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针灸在治疗肺癌患者症状中的潜在作用:一项观察性纵向研究。

The potential role for acupuncture in treating symptoms in patients with lung cancer: an observational longitudinal study.

机构信息

Peter Brojde Lung Cancer Centre, Montreal, QC. ; Jewish General Hospital, Montreal, QC.

出版信息

Curr Oncol. 2013 Jun;20(3):152-7. doi: 10.3747/co.20.1312.

Abstract

BACKGROUND

Most lung cancer patients experience multiple symptoms related either to the disease or its treatment. The commonly reported symptoms are pain, depression, anxiety, nausea, and poor well-being. The aim of the present study was to evaluate the effect of acupuncture as a potential treatment modality in symptomatic lung cancer patients.

METHODS

This prospective observational study enrolled 33 lung cancer patients from the Peter Brojde Lung Cancer Centre between August 2010 and May 2012. All patients received 45-minute sessions of acupuncture, 1-2 times weekly for a minimum of 4 sessions. Symptom severity was assessed using the Edmonton Symptom Assessment System (esas) before and after completion of acupuncture.

RESULTS

The study cohort included 30 patients with non-small- cell lung cancer and 3 with small-cell lung cancer. Mean age was 62 years (range: 36-88 years); 17 of the patients were women. Most of the patients had advanced-stage cancer (73%) and good performance status (Eastern Cooperative Oncology Group 0-1: 88%). Of these patients, 67% received anticancer treatment (chemotherapy or radiotherapy, or both) with acupuncture. Of the remaining 10 patients, 8 received acupuncture after a complete surgical resection of their tumour, and because of their advanced age, 2 received acupuncture and best supportive care. The median number of acupuncture sessions was 7 (interquartile range: 4-13 sessions). Statistically significant improvements in pain, appetite, nausea, nervousness, and well-being were observed. A clinically important improvement (2 points on the esas) was reported by 61% of patients for pain and by 33% for well-being. A significant positive correlation between improved well-being and the number of acupuncture sessions was observed. This correlation remained significant even after controlling for treatment and narcotic use. Receiver operating characteristic analysis demonstrated that a minimum of 6 acupuncture sessions are required for a 70% chance of a clinically important improvement in well-being.

CONCLUSIONS

The present study is the first to demonstrate that acupuncture may be an effective approach for improving symptoms-in particular, pain and well-being-in lung cancer patients. Acupuncture is a safe and minimally invasive procedure, and it is potentially useful even in patients undergoing anticancer treatment.

摘要

背景

大多数肺癌患者会经历与疾病或其治疗相关的多种症状。常见的症状有疼痛、抑郁、焦虑、恶心和身体不适。本研究的目的是评估针灸作为一种有潜力的治疗方法,对有症状的肺癌患者的影响。

方法

本前瞻性观察性研究纳入了 2010 年 8 月至 2012 年 5 月期间彼得·布罗杰德肺癌中心的 33 例肺癌患者。所有患者均接受 45 分钟的针灸治疗,每周 1-2 次,至少 4 次。在完成针灸治疗前后,使用埃德蒙顿症状评估系统(esas)评估症状严重程度。

结果

研究队列包括 30 例非小细胞肺癌患者和 3 例小细胞肺癌患者。平均年龄为 62 岁(范围:36-88 岁);17 例为女性。大多数患者处于晚期癌症(73%)和良好的体能状态(东部肿瘤协作组 0-1:88%)。这些患者中,67%接受了抗癌治疗(化疗或放疗,或两者兼有)和针灸。其余 10 例患者中,8 例在肿瘤完全切除后接受了针灸治疗,由于年龄较大,2 例接受了针灸和最佳支持治疗。针灸治疗的中位数为 7 次(四分位距:4-13 次)。疼痛、食欲、恶心、紧张和身体舒适度方面均有显著改善。61%的患者报告疼痛有显著改善(esas 评分增加 2 分),33%的患者报告身体舒适度有显著改善。改善后的身体舒适度与针灸治疗次数之间存在显著的正相关关系。即使在控制了治疗和使用阿片类药物的情况下,这种相关性仍然显著。受试者工作特征曲线分析显示,至少需要 6 次针灸治疗,才能有 70%的机会使身体舒适度有显著改善。

结论

本研究首次表明,针灸可能是改善肺癌患者症状的有效方法,特别是疼痛和身体舒适度。针灸是一种安全且微创的治疗方法,即使在接受抗癌治疗的患者中也可能有用。

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