Kashyap Komal, Singh Vishwajeet, Dwivedi Sada Nand, Gielen Joris, Bhatnagar Sushma
Department of Oncoanaesthesia and Palliative Medicine, Dr. B. R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
Indian J Palliat Care. 2022 Jul-Sep;28(3):287-294. doi: 10.25259/IJPC_94_2021. Epub 2022 Jul 13.
Given the known side effects of opioids and the negative impact of these side effects on quality of life (QOL), there is a need for therapies that can reduce opioid intake and improve QOL in patients suffering from cancer pain. Scrambler therapy (ST) is a neuromodulatory therapy that has been shown to reduce cancer pain, but its effect on QOL is not well understood. This study intended to evaluate the efficacy of ST for enhancing QOL in cancer patients through minimising pain and opioid intake.
This was a randomised controlled trial including 80 patients with head, neck and thoracic cancer. In both arms, patients were given pain management drugs following the WHO analgesic ladder for ten consecutive days. In the intervention arm each day ST was given. Pain, morphine intake, and QOL (WHOQOL-BREF) were assessed.
All domains of QOL improved significantly in the intervention arm in comparison to the control arm. In comparison to baseline, pain improved in both the intervention and the control arm on day 10 and at follow-up. However, QOL significantly improved in the intervention arm, while morphine intake decreased. In the control arm, QOL deteriorated, while morphine intake increased.
ST significantly improved QOL. Since the increase in QOL took place along with a significantly lower morphine intake, the improvement in QOL may not only be explained by lower pain scores but, also, by a reduced intake of morphine, because the lower dosages of morphine will decrease the likelihood of side effects associated with the drug.
鉴于阿片类药物已知的副作用以及这些副作用对生活质量（QOL）的负面影响，需要有能够减少阿片类药物摄入量并改善癌症疼痛患者生活质量的治疗方法。扰频器疗法（ST）是一种神经调节疗法，已被证明可减轻癌症疼痛，但其对生活质量的影响尚不清楚。本研究旨在评估ST通过减轻疼痛和减少阿片类药物摄入量来提高癌症患者生活质量的疗效。
这是一项随机对照试验，纳入80名头颈部和胸部癌症患者。在双臂试验中，患者连续十天按照世界卫生组织镇痛阶梯给予疼痛管理药物。在干预组中，每天给予ST治疗。评估疼痛、吗啡摄入量和生活质量（WHOQOL - BREF）。
与对照组相比，干预组生活质量的所有领域均有显著改善。与基线相比，干预组和对照组在第10天和随访时疼痛均有所改善。然而，干预组生活质量显著提高，同时吗啡摄入量减少。在对照组中，生活质量恶化，而吗啡摄入量增加。
ST显著改善了生活质量。由于生活质量的提高伴随着吗啡摄入量的显著降低，生活质量的改善可能不仅可以通过较低的疼痛评分来解释，还可以通过吗啡摄入量的减少来解释，因为较低剂量的吗啡会降低与该药物相关的副作用的可能性。
