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针灸用于癌症治疗相关血小板减少症患者的安全性

The Safety of Acupuncture in Patients with Cancer Therapy-Related Thrombocytopenia.

作者信息

Cybularz Paul A, Brothers Karen, Singh Gurneet M, Feingold Jennifer L, Lewis Mark E, Niesley Michelle L

机构信息

Cancer Treatment Centers of America at Eastern Regional Medical Center , Philadelphia, PA.

出版信息

Med Acupunct. 2015 Jun 1;27(3):224-229. doi: 10.1089/acu.2015.1099.

Abstract

Acceptance of acupuncture as an efficacious integrative modality for oncology-related side-effect management is rapidly expanding. It is imperative that guidelines regarding safe treatment supported by clinical experience are established. Oncology patients frequently experience thrombocytopenia as a side-effect of chemotherapy or radiation. However, safety data for acupuncture in adult patients with cancer who are thrombocytopenic is lacking. The medical records of 684 patients who received acupuncture treatments in an established acupuncture program at a private cancer treatment hospital were reviewed for adverse events occurring within the context of thrombocytopenia. Of 2135 visits eligible for evaluation, 98 individual acupuncture visits occurred in patients with platelet counts <100,000/μL, including nine visits in which platelet counts were <50,000/μL. No adverse events of increased bruising or bleeding were noted. Medications and nutritional supplements or botanicals that may influence coagulation were also tabulated, with no apparent adverse events in this patient population. Discrepancies in the literature highlight the need to create cohesive safety guidelines backed by clinical research, specifically for groups at higher risk for adverse events. The preliminary evidence put forth in this study lays the foundation that supports the notion that acupuncture can be used safely with a high-need oncology population within an integrated model of care. In this descriptive retrospective case series of adult oncology patients with thrombocytopenia, no adverse events of increased bruising or bleeding were documented. Prospective trials are needed to confirm these initial observations.

摘要

针灸作为一种治疗肿瘤相关副作用的有效综合疗法,其认可度正在迅速扩大。制定基于临床经验的安全治疗指南势在必行。肿瘤患者经常会因化疗或放疗出现血小板减少的副作用。然而,目前缺乏针对血小板减少的成年癌症患者进行针灸治疗的安全性数据。我们回顾了一家私立癌症治疗医院既定针灸项目中684例接受针灸治疗患者的病历,以查找在血小板减少情况下发生的不良事件。在2135次符合评估条件的就诊中,血小板计数<100,000/μL的患者进行了98次单独的针灸就诊,其中9次就诊时血小板计数<50,000/μL。未发现有瘀伤或出血增加的不良事件。还列出了可能影响凝血的药物、营养补充剂或植物药,该患者群体中未出现明显不良事件。文献中的差异凸显了制定以临床研究为依据的统一安全指南的必要性,特别是针对不良事件风险较高的群体。本研究提出的初步证据为以下观点奠定了基础,即针灸可以在综合护理模式下安全地用于高需求的肿瘤患者群体。在这个关于血小板减少的成年肿瘤患者的描述性回顾性病例系列中,未记录到瘀伤或出血增加的不良事件。需要进行前瞻性试验来证实这些初步观察结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cb26/4491150/9b660ac914f9/fig-1.jpg

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