针刺改善造血干细胞移植患者睡眠的某些方面：一项随机对照试验的二次分析。
Acupuncture improves certain aspects of sleep in hematopoietic stem cell transplantation patients: a secondary analysis of a randomized controlled trial.
机构信息
Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
出版信息
Acupunct Med. 2023 Dec;41(6):319-326. doi: 10.1177/09645284231181403. Epub 2023 Jul 6.
BACKGROUND
High-dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT) is associated with a high symptom burden including sleep disturbance. Here we present the results of a secondary analysis of a randomized, sham-controlled trial assessing the effect of acupuncture on sleep quality during HSCT.
METHODS
Adult multiple myeloma patients undergoing inpatient and outpatient autologous HSCT were randomized and blinded to receive either true or sham acupuncture (by licensed acupuncturists) once daily for 5 days starting the day after chemotherapy. Sleep onset, total sleep time, sleep efficiency percentage and sleep-onset latency time were assessed using an actigraphy-based sleep monitor. A multivariate regression analysis was conducted to compare the average area-under-the-curve of five acupuncture intervention days for each sleep outcome between groups, adjusted by baseline score and inpatient or outpatient chemotherapy stratum.
RESULTS
Over 32 months, 63 patients were enrolled. Participants undergoing true acupuncture experienced a significant improvement in sleep efficiency when compared to sham (-6.70, 95% CI -13.15, -0.25, p = 0.042). Subgroup analysis showed that the improvement was more prominent in the inpatient setting (-9.62, 95% CI -18.76, -0.47; p = 0.040). True acupuncture tended to improve wake time after sleep onset (WASO; -10.95, p = 0.054). Between-group differences in other sleep related variables were not statistically significant.
CONCLUSION
Our data suggest that true acupuncture may improve certain aspects of sleep, including sleep efficiency and possibly WASO, in multiple myeloma patients undergoing HSCT. By studying patient reported outcomes in future larger scale studies, acupuncture's role in improving sleep quality during HSCT treatment could be further elucidated.
TRIAL REGISTRATION NUMBER
NCT01811862 (ClinicalTrials.gov).
背景
大剂量化疗后进行造血干细胞移植（HSCT）会导致高症状负担，包括睡眠障碍。在这里，我们报告了一项评估针刺对 HSCT 期间睡眠质量影响的随机、假对照试验的二次分析结果。
方法
接受住院和门诊自体 HSCT 的成人多发性骨髓瘤患者被随机分组并接受盲法治疗，每天接受一次真正或假针刺（由持牌针灸师进行），从化疗后第一天开始连续 5 天。使用基于活动记录仪的睡眠监测器评估入睡时间、总睡眠时间、睡眠效率百分比和入睡潜伏期时间。采用多元回归分析比较两组之间 5 天针刺干预的每个睡眠结局的平均曲线下面积，通过基线评分和住院或门诊化疗分层进行调整。
结果
在 32 个月期间，共纳入 63 名患者。与假针刺组相比，接受真针刺的患者睡眠效率显著改善（-6.70，95%置信区间-13.15，-0.25，p=0.042）。亚组分析显示，在住院患者中改善更为明显（-9.62，95%置信区间-18.76，-0.47；p=0.040）。真针刺组患者的睡眠后觉醒时间（WASO）有改善趋势（-10.95，p=0.054）。两组间其他睡眠相关变量的差异无统计学意义。
结论
我们的数据表明，在接受 HSCT 的多发性骨髓瘤患者中，真针刺可能改善睡眠的某些方面，包括睡眠效率和可能的 WASO。通过在未来更大规模的研究中研究患者报告的结果，可以进一步阐明针刺在改善 HSCT 治疗期间睡眠质量方面的作用。
试验注册号
NCT01811862（ClinicalTrials.gov）。
Zotero 插件