Yeh Chao Hsing, Lukkahatai Nada, Campbell Claudia, Sair Haris, Zhang Fengzhi, Mensah Sylvanus, Garry Courtney, Zeng Jing, Chen Changying, Pinedo Mariela, Khoshnoodi Mohammad, Perrin Nancy, Smith Thomas J, Saligan Leorey N
Johns Hopkins University School of Nursing, Baltimore, Maryland.
Johns Hopkins University School of Nursing, Baltimore, Maryland.
Pain Manag Nurs. 2019 Dec;20(6):623-632. doi: 10.1016/j.pmn.2019.04.004. Epub 2019 Jun 14.
PURPOSE: To manage chemotherapy-induced neuropathy (CIN), this paper explores reliable and valid objectives measures to evaluate the treatment effects of auricular point acupressure (APA). DESIGN/METHOD: This study was a repeated-measures one-group design. Participants received four weeks of APA to manage their CIN. The laboratory-assessed and objective outcomes included quantitative sensory testing, grip and pinch strength, and inflammatory biomarkers. Wilcoxon matched pairs signed-rank tests were conducted to determine change scores of outcomes at pre- vs. post- and pre- vs. 1-month follow-up. Spearman's rho correlation coefficient was used to examine the linear association of score changes of all objective study outcomes. RESULTS: Comparing pre-and-post APA, (1) the mean score of the monofilament for all lower extremity sites tested decreased after APA, indicating sensory improvement; (2) the suprathreshold pinprick stimuli mean scores on the upper extremities increased, except the scores from the index finger and thumb; (3) the pain tolerance of thumb and trapezius areas increased; (4) decreasing IL1β (p = .05), IFNγ (p = .02), IL-2 (p = .03), IL-6 (p = .05), IL-10 (p = .05), and IP10/CXCL10 (p = .04) were observed pre-post APA. Conditional pain modulation was significantly (p< .05) associated with pain intensity (r = 0.55), tingling (r = 0.59); and IL1β concentration (r = 0.53) pre-post APA. The sustained effects of 4-week APA were observed at the 1-month follow-up. CONCLUSIONS: Our study findings demonstrated the promising effectiveness of APA in the management of CIN, and these treatment effects can be assessed using reliable and valid objective measures. CLINICAL IMPLICATIONS: If the efficacy of APA to manage CIN is confirmed in a larger sample, APA has the potential to be a scalable treatment for CIN because it is a reproducible, standardized, and easy-to-perform intervention.
目的:为了管理化疗引起的神经病变(CIN),本文探索可靠且有效的客观指标来评估耳穴按压(APA)的治疗效果。 设计/方法:本研究为重复测量单组设计。参与者接受为期四周的APA以管理其CIN。实验室评估的客观结果包括定量感觉测试、握力和捏力,以及炎症生物标志物。采用Wilcoxon配对符号秩检验来确定治疗前后以及治疗前与1个月随访时结果的变化分数。使用Spearman等级相关系数来检验所有客观研究结果分数变化的线性关联。 结果:比较APA治疗前后,(1)所有测试下肢部位的单丝平均得分在APA治疗后降低,表明感觉改善;(2)上肢超阈值针刺刺激平均得分增加,但食指和拇指得分除外;(3)拇指和斜方肌区域的疼痛耐受性增加;(4)观察到治疗前后白细胞介素1β(IL1β,p = 0.05)、干扰素γ(IFNγ,p = 0.02)、白细胞介素2(IL - 2,p = 0.03)、白细胞介素6(IL - 6,p = 0.05)、白细胞介素10(IL - 10,p = 0.05)和IP10/CXCL10(p = 0.04)降低。条件性疼痛调制与治疗前后的疼痛强度(r = 0.55)、刺痛感(r = 0.59)以及IL1β浓度(r = 0.53)显著相关(p < 0.05)。在1个月随访时观察到为期4周的APA的持续效果。 结论:我们的研究结果证明了APA在管理CIN方面具有有前景的疗效,并且这些治疗效果可以使用可靠且有效的客观指标进行评估。 临床意义:如果在更大样本中证实APA管理CIN的疗效,APA有可能成为CIN的一种可扩展治疗方法,因为它是一种可重复、标准化且易于实施的干预措施。
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