Department of Nursing, Chang Gung University of Science and Technology, Taiwan School of Nursing, Hung Kuang University, Taiwan College of Nursing, University of Illinois at Chicago, Chicago, IL, USA Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA Psychosocial & Community Health Systems, University of Washington, Seattle, WA, USA Department of Nursing, Chang Gung Memorial Hospital, Taiwan Administration Center of Medical Research Department, Chang Gung Memorial Hospital, Taiwan.
Pain. 2011 Oct;152(10):2432-2442. doi: 10.1016/j.pain.2011.06.021. Epub 2011 Jul 29.
To date, patients with bony metastases were only a small fraction of the samples studied, or they were entirely excluded. Patients with metastatic cancers, such as bone metastases, are more likely to report pain, compared to patients without metastatic cancer (50-74% and 15%, respectively). Their cancer pain results in substantial morbidity and disrupted quality of life in 34-45% of cancer patients. Massage therapy (MT) appears to have positive effects in patients with cancer; however, the benefits of MT, specifically in patients with metastatic bone pain, remains unknown. The purpose of this randomized clinical trial was to compare the efficacy of MT to a social attention control condition on pain intensity, mood status, muscle relaxation, and sleep quality in a sample (n=72) of Taiwanese cancer patients with bone metastases. In this investigation, MT was shown to have beneficial within- or between-subjects effects on pain, mood, muscle relaxation, and sleep quality. Results from repeated-measures analysis of covariance demonstrated that massage resulted in a linear trend of improvements in mood and relaxation over time. More importantly, the reduction in pain with massage was both statistically and clinically significant, and the massage-related effects on relaxation were sustained for at least 16-18 hours postintervention. Furthermore, massage-related effects on sleep were associated with within-subjects effects. Future studies are suggested with increased sample sizes, a longer interventional period duration, and an objective and sensitive measure of sleep. Overall, results from this study support employing MT as an adjuvant to other therapies in improving bone pain management.
迄今为止，只有一小部分研究样本（或完全排除）包含有骨转移的患者。与没有转移性癌症的患者相比，患有转移性癌症（如骨转移）的患者更有可能报告疼痛（分别为 50-74%和 15%）。转移性癌症患者的癌症疼痛会导致大量发病率，并在 34-45%的癌症患者中扰乱生活质量。按摩疗法（MT）似乎对癌症患者有积极影响；然而，MT 的益处，特别是在患有转移性骨痛的患者中的益处，尚不清楚。本随机临床试验的目的是比较按摩疗法与社会关注对照组在 72 名台湾骨转移癌症患者的疼痛强度、情绪状态、肌肉放松和睡眠质量方面的疗效。在这项研究中，按摩疗法显示出对疼痛、情绪、肌肉放松和睡眠质量具有有益的组内或组间效果。重复测量协方差分析的结果表明，按摩在情绪和放松方面随着时间的推移呈现出线性改善趋势。更重要的是，按摩对疼痛的缓解具有统计学和临床意义，并且按摩对放松的影响至少持续 16-18 小时。此外，按摩对睡眠的影响与组内效应有关。建议进行更多样本量、更长干预期持续时间以及客观和敏感的睡眠测量的未来研究。总的来说，这项研究的结果支持将 MT 作为其他治疗方法的辅助手段，以改善骨痛管理。
