经皮穴位电刺激对老年肺癌患者术后认知功能的影响：一项随机、双盲、安慰剂对照试验
Effect of transcutaneous electrical acupoint stimulation on postoperative cognitive function in older patients with lung cancer: A randomized, double-blind, placebo-controlled trial.
作者信息
Guo Fei, Han Ruili, Sun Li, Zheng Lanlan, Wang Yanzheng, Yan Yuting, Liu Chen, Qin Yuan, Yuan Chen, Wang Shuang, Sun Xude, Gao Changjun
机构信息
Department of Anesthesiology, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China.
出版信息
Heliyon. 2023 Aug 24;9(9):e19386. doi: 10.1016/j.heliyon.2023.e19386. eCollection 2023 Sep.
OBJECTIVE
This trial was to examine the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive function in older patients who underwent thoracoscopic pulmonary resection.
METHODS
This was a prospective, randomized, double-blind, placebo-controlled study. 128 patients scheduled for surgery were randomly assigned to the TEAS group and sham-TEAS group. A standardized intervention of TEAS or sham-TEAS on the acupoints of Baihui (DU20) and bilateral Neiguan (PC6), Hegu (LI4), and Zusanli (ST36) from 30 min before anesthesia induction until the end of the surgery, combined with a general anesthetic protocol performed in the two groups respectively. The primary outcome was the incidence of postoperative cognitive dysfunction (POCD) assessed via the Montreal Cognitive Assessment (MoCA) scale at each time point. The secondary outcomes included the results of the Mini-Mental State Examination (MMSE) score, the Numerical Rating Scale (NRS) on pain and sleep, the European Organization for Research and Treatment of Cancer Quality of Life (EORTC-QLQ-C30), and a chronic pain questionnaire at relative time points.
RESULTS
Participants who completed the 12-month trial of the two groups were well-matched in baseline demographic and clinical parameters. At postoperative day 1, day 7, and day 30 time points, the incidence of POCD in the sham-TEAS group was always significantly higher than in the TEAS group (65.4% vs 20%, 43.6% vs 7.3%, 40% vs 3.6%, all P < 0.001). Also, the TEAS group showed better scores of MMSE, sleep, and pain compared with the sham-TEAS group (all P < 0.001). At 6 and 12 months points, the global health scores of the TEAS group were still significantly higher than the sham-TEAS group, and the prevalence of chronic pain was significantly lower than the sham-TEAS group (all P < 0.05).
CONCLUSION
TEAS could effectively improve the postoperative cognitive function and long-term life quality of geriatric patients with lung cancer.
目的
本试验旨在研究经皮穴位电刺激（TEAS）对接受胸腔镜肺切除术的老年患者术后认知功能的影响。
方法
这是一项前瞻性、随机、双盲、安慰剂对照研究。128例计划接受手术的患者被随机分为TEAS组和假TEAS组。从麻醉诱导前30分钟至手术结束，对百会（DU20）及双侧内关（PC6）、合谷（LI4）、足三里（ST36）穴位进行标准化的TEAS或假TEAS干预，并分别结合两组实施的全身麻醉方案。主要结局是通过蒙特利尔认知评估（MoCA）量表在各时间点评估的术后认知功能障碍（POCD）发生率。次要结局包括简易精神状态检查表（MMSE）评分结果、疼痛和睡眠的数字评定量表（NRS）、欧洲癌症研究与治疗组织生活质量量表（EORTC-QLQ-C30）以及在相关时间点的慢性疼痛问卷。
结果
完成两组12个月试验的参与者在基线人口统计学和临床参数方面匹配良好。在术后第1天、第7天和第30天时间点，假TEAS组的POCD发生率始终显著高于TEAS组（65.4%对20%，43.6%对7.3%，40%对3.6%，均P<0.001）。此外，与假TEAS组相比，TEAS组在MMSE、睡眠和疼痛方面得分更高（均P<0.001）。在6个月和12个月时，TEAS组的整体健康评分仍显著高于假TEAS组，慢性疼痛患病率显著低于假TEAS组（均P<0.05）。
结论
TEAS可有效改善老年肺癌患者的术后认知功能和长期生活质量。
Zotero 插件