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Effectiveness of acupuncture in managing aromatase inhibitor-related arthralgia in breast cancer: a systematic review and meta-analysis
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Zheng Zhu1, 2, 3, Xinru Yuan3, 4, Yaman Zheng3, 4, Baomin Dou5, Liang Liu6, Pei Yong Loh7, Bo Chen2, 3, 4, *, Aoxiang Chen8, Peihong Ma9, Zelin Chen2, 3, 4, Yi Guo2, 3, *
Acupuncture and Herbal Medicine | 2025, 5(3) : 352 - 365
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Acupuncture and Herbal Medicine | 2025, 5(3): 352-365
• Original Articles •
Effectiveness of acupuncture in managing aromatase inhibitor-related arthralgia in breast cancer: a systematic review and meta-analysis
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Zheng Zhu1, 2, 3, Xinru Yuan3, 4, Yaman Zheng3, 4, Baomin Dou5, Liang Liu6, Pei Yong Loh7, Bo Chen2, 3, 4, *, Aoxiang Chen8, Peihong Ma9, Zelin Chen2, 3, 4, Yi Guo2, 3, *
Affiliations
  • 1First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 3Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 4School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
  • 5Department of Anesthesiology, Rutgers University, the State University of New Jersey, Newark, NJ, United States
  • 6Developmental Therapeutics Branch, Center for Cancer Research, NCI, Bethesda, MD, United States
  • 7Inti Health Management School, Inti International University, Negeri Sembilan, Malaysia
  • 8National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
  • 9School of Medical Technology; Tianjin University of Traditional Chinese Medicine, Tianjin, China
Published: 2025-09-25 doi: 10.1097/HM9.0000000000000172
Outline
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Objective:

Breast cancer is the second most prevalent cause of mortality in women and the predominant malignancy type. However, breast cancer treatment faces challenges in managing aromatase inhibitor-induced arthralgia. Aromatase inhibitors have been shown to decrease recurrence risk in hormone receptor-positive cases; however, joint discomfort remains the primary adverse effect. Randomized clinical trials have evaluated the therapeutic outcomes of acupuncture for medication-related musculoskeletal complications. This comprehensive analysis sought to elucidate both the therapeutic efficacy and placebo responses associated with acupuncture intervention.

Methods:

Two reviewers searched for randomized controlled trials (RCTs) in four English (PubMed, Embase, Web of Science, and the Cochrane Library) and four Chinese databases (CNKI, Wanfang Database, VIP, and SinoMed) from their inception to May 31, 2024. Methodological quality was assessed using the Cochrane risk of bias tool. Data were synthesized using random effects models and presented with forest plots.

Results:

Seven trials involving 604 patients were included. The primary outcome and Brief Pain Inventory (BPI) score differed between the acupuncture and control groups (sham acupuncture or usual medication) in three subscales over the course of 6 weeks: worst pain: standardized mean difference (SMD) = -1.18, 95% confidence interval (CI): -1.74, -0.63, P < 0.001; pain-related interference: SMD = -0.87, 95% CI: -1.70, -0.05, P = 0.038; pain severity: SMD = -0.63, 95% CI: -1.22, -0.04, P = 0.036. No severe adverse events were reported in any study.

Conclusions:

This meta-analysis showed that acupuncture is a safe and effective treatment for patients with breast cancer with aromatase inhibitor-induced arthralgia during the course of 6 weeks. Improvements in the blinding method and clarification of the total treatment recommendations and intervals need to be explored further.

Acupuncture  /  Aromatase inhibitor-induced arthralgia  /  Breast cancer  /  Meta-analysis
Zheng Zhu, Xinru Yuan, Yaman Zheng, Baomin Dou, Liang Liu, Pei Yong Loh, Bo Chen, Aoxiang Chen, Peihong Ma, Zelin Chen, Yi Guo. Effectiveness of acupuncture in managing aromatase inhibitor-related arthralgia in breast cancer: a systematic review and meta-analysis[J]. Acupuncture and Herbal Medicine, 2025 , 5 (3) : 352 -365 . DOI: 10.1097/HM9.0000000000000172
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Funding
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  • National Key R&D Program of China(2019YFC1712200-2019YFC1712204)
  • National Natural Science Foundation of China(82004467; 82030125)
  • Youth Project of Traditional Chinese Medicine-Integration of Traditional and Western Medicine Projects of Tianjin Health Commission(2025027)
Appendix
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Year 2025 volume 5 Issue 3
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Article Info
doi: 10.1097/HM9.0000000000000172
  • Receive Date：2025-02-13
  • Online Date：2026-11-04
  • Published：2025-09-25
Article Data
Affiliations
History
  • Received：2025-02-13
  • Accepted：2025-08-25
Funding
National Key R&D Program of China(2019YFC1712200-2019YFC1712204)
National Natural Science Foundation of China(82004467; 82030125)
Youth Project of Traditional Chinese Medicine-Integration of Traditional and Western Medicine Projects of Tianjin Health Commission(2025027)
Affiliations
    1First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
    2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, China
    3Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China
    4School of Acupuncture & Moxibustion and Tuina, Tianjin University of Traditional Chinese Medicine, Tianjin, China
    5Department of Anesthesiology, Rutgers University, the State University of New Jersey, Newark, NJ, United States
    6Developmental Therapeutics Branch, Center for Cancer Research, NCI, Bethesda, MD, United States
    7Inti Health Management School, Inti International University, Negeri Sembilan, Malaysia
    8National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
    9School of Medical Technology; Tianjin University of Traditional Chinese Medicine, Tianjin, China

Corresponding:

* Bo Chen, E-mail: ;
Yi Guo, E-mail: .
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表12种不同金属材料的力学参数
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Number of
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Number of
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Percentage of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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