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评估经皮穴位电刺激联合阿片类药物治疗中重度癌痛的镇痛效果及优势:一项随机对照试验的研究方案

Evaluating the analgesic effect and advantage of transcutaneous electrical acupoint stimulation combined with opioid drugs for moderate to severe cancer-related pain: a study protocol for a randomized controlled trial.

作者信息

Liang Yi, Bao Guanai, Gong Liyan, Zhou Jie, Kong Xiangming, Ran Ran, Shao Xiaomei, Jiang Yongliang, Zhang Weiping, Liu Boyi, Du Junying, Fang Junfan, Nie Na, Ji Conghua, Fang Jianqiao

机构信息

Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, No. 219 Moganshan Road, XiHu District, Hangzhou, 310005, Zhejiang Province, China.

The Third Clinical Medical College of Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, 310053, Zhejiang Province, China.

出版信息

Trials. 2019 Jan 11;20(1):40. doi: 10.1186/s13063-018-3145-y.

Abstract

BACKGROUND

Transcutaneous electrical acupoint stimulation (TEAS), which is also known as acupuncture-like transcutaneous electrical nerve stimulation (TENS), has been widely used in acute or chronic pain. However, previous research has not demonstrated that TEAS is effective for cancer-related pain. Opioid drugs are strongly recommended for treating cancer-related pain, but opioid-induced immunosuppression is still the most intractable drug-induced medical problem. Evaluating the efficacy and potential advantage of TEAS combined with opioid drugs in moderate and severe cancer-related pain in China is important because such studies are lacking.

METHODS/DESIGN: This trial is a multicenter, prospective randomized controlled clinical trial. In total, 160 patients who were enrolled from two hospitals in the Zhejiang Province (China) will be randomly allocated into two groups: a TEAS group and sham TEAS group without acupoint electrical stimulation. Both groups will receive a 21-day interval of chemotherapy and conventional cancer pain therapy. Fifteen treatment sessions will be performed over a three-week period. The primary outcomes will be measured by changes in the Numerical Rating Scale (NRS) scores and equivalent dosage of morphine at baseline, three weeks of treatment and one two-week follow-up. The secondary outcome measures include cellular immunity function, life quality assessment, opioids side effects assessment, and safety and compliance evaluation.

DISCUSSION

This trial is expected to clarify whether TEAS is effective for cancer-related pain. These results demonstrate the advantage of TEAS combined with opioid drugs on improving immune function and decreasing opioid induced side effects.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR-13003803 . Registered on 27 August 2013.

摘要

背景

经皮穴位电刺激(TEAS),也被称为类针刺经皮电神经刺激(TENS),已广泛应用于急慢性疼痛。然而,以往研究尚未证实TEAS对癌症相关疼痛有效。强烈推荐使用阿片类药物治疗癌症相关疼痛,但阿片类药物引起的免疫抑制仍是最棘手的药物所致医学问题。在中国评估TEAS联合阿片类药物治疗中度和重度癌症相关疼痛的疗效和潜在优势很重要,因为此类研究尚缺。

方法/设计:本试验为多中心、前瞻性随机对照临床试验。总共160例从中国浙江省两家医院招募的患者将被随机分为两组:TEAS组和无穴位电刺激的假TEAS组。两组均接受为期21天的化疗和常规癌症疼痛治疗。在三周内进行15次治疗。主要结局将通过基线、治疗三周和两周随访时数字评分量表(NRS)评分变化和吗啡等效剂量来衡量。次要结局指标包括细胞免疫功能、生活质量评估、阿片类药物副作用评估以及安全性和依从性评估。

讨论

本试验有望阐明TEAS对癌症相关疼痛是否有效。这些结果将证明TEAS联合阿片类药物在改善免疫功能和减少阿片类药物所致副作用方面的优势。

试验注册

中国临床试验注册中心,ChiCTR-13003803。于2013年8月27日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2b4/6329064/e930653e736c/13063_2018_3145_Fig1_HTML.jpg

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