 (SD: 6.76) in nursing students. The top four most commonly used CAM treatments in China were proprietary Chinese medicine, diet therapy, decoction, and acupuncture and moxibustion (59.66 %, 22.28 %, 11.66 %, 9.85 %). The students had a good mastery of knowledge about CAM-based prevention and control of COVID-19 (mean score 7.36). The score of CAM knowledge in nursing students was significantly higher than that in clinical students (7.56 VS 7.04, P = 0.000). Gender, grade, previous use, age, and knowledge score could affect students' attitude towards CAM. The main barriers in spreading CAM use included time-consumption, bad taste, and fear of treatment-related pain (24.5 %). Compared with clinical students, nursing students were more likely to recommend CAM to patients in the future (P = 0.002).

Conclusions

During the COVID-19 pandemic, nursing students were more positive towards CAM use, had a better mastery of CAM knowledge than clinical students. CAM is expected to provide better outcomes in COVID-19 patients. Future studies should focus on the changes in students' attitudes over time and exploration of influencing factors on CAM use.

Effects of Mind-Regulation Acupuncture Therapy on Serum Ghrelin, Gastric Inhibitory Polypeptide, Leptin, and Insulin Levels in Breast Cancer Survivors with Cancer-Related Fatigue: A Randomized Controlled Trial

Aim

The aim of this research is to analyze the effects of mind-regulation acupuncture on serum ghrelin, gastric inhibitory polypeptide, leptin, and insulin levels, fatigue, quality of sleep, depression, and quality of life in survivors of breast cancer with cancer-related fatigue.

Methods

Total 136 breast cancer survivors with cancer-related fatigue were randomly allocated to the mind-regulation acupuncture group and the control group in a 1:1 ratio, with 68 cases in each group. Finally, 57 cases each in both groups completed the study. The serum ghrelin, gastric inhibitory polypeptide, leptin, and insulin levels were measured in pre-treatment and post-treatment. The 20-item Multidimensional Fatigue Symptom Inventory, Pittsburgh Sleep Quality Index, Hamilton Depression Scale, and Karnofsky Performance Status were used to evaluate patients' fatigue, quality of sleep, symptoms of depression, and quality of life, respectively.

Results

In post-treatment, the serum ghrelin, gastric inhibitory polypeptide, leptin, and insulin levels significantly reduced, 20-item Multidimensional Fatigue Symptom Inventory, Pittsburgh Sleep Quality Index, and Hamilton Depression scores were remarkably decreased, whereas the Karnofsky Performance Status scores were significantly increased in mind-regulation acupuncture group and control group comparing to those pre-treatment, while those in mind-regulation acupuncture group changed more significantly. The 20-item Multidimensional Fatigue Symptom Inventory, Pittsburgh Sleep Quality Index, and Hamilton Depression scores were remarkably lower, and remarkably higher Karnofsky Performance Status scores in the mind-regulation acupuncture group were seen than those in the control group.

Conclusion

Mind-regulation acupuncture could reduce serum ghrelin, gastric inhibitory polypeptide, leptin, and insulin levels of breast cancer survivors with cancer-related fatigue. In addition, it alleviates cancer-related fatigue, sleep disturbance, and depression in these survivors and improves their quality of life. Therefore, mind-regulation acupuncture may have potential as an alternative and complementary therapy for breast cancer survivors with cancer-related fatigue.

A Meta-Analysis: Intervention Effect of Mind-Body Exercise on Relieving Cancer-Related Fatigue in Breast Cancer Patients

Objective

This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients.

Methods

Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses.

Results

17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p < 0.00001. Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable.

Conclusion

Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients.