University of Texas Health Science Center at Houston Cizik School of Nursing.
Johns Hopkins University School of Nursing.
Pain Manag Nurs. 2023 Feb;24(1):19-26. doi: 10.1016/j.pmn.2022.11.004. Epub 2022 Dec 19.
BACKGROUND: To identify candidate inflammatory biomarkers for the underlying mechanism of auricular point acupressure (APA) on pain relief and examine the correlations among pain intensity, interference, and inflammatory biomarkers. DESIGN: This is a secondary data analysis. METHODS: Data on inflammatory biomarkers collected via blood samples and patient self-reported pain intensity and interference from three pilot studies (chronic low back pain, n = 61; arthralgia related to aromatase inhibitors, n = 20; and chemotherapy-induced neuropathy, n = 15) were integrated and analyzed. This paper reports the results based on within-subject treatment effects (change in scores from pre- to post-APA intervention) for each study group (chronic low back pain, cancer pain), between-group differences (changes in scores from pre- to post-intervention between targeted-point APA [T-APA] and non-targeted-point APA [NT-APA]), and correlations among pain intensity, interference, and biomarkers. RESULTS: Within-group analysis (the change score from pre- to post-APA) revealed statistically significant changes in three biomarkers: TNF-α (cancer pain in the APA group, p = .03), β-endorphin (back pain in the APA group, p = .04), and IL-2 (back pain in the NT-APA group, p = .002). Based on between-group analysis in patients with chronic low back pain (T-APA vs NT-APA), IL-4 had the largest effect size (0.35), followed by TNF-α (0.29). A strong positive monotonic relationship between IL-1β and IL-2 was detected. CONCLUSIONS: The current findings further support the potential role of inflammatory biomarkers in the analgesic effects of APA. More work is needed to gain a comprehensive understanding of the underlying mechanisms of APA on chronic pain. Because it is simple, inexpensive, and has no negative side effects, APA can be widely disseminated as an alternative to opioids.
背景:为了确定耳穴压豆(APA)缓解疼痛的潜在机制的候选炎症生物标志物,并检查疼痛强度、干扰和炎症生物标志物之间的相关性。
设计:这是一项二次数据分析。
方法:通过整合和分析来自三项初步研究(慢性下腰痛,n=61;与芳香化酶抑制剂相关的关节痛,n=20;和化疗引起的周围神经病变,n=15)中收集的血液样本和患者自我报告的疼痛强度和干扰的炎症生物标志物数据,本文报告了基于每个研究组(慢性下腰痛、癌痛)的个体内治疗效果(从 APA 干预前到后评分的变化)、组间差异(从干预前到干预后靶向点 APA[T-APA]与非靶向点 APA[NT-APA]之间评分的变化)以及疼痛强度、干扰和生物标志物之间的相关性的结果。
结果:个体内分析(APA 前后的变化评分)显示三个生物标志物发生了统计学上的显著变化:TNF-α(APA 组的癌痛,p=0.03)、β-内啡肽(APA 组的腰痛,p=0.04)和 IL-2(NT-APA 组的腰痛,p=0.002)。基于慢性下腰痛患者的组间分析(T-APA 与 NT-APA),IL-4 的效应量最大(0.35),其次是 TNF-α(0.29)。检测到 IL-1β和 IL-2 之间存在强正单调关系。
结论:目前的研究结果进一步支持炎症生物标志物在 APA 镇痛作用中的潜在作用。需要进一步的研究来全面了解 APA 对慢性疼痛的潜在机制。由于 APA 简单、廉价且无副作用,因此可以作为阿片类药物的替代物广泛传播。
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