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耳针治疗癌痛的镇痛效果:一项随机、双盲、对照试验。

Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial.

作者信息

Alimi David, Rubino Carole, Pichard-Léandri Evelyne, Fermand-Brulé Sabine, Dubreuil-Lemaire Marie-Laure, Hill Catherine

机构信息

Pain Management Unit, INSERM, U521, Villejuif, France.

出版信息

J Clin Oncol. 2003 Nov 15;21(22):4120-6. doi: 10.1200/JCO.2003.09.011.

Abstract

PURPOSE

During the last 30 years, auricular acupuncture has been used as complementary treatment of cancer pain when analgesic drugs do not suffice. The purpose of this study is to examine the efficacy of auricular acupuncture in decreasing pain intensity in cancer patients.

PATIENTS AND METHODS

Ninety patients were randomly divided in three groups; one group received two courses of auricular acupuncture at points where an electrodermal signal had been detected, and two placebo groups received auricular acupuncture at points with no electrodermal signal (placebo points) and one with auricular seeds fixed at placebo points. Patients had to be in pain, attaining a visual analog score (VAS) of 30 mm or more after having received analgesic treatment adapted to both intensity and type of pain, for at least 1 month of therapy. Treatment efficacy was based on the absolute decrease in pain intensity measured 2 months after randomization using the VAS.

RESULTS

The main outcome was pain assessed at 2 months, with the assessment at 1 month carried over to 2 months for the eight patients who interrupted treatment after 1 month. For three patients, no data were available because they withdrew from the study during the first month. Pain intensity decreased by 36% at 2 months from baseline in the group receiving acupuncture; there was little change for patients receiving placebo (2%). The difference between groups was statistically significant (P <.0001).

CONCLUSION

The observed reduction in pain intensity measured on the VAS represents a clear benefit from auricular acupuncture for these cancer patients who are in pain, despite stable analgesic treatment.

摘要

目的

在过去30年中,耳针疗法已被用作镇痛药不足以缓解癌症疼痛时的辅助治疗方法。本研究的目的是检验耳针疗法在降低癌症患者疼痛强度方面的疗效。

患者与方法

90名患者被随机分为三组;一组在检测到皮电信号的穴位接受两个疗程的耳针治疗,两个安慰剂组分别在无皮电信号的穴位(安慰剂穴位)接受耳针治疗,其中一组还在安慰剂穴位固定耳穴籽。患者必须处于疼痛状态,在接受根据疼痛强度和类型调整的镇痛治疗至少1个月后,视觉模拟评分(VAS)达到30毫米或更高。治疗效果基于随机分组2个月后使用VAS测量的疼痛强度的绝对降低值。

结果

主要观察指标是在2个月时评估的疼痛情况,对于1个月后中断治疗的8名患者,将1个月时的评估结果延续至2个月。有3名患者没有可用数据,因为他们在第一个月退出了研究。接受针刺治疗的组在2个月时疼痛强度较基线下降了36%;接受安慰剂治疗的患者变化不大(2%)。组间差异具有统计学意义(P<.0001)。

结论

尽管进行了稳定的镇痛治疗,但在这些疼痛的癌症患者中,观察到的VAS测量的疼痛强度降低表明耳针疗法带来了明显益处。

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