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电针三叉神经刺激联合体针治疗乳腺癌患者化疗引起的认知障碍:一项评估者参与、随机对照试验。

Electroacupuncture trigeminal nerve stimulation plus body acupuncture for chemotherapy-induced cognitive impairment in breast cancer patients: An assessor-participant blinded, randomized controlled trial.

机构信息

Department of Chinese Medicine, The University of Hong Kong Shenzhen Hospital (HKU-SZH), Shenzhen, Guangdong 518053, China; School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China.

出版信息

Brain Behav Immun. 2020 Aug;88:88-96. doi: 10.1016/j.bbi.2020.04.035. Epub 2020 Apr 16.

Abstract

Chemotherapy causes various side effects, including cognitive impairment, known as 'chemobrain'. In this study, we determined whether a novel acupuncture mode called electroacupuncture trigeminal nerve stimulation plus body acupuncture (EA/TNS + BA) could produce better outcomes than minimum acupuncture stimulation (MAS) as controls in treating chemobrain and other symptoms in breast cancer patients. In this assessor- and participant-blinded, randomized controlled trial, 93 breast cancer patients under or post chemotherapy were randomly assigned to EA/TNS + BA (n = 46) and MAS (n = 47) for 2 sessions per week over 8 weeks. The Montreal Cognitive Assessment (MoCA) served as the primary outcome. Digit span test was the secondary outcomes for attentional function and working memory. The quality of life and multiple functional assessments were also evaluated. EA/TNS + BA treated group had much better performance than MAS-treated group on reverse digit span test at Week 2 and Week 8, with medium effect sizes of 0.53 and 0.48, respectively, although no significant differences were observed in MoCA score and prevalence of chemobrain between the two groups. EA/TNS + BA also markedly reduced incidences of diarrhoea, poor appetite, headache, anxiety, and irritation, and improved social/family and emotional wellbeing compared to MAS. These results suggest that EA/TNS + BA may have particular benefits in reducing chemotherapy-induced working memory impairment and the incidence of certain digestive, neurological, and distress-related symptoms. It could serve as an effective intervention for breast cancer patients under and post chemotherapy (trial registration: https://www.clinicaltrials.gov: NCT02457039).

摘要

化疗会引起各种副作用,包括认知障碍,即“化疗脑”。在这项研究中,我们确定了一种新的针刺模式,即电刺激三叉神经加体针(EA/TNS+BA),是否比最小针刺刺激(MAS)作为对照更能治疗乳腺癌患者的化疗脑和其他症状。在这项评估者和参与者双盲、随机对照试验中,93 名接受或接受化疗后的乳腺癌患者被随机分为 EA/TNS+BA(n=46)和 MAS(n=47)组,每周接受 2 次治疗,共 8 周。蒙特利尔认知评估(MoCA)作为主要结局。数字跨度测试是注意力功能和工作记忆的次要结局。生活质量和多项功能评估也进行了评估。在第 2 周和第 8 周,EA/TNS+BA 治疗组在反向数字跨度测试中的表现明显优于 MAS 治疗组,分别具有 0.53 和 0.48 的中等效应大小,尽管两组之间 MoCA 评分和化疗脑的发生率没有显著差异。与 MAS 相比,EA/TNS+BA 还显著降低了腹泻、食欲不振、头痛、焦虑和烦躁的发生率,并改善了社会/家庭和情绪健康。这些结果表明,EA/TNS+BA 可能在减轻化疗引起的工作记忆障碍和某些消化、神经和相关症状的发生率方面具有特殊益处。它可以作为化疗期间和化疗后的乳腺癌患者的有效干预措施(试验注册:https://www.clinicaltrials.gov:NCT02457039)。

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