针灸可以舒缓乳癌引起的热潮红


  【24drs.com】在线发表于8月24日临床肿瘤学期刊的研究认为,将古老的中国传统医术加上现代化的仪表显示,可以有效缓解乳癌相关的热潮红不适。
  
  根据一篇随机控制试验,将小电流施加到传统的针灸针进行电子针灸,效果优于此症状常用的药物gabapentin。
  
  这篇试验包括了120名主诉有治疗相关之热潮红的患者,这些妇女被随机分组进行每周一次的电子针灸、每天一次服用gabapentin、假的针灸、安慰剂,共计8周。
  
  这篇试验在费城的宾夕法尼亚大学进行,主要结果是受试者每天自我报告热潮红综合分数。第8周时,电子针灸组的热潮红分数平均降低最多,依序是假的针灸、gabapentin以及安慰剂(–7.4 vs –5.9 vs –5.2 vs –3.4;P< .001)。
  
  虽然在第8周时结束试验,病患持续在日记中记录她们每天的热潮红情况,直到第24周。第24周时,依旧是电子针灸组的热潮红分数平均降低最多,依序是假的针灸、安慰剂组、gabapentin组(–8.5 vs –6.1 vs –4.6 vs –2.8;P= .002)。
  
  研究作者、家庭医学暨社区健康副教授Jun Mao医师等人写道,需要以更大型且追踪期间更久的随机控制试验来确认这些初步结果。
  
  一名未参与此次试验的专家对此篇研究的设计感到印象深刻。
  
  波士顿达那-法柏癌症研究中心、Leonard P. Zakim整合治疗中心主任Jennifer Ligibel医师表示,Mao医师的团队建立了一个相当好的控制条件。她表示,药物治疗的选择也很适当,Gabapentin是我们广泛使用的药物;它对癌症患者的热潮红有效。
  
  Ligibel医师本身并未接受过针灸,但是对她服务的波士顿门诊进行的治疗印象深刻。她表示,我们对一些患者试过多种疗法但都失败,当我们尝试使用针灸时,得到了相当不同的结果。
  
  Ligibel医师解释,我们知道针灸可有效治疗癌症相关或治疗相关的恶心、神经病变、和疼痛,这些都是癌症存活者常发生的症状,我们能做的疗法其实不多。
  
  Mao曾经参与一篇电子针灸用于乳癌患者、缓解芳香酶抑制剂引起的相关症状的研究,该篇研究(Cancer. 2014;120:3744-3751)显示,对于关节疼痛妇女的疲劳、焦虑与忧郁有临床相关的改善。
  
  那么,没有加上电流的一般针灸也会对热潮红有效吗?
  
  Mao医师对此不置可否,他表示,很少有研究比较电子针灸是否优于没有电流的传统针灸。
  
  不过,他指出,假的针灸组是将针缩回针柄内(就像演戏用的假刀)来假装针灸,而且还有一定效果。这表示,即使只是轻轻地刺激人体穴位也是会有效果的,但这也可能是安慰剂效应。
  
  实验室数据也认为电子针灸是真的有用。
  
  Mao医师表示,针对电子针灸进行了一些基本科学实验,显示它在脑中如何释放与疼痛处置和情绪调节有关的特定神经化学物质。
  
  藉由电子针灸,插入针后操作到「得气」(表示有酸痛和刺痛的感觉)。研究者解释,使用一组经皮神经电刺激单元,将两个针灸点之间用双向的2 Hz电流连接,这些针留在该处30分钟。
  
  资料来源:http://www.24drs.com/
  
  Native link:Acupuncture Cools Breast Cancer Hot Flashes
  
  

Acupuncture Cools Breast Cancer Hot Flashes

By Nick Mulcahy
Medscape Medical News

The heat of breast-cancer-related hot flashes can be effectively diminished with an ancient Chinese medical practice infused with a dash of modernity, suggests research published online August24 in the Journal of Clinical Oncology.

Electroacupuncture, in which small electric currents are applied to traditional acupuncture needles, might be more effective than gabapentin, a drug commonly used in this setting, according to a randomized controlled trial.

The trial involved 120 patients with existing complaints of treatment-related hot flashes. The women were randomized to weekly electroacupuncture, once-daily gabapentin, sham acupuncture, or placebo for 8 weeks.

A daily self-reported hot flash composite score was the primary outcome measure in the trial, which was conducted at the University of Pennsylvania in Philadelphia.

At 8 weeks, the mean reduction the hot flash score was greatest with electroacupuncture, followed by sham acupuncture, gabapentin, and placebo (–7.4 vs –5.9 vs –5.2 vs –3.4; P< .001).

Despite the fact that treatment stopped at week8, the patients continued to record their daily hot flash experience in diaries until week24.

At week24, the mean reduction the hot flash score was again greatest with electroacupuncture, followed by sham acupuncture, but by this time, placebo was better than gabapentin (–8.5 vs –6.1 vs –4.6 vs –2.8; P= .002).

"These preliminary findings need to be confirmed in larger randomized controlled trials with long-term follow-up," write the study authors, led by Jun Mao, MD, associate professor of family medicine and community health at Penn.

An expert not involved in the study was impressed by the trial design.

Dr Mao's team "did a very good job creating adequate control conditions," said Jennifer Ligibel, MD, director of the LeonardP. Zakim Center for Integrative Therapies at the Dana-Farber Cancer Institute in Boston.

The choice of drug treatment was also appropriate, she told Medscape Medical News. "Gabapentin is something we use widely; it is effective for hot flashes in cancer patients."

Dr Ligibel, who has never personally undergone acupuncture, has been impressed by the treatment in her Boston clinic.

"I have had patients with symptoms for whom we tried everything and failed, and then we try acupuncture and it makes a big difference," she said.

Acupuncture has also been found to be effective for cancer- or treatment-related nausea, neuropathy, and pain — the kind of symptoms that often linger in survivors that "we can't do much of anything about," Dr Ligibel explained.

Dr Mao was involved in a previous study of electroacupuncture for the relief of symptoms associated with aromatase inhibitors in breast cancer patients, which demonstrated "clinically relevant improvements" in fatigue, anxiety, and depression in women with joint pain, as reported by Medscape Medical News (Cancer. 2014;120:3744-3751).

Would regular acupuncture — without electricity — work as well for the hot flashes?

Dr Mao was noncommittal in answering. "Very little research has been done to determine whether electroacupuncture is more potent than 'regular' acupuncture without electric stimulation," he told Medscape Medical News.

However, he pointed out that sham acupuncture, which consisted of needles that retracted into their handles — like a "stage dagger" — had some treatment effect. This suggests that stimulating standard body points even lightly is worthwhile, or perhaps it induces a placebo effect, he noted.

Lab science also suggests that electroacupuncture is the real deal.

"There are also a good amount of basic science experiments performed on electroacupuncture to show that it makes the brain release specific neurochemicals that are involved in pain processing and mood regulation," said Dr Mao.

With electroacupuncture, the needles are inserted and manipulated until deqi (the sensation of soreness and tingling) is reported. "A bilateral 2Hz current is connected between two acupuncture points using a transcutaneous electrical nerve stimulation unit," the investigators explain. The needles are left in place for 30 minutes.

This trial was supported by a National Center for Complementary and Integrative Health grant. Dr Ligibel has disclosed no relevant financial relationships. Some of the study coauthors have ties to pharmaceutical companies.

J Clin Oncol. Published online August24, 2015.

    
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