Lu Chao, Feng Xukang, Shen Qiongying, Li Guangliang, Wu Taoping, Li Xiaoyu, Shao Xiying, Wang Peipei, Li Rongrong, Deng Yaping, Chen Weiji
Department of TCM, Zhejiang Cancer Hospital, Hangzhou 310022, China.
Third Clinical Medical College of Zhejiang Chinese Medical University.
Zhongguo Zhen Jiu. 2024 Oct 12;44(10):1139-45. doi: 10.13703/j.0255-2930.20240123-0001.
To observe the clinical efficacy of electroacupuncture (EA) at frequencies of 2 Hz, 100 Hz, and 2 Hz/100 Hz for chemotherapy-induced peripheral neuropathy (CIPN).
One hundred and sixty female breast cancer patients with CIPN induced by paclitaxel were randomly divided into a 2 Hz EA group (40 cases, 1 case dropped out), a 100 Hz EA group (40 cases, 2 cases dropped out), a 2 Hz/100 Hz EA group (40 cases, 3 cases dropped out), and a medication group (40 cases, 2 cases dropped out). The three EA groups received acupuncture at bilateral Quchi (LI 11), Waiguan (TE 5), Hegu (LI 4), Zusanli (ST 36), and Yanglingquan (GB 34). Electrodes of the HANS-200E acupoint nerve stimulator were connected to the same side Hegu (LI 4) and Waiguan (TE 5), and Zusanli (ST 36) and Sanyinjiao (SP 6), with EA stimulation frequencies of 2 Hz, 100 Hz, and 2 Hz/100 Hz, respectively. Each session lasted 30 min, once every other day, three times a week. The medication group received oral mecobalamin tablets, 0.5 mg per dose, three times a day. All groups were treated for four weeks. The functional assessment of cancer therapy/gynaecologic oncology group-neurotoxicity (FACT/GOG-Ntx), peripheral neurotoxicity grading based on the National Cancer Institute-common terminology criteria for adverse events Version 5.0 (NCI-CTCAE V5.0), and peripheral neuropathy pain visual analogue scale (VAS) scores were observed before and after treatment, and at follow-up after 4 weeks of treatment completion, and clinical efficacy was evaluated after theatment.
Compared before treatment, FACT/GOG-Ntx scores in all groups were decreased after treatment and during follow-up (<0.01). The score reduction between before and after treatment in the three EA groups was greater than the medication group (<0.01, <0.05), with the 2 Hz and 2 Hz/100 Hz EA groups showing a greater reduction than the 100 Hz EA group (<0.05). The reduction of FACT/GOG-Ntx score between before treatment and follow-up in the 2 Hz and 2 Hz/100 Hz EA groups was greater than the medication group (<0.01). Peripheral neurotoxicity grading in the three EA groups were improved after treatment (<0.01). Compared before treatment, the peripheral neurotoxicity grading in the 2 Hz and 2 Hz/100 Hz EA groups was improved at follow-up (<0.01, <0.05). The VAS scores for peripheral neuropathy pain in the three EA groups were decreased after treatment (<0.01, <0.05). At follow-up, VAS scores in the 2 Hz, 2 Hz/100 Hz, and medication groups were decreased (<0.01, <0.05), with a greater reduction in the 2 Hz/100 Hz EA group than the medication group after treatment and follow-up (<0.01, <0.05). The overall effective rates for the 2 Hz, 100 Hz, 2 Hz/100 Hz, and medication groups were 79.5% (31/39), 68.4% (26/38), 81.1% (30/37), and 47.4% (18/38), respectively, with the 2 Hz and 2 Hz/100 Hz groups showing higher effective rates than the medication group (<0.05).
EA is effective in treating paclitaxel-induced CIPN. While there is no overall difference in efficacy among the different frequencies, 2 Hz and 2 Hz/100 Hz EA showing potential advantages. For patients with concurrent peripheral neuropathy pain, 2 Hz/100 Hz electroacupuncture is recommended.
观察2Hz、100Hz及2Hz/100Hz频率电针对化疗所致周围神经病变（CIPN）的临床疗效。
160例因紫杉醇导致CIPN的女性乳腺癌患者随机分为2Hz电针组（40例，脱落1例）、100Hz电针组（40例，脱落2例）、2Hz/100Hz电针组（40例，脱落3例）和药物组（40例，脱落2例）。3个电针组取双侧曲池（LI 11）、外关（TE 5）、合谷（LI 4）、足三里（ST 36）和阳陵泉（GB 34）进行针刺。HANS - 200E型穴位神经刺激仪电极分别连接同侧合谷（LI 4）与外关（TE 5）、足三里（ST 36）与三阴交（SP 6），电针刺激频率分别为2Hz、100Hz、2Hz/100Hz。每次治疗持续30分钟，隔日1次，每周3次。药物组口服甲钴胺片，每次0.5mg，每日3次。所有组均治疗4周。观察治疗前、治疗后及治疗结束后4周随访时癌症治疗功能评估/妇科肿瘤组神经毒性（FACT/GOG - Ntx）、基于美国国立癌症研究所不良事件通用术语标准第5.0版（NCI - CTCAE V5.0）的周围神经毒性分级及周围神经病变疼痛视觉模拟量表（VAS）评分，并在治疗后评估临床疗效。
与治疗前比较，所有组治疗后及随访时FACT/GOG - Ntx评分均降低（<0.01）。3个电针组治疗前后评分降低幅度大于药物组（<0.01，<0.05），其中2Hz电针组和2Hz/100Hz电针组降低幅度大于100Hz电针组（<0.05）。2Hz电针组和2Hz/100Hz电针组治疗前与随访时FACT/GOG - Ntx评分降低幅度大于药物组（<0.01）。3个电针组治疗后周围神经毒性分级改善（<0.01）。与治疗前比较，2Hz电针组和2Hz/100Hz电针组随访时周围神经毒性分级改善（<0.01，<0.05）。3个电针组周围神经病变疼痛VAS评分治疗后降低（<0.01，<0.05）。随访时，2Hz、2Hz/100Hz电针组及药物组VAS评分降低（<0.01，<0.05），其中2Hz/100Hz电针组治疗后及随访时降低幅度大于药物组（<0.01，<0.05）。2Hz、100Hz、2Hz/100Hz电针组及药物组总有效率分别为79.5%（31/39）、68.4%（26/38）、81.1%（30/37）、47.4%（18/38），2Hz电针组和2Hz/100Hz电针组有效率高于药物组（<0.05）。
电针治疗紫杉醇所致CIPN有效。不同频率电针疗效总体无差异，但2Hz和2Hz/100Hz电针显示出潜在优势。对于合并周围神经病变疼痛的患者，推荐2Hz/100Hz电针治疗。
