Supportive Oncology Research Team, East and North Hertfordshire NHS Trust Incorporating Mount Vernon Cancer Centre, Rickmansworth Road, Northwood, HA6 2RN, Middlesex, UK.
Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
Support Care Cancer. 2022 Jun;30(6):5063-5074. doi: 10.1007/s00520-022-06898-7. Epub 2022 Feb 26.
While clinical trials provide valuable data about efficacy of interventions, findings often do not translate into clinical settings. We report real world clinical outcomes of a 15-year service offering breast cancer survivors auricular acupuncture to manage hot flushes and night sweats (HFNS) associated with adjuvant hormonal treatments. This service evaluation aims to (1) assess whether usual practice alleviates symptoms in a clinically meaningful way and (2) compare these results with scientific evidence.
Data were analysed from 415 referrals to a service offering women eight standardised treatments using the National Acupuncture Detoxification Association (NADA) protocol. Outcome measures administered at baseline, end of treatment (EOT), and 4 and 18 weeks after EOT included hot flush diaries, hot flush rating scale (HFRS) and women's health questionnaire (WHQ).
Over 2285 treatments were given to 300 women; 275 (92.3%) completed all eight treatments. Median daily frequency of HFNS reduced from 9.6 (IQR 7.3) to 5.7 (IQR 5.8) at EOT and 6.3 (IQR 6.5) 18 weeks after EOT. HFRS problem rating showed a clinically meaningful reduction of ≥ 2 points at all measurement points. WHQ showed improvements in several symptoms associated with the menopause. Two adverse events were reported, neither were serious. Results are comparable to published research.
This first analysis of a long-term auricular acupuncture service compares favourably with outcomes of other studies for reducing HFNS frequency and associated menopausal symptoms. In day-to-day clinical practice, NADA appears to be a safe effective intervention for breast cancer survivors.
虽然临床试验提供了关于干预措施疗效的有价值数据，但研究结果往往无法转化为临床环境。我们报告了一项为期 15 年的服务的真实临床结果，该服务为接受辅助激素治疗的乳腺癌幸存者提供耳针治疗以管理热潮红和盗汗（HFNS）。这项服务评估旨在（1）评估常规实践是否以有临床意义的方式缓解症状，以及（2）将这些结果与科学证据进行比较。
从提供 8 次基于美国国家针灸戒毒协会（NADA）方案的标准治疗的服务中，对 415 名患者的转介数据进行了分析。在基线、治疗结束（EOT）以及 EOT 后 4 周和 18 周时，进行了热潮红日记、热潮红评分量表（HFRS）和女性健康问卷（WHQ）等结局测量。
对 300 名妇女进行了 2285 多次治疗；275 名（92.3%）完成了所有 8 次治疗。EOT 时，HFNS 的每日频率中位数从 9.6（IQR 7.3）减少到 5.7（IQR 5.8），EOT 后 18 周时减少到 6.3（IQR 6.5）。HFRS 问题评分在所有测量点均显示出≥2 分的有临床意义的降低。WHQ 显示与更年期相关的几种症状有所改善。报告了 2 起不良事件，均不严重。结果与已发表的研究结果相当。
这是对长期耳针服务的首次分析，与降低 HFNS 频率和相关更年期症状的其他研究结果相比，结果更为有利。在日常临床实践中，NADA 似乎是一种安全有效的乳腺癌幸存者干预措施。
