背景　癌因性疲憊為全球癌症患者苦惱且常見症狀，在臺灣有高達92%癌症患者受到癌因性疲憊困擾。美國國家癌症資訊網建議癌因性疲憊應以非藥物治療為首選，其中亞洲常見的穴位刺激療法已有多篇文獻證實可有效緩解癌因性疲憊，穴位刺激在臺灣亦為常見的傳統中醫療法。穴位刺激意指透過不同種方式刺激身體穴位點，如：針灸（acupuncture）、穴位指壓（acupressure）、艾灸（moxibustion）、電針灸（electric acupuncture）等方式。然而，目前國內、外仍少有探討穴位刺激緩解癌因性疲憊效果之統合分析研究。
研究目的　（1）比較不同種穴位刺激方式緩解癌因性疲憊效果排名；（2）了解穴位刺激方式應用於緩解癌因性疲憊之不同癌別、治療階段效果；（3）了解特定穴位刺激方式之不同施做者、操作時間、頻次應用於緩解癌因性疲憊效果。
研究方法　本研究採用搜尋資料庫包含華藝線上圖書館、Cochrane Library、Embase、CINAHL、MEDLINE、Web of Science，依循PRISMA 2020進行文章篩選，並以RoB 2.0進行文獻品質評估。納入文獻以CINeMA軟體評估整體文獻可信度，並使用Stata 14.2版軟體進行網絡統合分析、RevMan 5.4進行次群組分析。研究過程遵循PRISMA-NMA流程以確保研究嚴謹性。
研究結果　本研究共納入26篇隨機對照研究文獻，研究對象共2128位。經網絡統合分析與常規護理組相比，各組效果量排名第一為針灸SMD＝1.25（95%CI 0.71, 1.80），其次為穴位指壓組SMD＝1.18（95%CI 0.43, 1.93）。次群組分析中，不同癌別分組（SMD= -1.72至-0.78），p＝.35；已完成治療組（SMD＝-0.72）及進行治療中組（SMD＝-0.72），p＝.31；穴位指壓之自行操作組（SMD＝-0.8）及專業操作組（SMD＝-0.72），p＝.54，顯示無顯著差異。穴位指壓操作時間以3分鐘/次（SMD＝-0.77，權重71%）及每日一次（SMD＝-0.74，權重61.1%）結果較佳。
結論與實務應用　由研究結果得知穴位刺激方式應用於緩解癌因性疲憊排名由大至小為：針灸、穴位指壓、放鬆指壓、經皮穴位電刺激、無效穴位組、按摩油指壓、艾灸、常規護理。正在接受治療患者採用穴位刺激亦可達緩解疲憊效果，並建議選擇非侵入性穴位刺激方式。穴位指壓建議操作頻次為3分鐘/次、每日1次。藉此結果，期望提供臨床端更多癌因性疲憊患者照護處置上具體衛教建議，鼓勵癌症患者開發多元癌因性疲憊處置選擇。

This is a network meta-analysis (NMA) study to compare the effect size of different types of acupoint stimulation in reducing CRF, and to explore the specific acupoint stimulation applied to CRF of cancer type, treatment stage, interventionist, operation time, and frequency. The search database included Airiti Library, Cochrane Library, Embase, CINAHL, MEDLINE and Web of Science. RoB 2.0 were used as appraisal tools. Confidence in Network Meta-Analysis (CINeMA) web application was used to rate confidence in synthetic evidence. The statistical analyses were performed using Stata v14.2. A total of 26 studies comprising 2128 participants were included in the analysis. The NMA results showed that acupuncture (SMD ＝1.25, 95%CI 0.71, 1.80) and acupressure (SMD ＝ 1.18, 95%CI 0.43, 1.93) were ranked first and second, better than usual care. In subgroup analysis, there was no significant difference in the effect of reducing cancer-related fatigue among different cancer types or cancer treatment stages. Acupressure operation time is suggested once a day for 3 minutes.

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