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针刺治疗不同癌症幸存者认知功能障碍的可行性及初步效果:一项先导性、随机、安慰剂对照试验

Feasibility and Preliminary Effects of Acupuncture for Cognitive Dysfunction in Diverse Cancer Survivors: A Pilot, Randomized, Placebo-Controlled Trial.

作者信息

Li Xiaotong, Lampson Kaitlin, Ahles Tim A, Root James C, Li Q Susan, Li Yuelin, Ahsan Anam, Mao Jun J, Liou Kevin T

机构信息

Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.

出版信息

Curr Oncol. 2025 Jan 1;32(1):27. doi: 10.3390/curroncol32010027.

Abstract

(1) Background: This pilot study evaluates the feasibility and preliminary effects of acupuncture for cancer-related cognitive dysfunction (CRCD) in cancer survivors. (2) Methods: A randomized trial comparing real acupuncture (RA) to sham acupuncture (SA) and waitlist control (WLC) among cancer survivors reporting cognitive difficulties. Interventions were delivered weekly over 10 weeks. Feasibility was evaluated by recruitment, treatment adherence, and assessment completion. Subjective CRCD was assessed by the Functional Assessment of Cancer Therapy-Cognitive Function-Perceived Cognitive Impairment subscale (FACT-Cog PCI) and objective CRCD was assessed by the Hopkins Verbal Learning Test-Revised (HVLT-R). (3) Results: 32 participants (57.1% of eligible patients) were enrolled. All participants in acupuncture groups completed ≥8 of 10 treatments. Assessment completion rate was 100% for all participants. From baseline to week 10, the RA group (n = 19) reported a clinically meaningful 17.3-point increase in FACT-Cog PCI (95% confidence interval [CI] 12.5 to 22.1), compared to 9.7 points (95% CI 2.8 to 16.7) in the SA group (n = 9), and 6.8 points (95% CI -3.7 to 17.2) in the WLC group (n = 4). In the subgroup analysis among patients with a below-average baseline HVLT-R (T-score < 50), the RA group (n = 8) increased FACT-Cog PCI scores by 20.4 (95% CI 13.6 to 27.3), compared to 11.1 points (95% CI 0.6 to 21.5) in the SA group (n = 5). The improvements from RA persisted through week 16 in both the total sample and the sub-group. Eleven mild adverse events were reported, with pain and bleeding at the needling sites being the most common. (4) Conclusions: The findings support the feasibility and safety of conducting a randomized, placebo-controlled trial to evaluate acupuncture for cognitive dysfunction in cancer survivors.

摘要

(1) 背景:本试点研究评估针刺疗法对癌症幸存者癌症相关认知功能障碍(CRCD)的可行性和初步疗效。(2) 方法:一项随机试验,比较真实针刺(RA)、假针刺(SA)和等待名单对照(WLC)对报告有认知困难的癌症幸存者的效果。干预措施每周进行一次,持续10周。通过招募情况、治疗依从性和评估完成情况来评估可行性。主观CRCD通过癌症治疗功能评估-认知功能-感知认知障碍子量表(FACT-Cog PCI)进行评估,客观CRCD通过修订的霍普金斯言语学习测试(HVLT-R)进行评估。(3) 结果:招募了32名参与者(占 eligible患者的57.1%)。针刺组的所有参与者都完成了10次治疗中的≥8次。所有参与者的评估完成率为100%。从基线到第10周,RA组(n = 19)报告FACT-Cog PCI有临床意义的17.3分增加(95%置信区间[CI] 12.5至22.1),相比之下,SA组(n = 9)为9.7分(95% CI 2.8至16.7),WLC组(n = 4)为6.8分(95% CI -3.7至17.2)。在基线HVLT-R低于平均水平(T分数<50)的患者亚组分析中,RA组(n = 8)的FACT-Cog PCI分数增加了20.4(95% CI 13.6至27.3),相比之下,SA组(n = 5)为11.1分(95% CI 0.6至21.5)。RA组的改善在总样本和亚组中持续到第16周。报告了11起轻度不良事件针,最常见的是针刺部位的疼痛和出血。(4) 结论:这些发现支持进行一项随机、安慰剂对照试验以评估针刺疗法对癌症幸存者认知功能障碍的可行性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0436/11763785/199cdf906c46/curroncol-32-00027-g001.jpg

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