Department of Kampo Medical Research Institute and Aizu Medical Center, Fukushima Medical University, Fukushima, Japan.
Department of Hematology, Aizu Medical Center, Fukushima Medical University, Fukushima, Japan.
J Integr Complement Med. 2024 Jan;30(1):77-84. doi: 10.1089/jicm.2022.0710. Epub 2023 Jul 4.
In recent years, it has been reported that acupuncture is useful for alleviating the symptoms of patients with hematological malignancies, but the safety of acupuncture for such patients has not been established. This study evaluated the risk of bleeding from acupuncture in patients with hematological malignancies accompanying thrombocytopenia. The authors performed a retrospective investigation of the medical records of patients with hematological malignancies who received acupuncture during hospitalization at the hematology department of a single medical center in Japan. The bleeding risk at the acupuncture site was evaluated in the following four groups according to the platelet count measured on the day of acupuncture treatment: (1) <20 × 10/μL, (2) 20-49 × 10/μL, (3) 50-99 × 10/μL, and (4) 100 × 10/μL or more. Occurrence of grade 2 or higher bleeding according to the Common Terminology Criteria for Adverse Events, version 5.0, within 24 h from the acupuncture session or before the next session was defined as an event, and the risk of occurrence of bleeding was examined in each group. Of 2423 acupuncture sessions conducted on 51 patients with hematological malignancies, 815 were included in the analysis. Ninety sessions were performed in the <20 × 10/μL platelet count group, 161 in the 20-49 × 10/μL group, 133 in the 50-99 × 10/μL group, and 431 in the 100 × 10/μL or more group. No bleeding event according to the authors' definition occurred in any of these groups. This study is the largest to date to assess the bleeding risk of acupuncture in patients with hematological malignancies accompanying thrombocytopenia. The authors considered that acupuncture could be safely performed without causing serious bleeding for patients with hematological malignancies accompanying thrombocytopenia.
近年来,有报道称针刺对于缓解血液系统恶性肿瘤患者的症状是有效的,但针刺治疗此类患者的安全性尚未得到证实。本研究评估了伴有血小板减少的血液系统恶性肿瘤患者针刺治疗时发生出血的风险。
作者对日本某单一医学中心血液科住院期间接受针刺治疗的血液系统恶性肿瘤患者的病历进行了回顾性调查。根据针刺治疗当天的血小板计数,将针刺部位出血风险分为以下四组:(1)<20×10/μL;(2)20-49×10/μL;(3)50-99×10/μL;(4)100×10/μL或以上。针刺后 24 小时内或下一次针刺前根据通用不良事件术语标准,版本 5.0 发生 2 级或以上出血定义为事件,并检查每组出血的发生风险。
在对 51 例血液系统恶性肿瘤患者进行的 2423 次针刺治疗中,815 次被纳入分析。<20×10/μL 血小板计数组进行了 90 次针刺,20-49×10/μL 组进行了 161 次,50-99×10/μL 组进行了 133 次,100×10/μL 或以上组进行了 431 次。在这些组中,均未发生作者定义的出血事件。
本研究是迄今为止评估伴有血小板减少的血液系统恶性肿瘤患者针刺出血风险的最大规模研究。作者认为,伴有血小板减少的血液系统恶性肿瘤患者可以安全地进行针刺治疗,而不会引起严重出血。