Author Affiliations: Department of Psychology, Mount Mercy University (Dr Lee and Ms Louison), Cedar Rapids, Iowa; College of Nursing, The University of Iowa (Drs Lee and Perkhounkova and Ms Sleeuwenhoek), Iowa City; and Radiation Oncology, The University of Iowa Hospitals and Clinics (Dr Anderson), Iowa City.
Cancer Nurs. 2019 May/Jun;42(3):218-228. doi: 10.1097/NCC.0000000000000594.
Individuals receiving radiation for head and neck cancer (HNC) often develop painful oral mucositis that impairs function, possibly leading to feeding tubes, hospitalization, and treatment delays. Although pharmacologic medications provide some relief, many report inadequate analgesia and adverse effects. Transcutaneous electrical nerve stimulation (TENS) is a safe, nonpharmacologic intervention; it decreases pain and analgesics and improves function, yet no studies examined TENS for HNC.
The aim of this study was to examine the efficacy of TENS for pain and function in HNC patients.
This study used a randomized, double-blinded crossover design; participants received 3 TENS treatments during weeks 4 to 6 of radiation: active, placebo, and no TENS over the temporomandibular joint and upper cervical region. Pain (McGill Pain Questionnaire, visual analog scale [VAS] resting and function), function (mouth opening, tongue movement, speaking), fatigue (VAS), and treatment effectiveness (VAS) were assessed before and after TENS at 3 visits.
Resting pain (McGill Pain Questionnaire and VAS) decreased significantly more after active TENS than placebo or no TENS; changes in function and pain with function did not differ between conditions. Active TENS decreased fatigue significantly more than no TENS and was rated as more effective than placebo TENS.
Transcutaneous electrical nerve stimulation improves pain in HNC patients receiving radiation but not function or pain with function relative to placebo or no TENS.
Transcutaneous electrical nerve stimulation may be a viable tool for radiation-induced HNC pain to complement pharmacologic approaches. This nonpharmacologic intervention could decrease the debilitating effects of radiation and analgesics, and improve quality of life. Clinical trials should examine the effects and safety of repeated, daily TENS in HNC patients receiving radiation.
接受头颈部癌症（HNC）放射治疗的个体常发生疼痛性口腔黏膜炎，从而损害功能，可能导致需要喂养管、住院和治疗延迟。尽管药物治疗提供了一定程度的缓解，但许多人报告说镇痛效果不足和存在不良反应。经皮神经电刺激（TENS）是一种安全的非药物干预措施；它可以减轻疼痛和镇痛药，并改善功能，但尚无研究检查 TENS 对头颈部癌症的作用。
本研究旨在检查 TENS 对头颈部癌症患者疼痛和功能的疗效。
本研究采用随机、双盲交叉设计；参与者在放射治疗的第 4 至 6 周期间接受 3 次 TENS 治疗：在颞下颌关节和上颈部区域接受主动、安慰剂和无 TENS 治疗。在 3 次就诊时，在 TENS 治疗前和治疗后评估疼痛（麦吉尔疼痛问卷、视觉模拟量表[VAS]静息和功能）、功能（张口、舌运动、说话）、疲劳（VAS）和治疗效果（VAS）。
与安慰剂或无 TENS 相比，主动 TENS 治疗后静息疼痛（麦吉尔疼痛问卷和 VAS）显著减轻；功能和疼痛与功能的变化在不同条件之间没有差异。与无 TENS 相比，主动 TENS 显著降低疲劳，且被评为比安慰剂 TENS 更有效。
经皮神经电刺激可改善接受放射治疗的头颈部癌症患者的疼痛，但与安慰剂或无 TENS 相比，对功能或疼痛与功能无影响。
经皮神经电刺激可能是一种可行的工具，可用于补充药物治疗方法，减轻头颈部癌症放射治疗引起的疼痛。这种非药物干预可以减少放射治疗和镇痛药的致残影响，提高生活质量。应在接受放射治疗的头颈部癌症患者中进行临床试验，以检查重复、每日 TENS 的效果和安全性。
