基于斯旺森理论的耳穴按压对化疗引起的周围神经病变及乳腺癌患者更广泛健康相关结局的影响：一项随机对照试验。
Effects of Swanson theory-based auricular acupressure on chemotherapy-induced peripheral neuropathy, and broader health-related outcomes in patients with breast cancer: A randomized controlled trial.
作者信息
Mi Yuanyuan, Chen Ying, Li Jing, Liu Xinxin, Li Zhengrong, Ye Quanlian, Guo Jinli, Liu Yuanfei
机构信息
Department of Nursing, Shanxi Medical University, Taiyuan, China.
Department of Breast Surgery, Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China.
出版信息
Asia Pac J Oncol Nurs. 2025 May 21;12:100729. doi: 10.1016/j.apjon.2025.100729. eCollection 2025 Dec.
OBJECTIVE
Chemotherapy-induced peripheral neuropathy (CIPN) is common in patients with breast cancer who received taxane-based chemotherapy. While auricular acupressure has shown promise in symptom management, its effects within a caring framework remain underexplored. This study aims to examine the effects of Swanson theory-based auricular acupressure on CIPN and broader health-related outcomes (e.g., sleep and quality of life) and the potential mediating role of inflammatory biomarkers.
METHODS
Seventy-four participants with breast cancer were recruited with 1:1 random assignment in intervention group and control group. Participants in the intervention group were instructed by nurses to do Swanson theory-based auricular acupressure during the 6 cycles of chemotherapy. Auricular acupressure was applied to10 ear points with each of them evenly for 1-2 minutes at a time and 3-5 times a day according to their feeling of discomfort. CIPN symptoms, sleep quality, inflammatory biomarkers, quality of life and patient-reported nurse-patient relationship were measured. Two-factor repeated measures analysis of variance was used to assess differential change in these outcomes between the two groups over time.
RESULTS
The levels of inflammatory biomarkers decreased over time in both groups. Compared to the control group, the intervention group experienced significantly larger reduction in Tumor Abnormal Protein level ( < 0.001), smaller increases in CIPN symptom severity ( < 0.001), improved sleep quality ( < 0.001), and higher levels of trust in nurses ( < 0.001) across chemotherapy cycles.
CONCLUSIONS
Swanson theory-based auricular acupressure may have a potential benefit to mitigate the worsening of CIPN symptoms, improve sleep and quality of life, reduce inflammatory biomarkers, and enhance the nurse-patient relationship during chemotherapy. These findings support the integration of auricular acupressure within holistic cancer care, highlighting the value of compassionate, theory-driven nursing interventions. Further large-scale studies are recommended to confirm these outcomes and explore underlying mechanisms.
TRIAL REGISTRATION
This study was registered in the National Health Security Information Platform (Medical Research Registration and Information System, https://www.medicalresearch.org.cn/) (MR-14-24-054013).
目的
化疗引起的周围神经病变（CIPN）在接受紫杉烷类化疗的乳腺癌患者中很常见。虽然耳穴按压在症状管理方面已显示出前景，但其在关怀框架内的效果仍未得到充分探索。本研究旨在探讨基于斯旺森理论的耳穴按压对CIPN及更广泛的健康相关结局（如睡眠和生活质量）的影响，以及炎症生物标志物的潜在中介作用。
方法
招募74名乳腺癌患者，以1:1随机分配至干预组和对照组。干预组的参与者在化疗的6个周期中由护士指导进行基于斯旺森理论的耳穴按压。根据不适感，耳穴按压应用于10个耳穴，每个穴位每次均匀按压1 - 2分钟，每天3 - 5次。测量CIPN症状、睡眠质量、炎症生物标志物、生活质量和患者报告的护患关系。采用双因素重复测量方差分析来评估两组随时间这些结局的差异变化。
结果
两组炎症生物标志物水平均随时间下降。与对照组相比，干预组在整个化疗周期中肿瘤异常蛋白水平显著降低（<0.001），CIPN症状严重程度增加较小（<0.001），睡眠质量改善（<0.001），对护士的信任度更高（<0.001）。
结论
基于斯旺森理论的耳穴按压可能有助于减轻CIPN症状的恶化，改善睡眠和生活质量，降低炎症生物标志物水平，并在化疗期间增强护患关系。这些发现支持将耳穴按压纳入整体癌症护理，突出了富有同情心、理论驱动的护理干预的价值。建议进一步开展大规模研究以证实这些结果并探索潜在机制。
试验注册
本研究在国家卫生安全信息平台（医学研究注册与信息系统，https://www.medicalresearch.org.cn/）（MR - 14 - 24 - 054013）注册。
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