Sub-committee of Anesthesiology of Guangzhou Integrated Traditional Chinese and Western Medicine Society

doi:10.12122/j.issn.1673-4254.2025.08.24

Journal of Southern Medical University ›› 2025, Vol. 45 ›› Issue (8): 1800-1808.doi: 10.12122/j.issn.1673-4254.2025.08.24

Sub-committee of Anesthesiology of Guangzhou Integrated Traditional Chinese and Western Medicine Society

Yi LU¹(), Cunzhi² LIU², Wujun³ GENG³, Xiaozhen⁴ ZHENG⁴, Jingdun XIE⁵, Guangfang⁶ ZHANG⁶, Chao⁷ LIU⁷, Yun⁸ LI⁸, Yan⁹ QU⁹, Lei ⁰ CHEN¹⁰, Xizhao HUANG¹¹, Hang ² TIAN¹², Yuhui ³ LI¹³, Hongxin ⁴ LI¹⁴, Heying ⁵ ZHONG¹⁵, Ronggui ⁶ TAO¹⁶, Jie ⁷ ZHONG¹⁷, Yue ⁸ ZHUANG¹⁸, Junyang ⁹ MA¹⁹, Yan²⁰ HU²⁰, Jian² FANG²¹, Gaofeng ZHAO⁶, Jianbin⁶ XIAO⁶, Weifeng TU¹⁵, Jiaze SUN¹, Yuting DUAN¹, Bao⁷ WANG⁷()

^1.The Affiliated Traditional Chinese Medicine Hospital, Guangzhou Medical University, Guangzhou 510130, China
^2.School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
^3.The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China
^4.The First Affiliated Hospital of Henan University, Luoyang 471000, China
^5.Sun Yat-sen University Cancer Center, Guangzhou 510060, China
^6.Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
^7.Guangzhou Twelfth People's Hospital, Guangzhou 510700, China
^8.Zhongshan Hospital of Xiamen University, Xiamen 361000, China
^9.Affiliated Hospital of Yunnan University, Kunming 650000, China
^10.Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou 510095, China
^11.Guangdong Provincial Maternal and Child Health Hospital, Guangzhou 511400, China
^12.Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
^13.The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, China
^14.Guangzhou Chest Hospital, Guangzhou 510000, China
^15.Guangzhou Hospital of Integrated Traditional and Western Medicine, Guangzhou 510800, China
^16.Guangzhou Zengcheng District Hospital of Traditional Chinese Medicine, Guangzhou 511340, China
^17.Panyu Maternal and Child Care Service Centre of Guangzhou, Guangzhou 511400, China
^18.Guangzhou Development Distriet Hospital, Guangzhou 510730, China
^19.Xiaolan People's Hospital of Zhongshan, Zhongshan 528400, China
^20.Dongguan Qingxi Hospital of Guangdong Pharmaceutical University, Dongguan 523660, China
^21.Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai 519000, China

Received:2025-04-14 Online:2025-08-20 Published:2025-09-05
Contact: Bao? WANG E-mail:2019620769@gzhmu.edu.cn;78wb@163.com

Abstract

Abstract:

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and Results Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Key words: neoplasms, cancer pain, DSA Guidance, Zi Wu Liu Zhu Acupoint Therapy, integration of traditional Chinese and Western medicine, individualized treatment, quality of life, immune function, expert consensus

Yi LU, Cunzhi² LIU, Wujun³ GENG, Xiaozhen⁴ ZHENG, Jingdun XIE, Guangfang⁶ ZHANG, Chao⁷ LIU, Yun⁸ LI, Yan⁹ QU, Lei ⁰ CHEN, Xizhao HUANG, Hang ² TIAN, Yuhui ³ LI, Hongxin ⁴ LI, Heying ⁵ ZHONG, Ronggui ⁶ TAO, Jie ⁷ ZHONG, Yue ⁸ ZHUANG, Junyang ⁹ MA, Yan²⁰ HU, Jian² FANG, Gaofeng ZHAO, Jianbin⁶ XIAO, Weifeng TU, Jiaze SUN, Yuting DUAN, Bao⁷ WANG. Sub-committee of Anesthesiology of Guangzhou Integrated Traditional Chinese and Western Medicine Society[J]. Journal of Southern Medical University, 2025, 45(8): 1800-1808.

Figures/Tables 5

References 54

[1]	Chiriac VF, Ciurescu D, Moșoiu DV. Cancer pain and non-invasive brain stimulation-a narrative review[J]. Medicina: Kaunas, 2023, 59(11): 1957. doi：10.3390/medicina59111957
[2]	Calvert CM, Burgess D, Erickson D, et al. Cancer pain and alcohol self-medication[J]. J Cancer Surviv, 2023, 17(6): 1561-70. doi：10.1007/s11764-022-01215-x
[3]	张力苹, 刘喜娟, 胡潇, 等. 经动脉化疗栓塞续贯肝动脉灌注化疗联合TKI和PD-1单抗在晚期肝癌一线治疗中的疗效观察 [J]. 南方医科大学学报, 2024, 44(9): 1831-8. doi：10.12122/j.issn.1673-4254.2024.09.24
[4]	Mestdagh F, Steyaert A, Lavand' homme P. Cancer pain management: a narrative review of current concepts, strategies, and techniques[J]. Curr Oncol, 2023, 30(7): 6838-58. doi：10.3390/curroncol30070500
[5]	Cherny NI, Ziff-Werman B. Ethical considerations in the relief of cancer pain[J]. Support Care Cancer, 2023, 31(7): 414. doi：10.1007/s00520-023-07868-3
[6]	Mulvey MR, Paley CA, Schuberth A, et al. Neuropathic pain in cancer: what are the current guidelines?[J]. Curr Treat Options Oncol, 2024, 25(9): 1193-202. doi：10.1007/s11864-024-01248-7
[7]	Isozaki AB, Brant JM. The impact of pain on mobility in patients with cancer[J]. Semin Oncol Nurs, 2024, 40(4): 151672. doi：10.1016/j.soncn.2024.151672
[8]	Fallon M, Dierberger K, Leng M, et al. An international, open-label, randomised trial comparing a two-step approach versus the standard three-step approach of the WHO analgesic ladder in patients with cancer[J]. Ann Oncol, 2022, 33(12): 1296-303. doi：10.1016/j.annonc.2022.08.083
[9]	Jin H, Liang J, Zhang S, et al. External treatment of traditional Chinese medicine for cancer pain: a systematic review and network meta-analysis[J]. Medicine: Baltimore, 2024, 103(8): e37024. doi：10.1097/md.0000000000037024
[10]	Luo WJ, Huang H, Zhou Y, et al. Implementation of pharmaceutical strategies using the PDCA cycle for standardized management of cancer pain medications[J]. Support Care Cancer, 2025, 33(3): 163. doi：10.1007/s00520-025-09228-9
[11]	Yu Z, Li W, Shangguan X, et al. Knowledge, practices, and perceived barriers in cancer pain management at oncology units: a cross-sectional survey of medical staff in China[J]. J Pain Res, 2022, 15: 159-69. doi：10.2147/jpr.s339377
[12]	Magill E, Demartis S, Gavini E, et al. Solid implantable devices for sustained drug delivery[J]. Adv Drug Deliv Rev, 2023, 199: 114950. doi：10.1016/j.addr.2023.114950
[13]	Goel V, Kaizer A, Darrow D, et al. Cancer patients quality of life after intrathecal drug delivery for advanced pain management: a patient-reported outcome analysis[J]. Pain Med, 2025, 26(5): 261-8. doi：10.1093/pm/pnaf012
[14]	Mitchell A, Somerville L, Williams N, et al. Implanted intrathecal drug delivery systems may be associated with improved survival in patients with cancer[J]. Br J Pain, 2024, 18(2): 110-9. doi：10.1177/20494637231202089
[15]	Wang W, Shi Q, Cao YT, et al. Intrathecal drug delivery systems for cancer pain: a retrospective analysis at a single tertiary medical center in China[J]. Heliyon, 2024, 10(14): e34522. doi：10.1016/j.heliyon.2024.e34522
[16]	Brogan SE, Sindt JE, Odell DW, et al. Controversies in intrathecal drug delivery for cancer pain[J]. Reg Anesth Pain Med, 2023, 48(6): 319-25. doi：10.1136/rapm-2022-103770
[17]	Ding Y, Deng H, Peng J. Clinical observation of the treatment of refractory cancer pain with cancer pain information platform and IDDS under home analgesia mode: a retrospective study[J]. Medicine: Baltimore, 2024, 103(27): e38765. doi：10.1097/MD.0000000000038765
[18]	Duarte R, Copley S, Nevitt S, et al. Effectiveness and safety of intrathecal drug delivery systems for the management of cancer pain: a systematic review and meta-analysis[J]. Neuromodulation Technol Neural Interface, 2023, 26(6): 1126-41. doi：10.1016/j.neurom.2022.03.003
[19]	He GQ, Li H, Liu J, et al. Recent progress in implantable drug delivery systems[J]. Adv Mater, 2024, 36(23): e2312530. doi：10.1002/adma.202312530
[20]	Li Y, Wang M, Shi Z, et al. Application of midnight-noon ebb-flow combined with five-element music therapy in continuous nursing of patients with chronic wounds[J]. J Eval Clin Pract, 2025, 31(1): e14216. doi：10.1111/jep.14216
[21]	Li J, Beh WF, Wang IT, et al. The effect of Chinese 5-element music with midnight-noon ebb-flow theory on depression, anxiety, quality of life satisfaction among older adults: a randomized controlled trial[J]. Medicine: Baltimore, 2025, 104(1): e41224. doi：10.1097/MD.0000000000041224
[22]	Tang X, Yang J, Feng Z, et al. Study of scraping with copper stone based on theory of midnight-noon ebb-flow in angina pectoris with coronary heart disease of qi stagnation and blood stasis[J]. Evid Based Complement Alternat Med, 2021, 2021: 2677696. doi：10.1155/2021/2677696
[23]	Li Y, Lu C, Chen L. Efficacy of midnight-noon Ebb-flow hour-prescription method combined with acupuncture at Baihui Bazhen acupoints in the rehabilitation of Aphasia after ischemic stroke[J]. Afr Health Sci, 2024, 24(4): 262-8. doi：10.4314/ahs.v24i4.34
[24]	Bao YC, Zhang F, Li Q, et al. Midnight-noon ebb-flow acupuncture combined with rehabilitation therapy for severe craniocerebral trauma patients with vegetative state: a randomized controlled trial [J]. Zhongguo Zhen Jiu, 2020, 40(3): 234-8. doi：10.13703/j.0255-2930.20191028-k0001
[25]	Wang DL, Wang XQ, Wang R, et al. Timing umbilical therapy in treatment of neurogenic bladder after spinal cord injury based on midnight-noon and ebb-flow doctrine: a randomized controlled trial[J]. Zhongguo Zhen Jiu, 2023, 43(11): 1246-50.
[26]	Faria M, Teixeira M, Pinto MJ, et al. Efficacy of acupuncture on cancer pain: a systematic review and meta-analysis[J]. J Integr Med, 2024, 22(3): 235-44. doi：10.1016/j.joim.2024.03.002
[27]	封佳丽, 杨卓. 基于中医时间医学研究探讨生物节律变化对胃癌作用 [J]. 临床军医杂志, 2025, 53(01): 99-102+105.
[28]	金海涛, 周芳, 马剑然, 等. 针刺配合子午流注开穴推拿治疗老年顽固性失眠疗效观察 [J]. 上海针灸杂志, 2024, 43(9): 969-73. doi：10.13460/j.issn.1005-0957.2024.13.4012
[29]	孙琪, 胡晓阳, 郭昌, 等. 针灸治疗癌性疼痛研究进展 [J]. 光明中医, 2025, 40(2): 403-7. doi：10.3969/j.issn.1003-8914.2025.02.056
[30]	杨银凯, 吴绪海, 高航, 等. 子午流注透灸法治疗寒湿型腰椎间盘突出症的疗效观察[J]. 上海针灸杂志, 2025, 44(2): 208-12.
[31]	Geenen RWF, van der Molen AJ, Dekkers IA, et al. Contrast media for hysterosalpingography: systematic search and review providing new guidelines by the Contrast Media Safety Committee of the European Society of Urogenital Radiology[J]. Eur Radiol, 2024, 34(10): 6435-43. doi：10.1007/s00330-024-10707-6
[32]	Lauri C, Noriega‑Álvarez E, Chakravartty RM, et al. Diagnostic imaging of the diabetic foot: an EANM evidence-based guidance[J]. Eur J Nucl Med Mol Imag, 2024, 51(8): 2229-46. doi：10.1007/s00259-024-06693-y
[33]	黄慧玲. 穴位贴敷结合系统化安宁疗护在重度癌痛患者护理中的应用效果研究[J]. 中国医学创新, 2025, 22(7): 85-8.
[34]	梁彐彐, 陈亚楠. 中药穴位贴敷温肾养血治疗肿瘤骨转移癌痛的临床疗效观察 [J]. 中医药临床杂志, 2025, 37(3): 547-51.
[35]	《胃癌中西医结合诊疗指南》标准化项目组. 胃癌中西医结合诊疗指南（2023年） [J]. 中国中西医结合杂志, 2024, 44(03): 261-272.
[36]	赖桂花, 王菲, 聂多锐, 等. 骨转移癌痛发病机制及中医药防治研究进展[J]. 中国实验方剂学杂志, 2023, 29(11): 231-9. doi：10.13422/j.cnki.syfjx.202202026
[37]	张昉, 李敏, 李嘉敏. 中西医结合治疗肺肿瘤骨转移的效果分析 [J]. 中国防痨杂志, 2024, 46(S2): 175-7.
[38]	Groninger H, Violanti D, Mete M. Virtual reality for pain management in hospitalized patients with cancer: a randomized controlled trial[J]. Cancer, 2024, 130(14): 2552-60. doi：10.1002/cncr.35282
[39]	Martini RS, Brown T, Singh V, et al. Integrative approaches for cancer pain management[J]. Curr Oncol Rep, 2024, 26(6): 691-705. doi：10.1007/s11912-024-01536-3
[40]	Sjattar EL, Arafat R, Ling LW. Cancer pain self-management interventions in adults: scoping review[J]. BMJ Support Palliat Care, 2024, 14(4): 411-5. doi：10.1136/spcare-2024-004893
[41]	Zhou T, Salman D, McGregor AH. Recent clinical practice guidelines for the management of low back pain: a global comparison[J]. BMC Musculoskelet Disord, 2024, 25(1): 344. doi：10.1186/s12891-024-07468-0
[42]	Hayek SM, Jones BA, Veizi E, et al. Efficacy of continuous intrathecal infusion trialing with a mixture of fentanyl and bupivacaine in chronic low back pain patients[J]. Pain Med, 2023, 24(7): 796-808. doi：10.1093/pm/pnac195
[43]	Perruchoud C, Dupoiron D, Papi B, et al. Management of cancer-related pain with intrathecal drug delivery: a systematic review and meta-analysis of clinical studies[J]. Neuromodulation Technol Neural Interface, 2023, 26(6): 1142-52. doi：10.1016/j.neurom.2021.12.004
[44]	Sun L, Fang M, Xu T, et al. Application of healthcare failure mode and effect analysis in the management of patients with intrathecal morphine pump implantation[J]. Pain Manag Nurs, 2025, 26(2): e207-14. doi：10.1016/j.pmn.2024.10.019
[45]	Winston GM, Winston GM, Zimering JH, et al. Safety and efficacy of surgical implantation of intrathecal drug delivery pumps in patients with cancer with refractory pain[J]. Neurosurgery, 2024, 95(5): 1072-81. doi：10.1227/neu.0000000000002978
[46]	Yoo Y, Oh JH, Lee H, et al. Myth and truth in opioid consumption with intrathecal morphine pump implantation in chronic pain: a retrospective cohort study with claims database in south Korea[J]. Pain Med, 2023, 24(1): 79-88. doi：10.1093/pm/pnac110
[47]	Zlotchenko DG, Johnson DT, Kelson K. Targeted drug delivery via intrathecal pain pump for the treatment of malignant pain[J]. Tech Vasc Interv Radiol, 2024, 27(3): 100985. doi：10.1016/j.tvir.2024.100985
[48]	凡国华, 孙静云, 纪娟, 等. 子午流注择时揿针疗法预防非小细胞肺癌患者化疗后骨髓抑制的效果研究 [J]. 中国全科医学, 2024, 27(6): 733-738.
[49]	管傲然, 管薇薇, 丁丽玲, 等. 管氏针灸学术流派的理论体系与临床特色[J]. 中华中医药杂志, 2024, 39(9): 4557-61.
[50]	李悦, 杨玉霞, 闫馨月, 等. 基于子午流注理论运用揿针早期介入促醒重型颅脑损伤昏迷患者的临床观察 [J]. 中华中医药杂志, 2024, 39(03): 1582-5.
[51]	唐小玲, 徐莎. 基于子午流注理论中药保留灌肠配合八髎灸治疗寒湿瘀滞型盆腔炎性后遗症的临床研究 [J]. 时珍国医国药, 2024, 35(07): 1682-4.
[52]	王东利, 王学乾, 王蕊, 等. 基于子午流注理论择时脐疗治疗脊髓损伤后神经源性膀胱: 随机对照试验[J]. 中国针灸, 2023, 43(11): 1246-50.
[53]	叶孙送, 陈铭, 周慧慧, 等. 子午流注针联合中药熏蒸对混合痔术后疼痛及炎症的影响 [J]. 辽宁中医杂志, 2024: 1-7.
[54]	尹中懿, 林宇煌, 李长君, 等. 子午流注针刺法治疗老年脑卒中后心脾两虚失眠症的临床疗效[J]. 中国老年学杂志, 2023, 43(15): 3605-8.

Level	Type of Evidence	Expert Consensus Level	Recommendation Strength
1a	Systematic review of randomized controlled trials	>80%	Strong
1b	Individual randomized controlled trial		Strong
1c	All or None Case Series		Strong
2a	Systematic review of cohort studies	50%-80%	Middle
2b	Individual cohort study		Middle
2c	Outcome research; Ecological studies		Middle
3a	Systematic review of case-control studies	30%-49.9%	Weak
3b	Individual case-control study		Weak
4	Case series (low-quality cohort and case-control studies)	<30%	Very Weak
5	Expert opinion without explicit critical appraisal		Very Weak

Level	Type of Evidence	Expert Consensus Level	Recommendation Strength
1a	Systematic review of randomized controlled trials	>80%	Strong
1b	Individual randomized controlled trial		Strong
1c	All or None Case Series		Strong
2a	Systematic review of cohort studies	50%-80%	Middle
2b	Individual cohort study		Middle
2c	Outcome research; Ecological studies		Middle
3a	Systematic review of case-control studies	30%-49.9%	Weak
3b	Individual case-control study		Weak
4	Case series (low-quality cohort and case-control studies)	<30%	Very Weak
5	Expert opinion without explicit critical appraisal		Very Weak

Sub-committee of Anesthesiology of Guangzhou Integrated Traditional Chinese and Western Medicine Society

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