Helianthi Dwi Rachma
Department of Medical Acupuncture, Faculty of Medicine Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo, Central Jakarta, Indonesia.
Med Acupunct. 2020 Aug 1;32(4):234-240. doi: 10.1089/acu.2020.1423. Epub 2020 Aug 13.
Pain is one of the most-frightening complications of cancer and disrupts quality of life. Cancer-related pain can be caused by primary cancer itself, metastases that occur, and interventions to treat cancer. Almost all cancer-related pain is pain with moderate-to-severe intensity. Thus, cancer-related pain management often involves administration of opioid analgesics. However, administration of opioid analgesics can cause side-effects that cause new problems for these patients. Several studies have shown that acupuncture can reduce cancer-related pain and data show that acupuncture therapy is safe and can provide clinically meaningful improvements when used in conjunction with standard therapy. A 72-year-old female patient had pain throughout her body since 1 month prior to before being admitted to the hospital. She was unable to sleep at night often cried because she was unable to stand the pain. This was reduced by morphine 3 × /day. Because of the drug's side-effects, she slept more often during the day, could not sleep at night, and was constipated. She also had breakthrough pain, on an average of 2-3 × /day. She had a history of malignancy in the pleura, liver, lungs, and cervix. There was an increase in some tumor markers. Her baseline numeric rating scale (NRS) assessment was 4 with an oral morphine slow-release tablet 3 × 15 mg/day. Acupuncture therapy was performed at Battlefield Acupuncture points of the right ear and body acupuncture points (LI 4, LI 11, ST 36, SP 6, and LR 3) was treated with 3-Hz continuous-wave electroacupuncture for 30 minutes at each session. During this therapy, there were reductions in pain (baseline NRS 4 became 2), need for morphine, morphine side-effects, and frequency of breakthrough pain. There were no significant side-effects due to acupuncture. Acupuncture is an effective and safe therapeutic option for reducing cancer pain with minimal side-effects. Acupuncture can enable a reduced need for narcotic analgesics.
疼痛是癌症最可怕的并发症之一,会破坏生活质量。癌症相关疼痛可由原发性癌症本身、发生的转移以及癌症治疗干预引起。几乎所有癌症相关疼痛都是中重度疼痛。因此,癌症相关疼痛管理通常涉及使用阿片类镇痛药。然而,使用阿片类镇痛药会引起副作用,给这些患者带来新问题。多项研究表明,针灸可以减轻癌症相关疼痛,数据显示针灸疗法是安全的,与标准疗法联合使用时可带来具有临床意义的改善。一名72岁女性患者在入院前1个月全身疼痛。她晚上无法入睡,常因无法忍受疼痛而哭泣。服用吗啡3次/天可缓解疼痛。由于药物副作用,她白天更常睡觉,晚上无法入睡,且便秘。她还出现爆发性疼痛,平均每天2 - 3次。她有胸膜、肝脏、肺部和子宫颈恶性肿瘤病史。一些肿瘤标志物有所升高。她的基线数字评定量表(NRS)评分为4分,口服吗啡缓释片3次/天,每次15毫克。在右耳战地穴位进行针灸治疗,并对体针穴位(合谷、曲池、足三里、三阴交和太冲)采用3赫兹连续波电针治疗,每次30分钟。在治疗期间,疼痛减轻(基线NRS 4分降至2分),吗啡用量、吗啡副作用及爆发性疼痛频率均降低。针灸未出现明显副作用。针灸是一种有效且安全的治疗选择,可减轻癌症疼痛且副作用最小。针灸可减少对麻醉性镇痛药的需求。