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耳穴按压治疗乳腺癌患者化疗相关性周围神经病的疗效和安全性:一项随机对照试验的研究方案。

Efficacy and safety of auricular acupressure for chemotherapy-induced peripheral neuropathy among patients with breast cancer: a study protocol for a randomized controlled trial.

机构信息

College of Nursing, Chungnam National University, Daejeon, Korea.

Department of Surgery and Research Institute for Medicinal Sciences, College of Medicine, Chungnam National University, Daejeon, Korea.

出版信息

Ann Palliat Med. 2021 Jan;10(1):721-732. doi: 10.21037/apm-20-1469. Epub 2020 Dec 23.

Abstract

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a frequently-reported distress symptom in breast carcinoma patients under chemotherapy. Although previous studies emphasized lack of ideal neuroprotective or therapeutic agents for CIPN, there are no strongly recommended treatments. Nevertheless, auricular acupressure (AA) is a novel remedy for controlling symptoms in many healthcare settings. However, therapeutic effects of AA among patients with CIPN have not yet been elucidated fully. Therefore, we designed a trial to examine the effectiveness and safety of AA in breast cancer patients.

METHODS

This randomized, double-blind, sham-controlled trial will assess 120 breast cancer survivors. After enrollment, the participants will be stratified depending on administration of medications prescribed for CIPN treatment, and then assigned randomly to the experimental or control groups in an allocation ratio of 1:1. For experimental groups, AA will be applied on four points, namely, shemen, liver, spleen, and finger/toe, while for the control groups, sham AA will be exerted on other four points that are remote from the treatment points and unrelated to neuropathic symptoms. All participants will undergo the same acupressure procedure, for two minutes each time, thrice daily for 3 weeks, and CIPN symptoms and health-related quality of life will be assessed by a blinded research assistant and a physician before, during, immediately after, and 4 weeks after AA. Occurrence, type, and severity of safety issues will be routinely monitored to confirm the non-toxic nature of AA. Repeated measures analysis of variance will be used to examine the changing pattern of CIPN symptoms and based on sensitivity analysis.

DISCUSSION

It is expected that the rationale and design of this protocol will offer knowledge regarding a standardized process to guide current and future studies and accumulates clinical experiences in applying non-pharmacological intervention. The present trial is the first to examine the therapeutic effects of AA in breast cancer patients with CIPN. The findings of the study may provide convincing evidence regarding the effectiveness of CIPN symptoms.

TRIAL REGISTRAION

Clinical Research Information Service, Republic of Korea, ID: KCT0004930. Registered retrospectively on April 14, 2020.

摘要

背景

化疗引起的周围神经病变(CIPN)是接受化疗的乳腺癌患者常报告的痛苦症状。尽管先前的研究强调缺乏理想的 CIPN 神经保护或治疗药物,但尚无强烈推荐的治疗方法。然而,耳穴按压(AA)是许多医疗保健环境中控制症状的新方法。然而,AA 在 CIPN 患者中的治疗效果尚未完全阐明。因此,我们设计了一项试验来检验 AA 在乳腺癌患者中的有效性和安全性。

方法

这项随机、双盲、假对照试验将评估 120 名乳腺癌幸存者。入组后,根据 CIPN 治疗药物的使用情况对参与者进行分层,然后按照 1:1 的分配比例随机分配到实验组或对照组。对于实验组,将在四门、肝、脾和手指/脚趾上进行 AA,而对于对照组,将在远离治疗点且与神经病变症状无关的其他四个点上进行假 AA。所有参与者都将接受相同的穴位按压程序,每次两分钟,每天三次,持续 3 周,在 AA 之前、期间、立即之后和 4 周后,由盲法研究助理和医生评估 CIPN 症状和健康相关生活质量。将常规监测安全性问题的发生、类型和严重程度,以确认 AA 的无毒性质。将使用重复测量方差分析来检查 CIPN 症状的变化模式,并基于敏感性分析。

讨论

预计本方案的原理和设计将提供有关指导当前和未来研究的标准化流程的知识,并积累应用非药物干预的临床经验。本试验是首次研究 AA 在 CIPN 乳腺癌患者中的治疗效果。该研究的结果可能为 CIPN 症状的有效性提供令人信服的证据。

试验注册

韩国临床研究信息服务处,注册号:KCT0004930。于 2020 年 4 月 14 日进行回顾性注册。

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