针刺治疗颈清扫术后疼痛和功能障碍:一项随机对照试验的结果。
Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial.
机构信息
Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
出版信息
J Clin Oncol. 2010 May 20;28(15):2565-70. doi: 10.1200/JCO.2009.26.9860. Epub 2010 Apr 20.
PURPOSE
To determine whether acupuncture reduces pain and dysfunction in patients with cancer with a history of neck dissection. The secondary objective is to determine whether acupuncture relieves dry mouth in this population.
PATIENTS AND METHODS
Patients at a tertiary cancer center with chronic pain or dysfunction attributed to neck dissection were randomly assigned to weekly acupuncture versus usual care (eg, physical therapy, analgesia, and/or anti-inflammatory drugs, per patient preference or physician recommendation) for 4 weeks. The Constant-Murley score, a composite measure of pain, function, and activities of daily living, was the primary outcome measure. Xerostomia, a secondary end point, was assessed using the Xerostomia Inventory.
RESULTS
Fifty-eight evaluable patients were accrued and randomly assigned from 2004 to 2007 (28 and 30 patients on acupuncture and control arms, respectively). Constant-Murley scores improved more in the acupuncture group (adjusted difference between groups = 11.2; 95% CI, 3.0 to 19.3; P = .008). Acupuncture produced greater improvement in reported xerostomia (adjusted difference in Xerostomia Inventory = -5.8; 95% CI, -0.9 to -10.7; P = .02).
CONCLUSION
Significant reductions in pain, dysfunction, and xerostomia were observed in patients receiving acupuncture versus usual care. Although further study is needed, these data support the potential role of acupuncture in addressing post-neck dissection pain and dysfunction, as well as xerostomia.
目的
确定针灸是否能减轻有颈部清扫术史的癌症患者的疼痛和功能障碍。次要目标是确定针灸是否能缓解该人群的口干。
患者和方法
在一家三级癌症中心,患有慢性疼痛或功能障碍归因于颈部清扫术的患者被随机分配接受每周一次的针灸治疗或常规护理(例如,物理治疗、止痛、和/或抗炎药,根据患者的偏好或医生的建议),为期 4 周。恒常-默雷评分(一种综合衡量疼痛、功能和日常生活活动的指标)是主要的疗效评估指标。口干作为次要终点,使用口干量表进行评估。
结果
2004 年至 2007 年期间共纳入并随机分配了 58 名可评估的患者(针灸组和对照组分别为 28 名和 30 名患者)。针灸组的恒常-默雷评分改善更多(组间调整差异=11.2;95%置信区间,3.0 至 19.3;P=0.008)。针灸在报告的口干方面产生了更大的改善(口干量表的调整差异=-5.8;95%置信区间,-0.9 至-10.7;P=0.02)。
结论
与常规护理相比,接受针灸治疗的患者疼痛、功能障碍和口干显著减轻。尽管还需要进一步的研究,但这些数据支持针灸在解决颈部清扫术后疼痛和功能障碍以及口干方面的潜在作用。