Kim Kyungsuk, Lee Sanghun
1 Department of Medical Consilience, Graduate school, Dankook University, Yongin-si, Republic of Korea.
Integr Cancer Ther. 2018 Dec;17(4):1137-1143. doi: 10.1177/1534735418786797. Epub 2018 Jul 16.
Ninety percent of patients with advanced cancer have moderate to severe pain, and up to 70% of patients with cancer pain do not receive adequate pain relief. This randomized controlled clinical trial was designed to determine the feasibility and evaluate the effects and safety of intradermal acupuncture (IA) in patients who were being administered analgesics for cancer pain.
Advanced cancer patients experiencing pain were randomly assigned to IA or sham IA treatment for 3 weeks (15 patients for each group), wherein the CV12, bilateral ST25, LI4, LR3, PC06, and Ashi points were selected and stimulated. Follow-up evaluations were conducted 3 weeks after the end of treatments. The grade and dosage of analgesics for cancer pain, pain intensity, quality of life, and safety were assessed.
Twenty-seven patients (90%) completed 6-week trial, and no serious adverse events were associated with either IA or sham IA procedures except the transient side effect such as fatigue. Nine patients in the IA group (64.3%) and 5 in the sham IA group (38.5%) responded to the 3-week intervention. These patients were mostly in the nonopioid and the weak opioid levels of the World Health Organization analgesic ladder. Self-reported pain declined by -1.54 ± 1.45 and -1.15 ± 1.57 in the IA and sham IA groups, respectively, with improved quality of life reported.
IA treatment appears feasible and safe for advanced cancer patients. It might reduce analgesic usage in the early World Health Organization analgesic ladder stage cancer patient, though it could not show significant outcome differences due to design limitation of sham IA.
90%的晚期癌症患者有中度至重度疼痛,高达70%的癌症疼痛患者未得到充分的疼痛缓解。本随机对照临床试验旨在确定皮内针刺(IA)在接受癌症疼痛镇痛治疗患者中的可行性,并评估其效果和安全性。
将经历疼痛的晚期癌症患者随机分配至IA或假IA治疗组,为期3周(每组15例患者),其中选取并刺激中脘(CV12)、双侧天枢(ST25)、合谷(LI4)、太冲(LR3)、内关(PC06)和阿是穴。在治疗结束3周后进行随访评估。评估癌症疼痛镇痛药物的分级和剂量、疼痛强度、生活质量和安全性。
27例患者(90%)完成了为期6周的试验,除疲劳等短暂副作用外,IA或假IA操作均未出现严重不良事件。IA组9例患者(64.3%)和假IA组5例患者(38.5%)对3周干预有反应。这些患者大多处于世界卫生组织镇痛阶梯的非阿片类和弱阿片类水平。IA组和假IA组患者自我报告的疼痛分别下降了-1.54±1.45和-1.15±1.57,生活质量有所改善。
IA治疗对晚期癌症患者似乎可行且安全。它可能会减少处于世界卫生组织镇痛阶梯早期阶段癌症患者的镇痛药物使用量,不过由于假IA设计的局限性,未能显示出显著的结果差异。