針灸可以舒緩乳癌引起的熱潮紅


  【24drs.com】線上發表於8月24日臨床腫瘤學期刊的研究認為,將古老的中國傳統醫術加上現代化的儀表顯示,可以有效緩解乳癌相關的熱潮紅不適。
  
  根據一篇隨機控制試驗,將小電流施加到傳統的針灸針進行電子針灸,效果優於此症狀常用的藥物gabapentin。
  
  這篇試驗包括了120名主訴有治療相關之熱潮紅的患者,這些婦女被隨機分組進行每週一次的電子針灸、每天一次服用gabapentin、假的針灸、安慰劑,共計8週。
  
  這篇試驗在費城的賓夕法尼亞大學進行,主要結果是受試者每天自我報告熱潮紅綜合分數。第8週時,電子針灸組的熱潮紅分數平均降低最多,依序是假的針灸、gabapentin以及安慰劑(–7.4 vs –5.9 vs –5.2 vs –3.4;P< .001)。
  
  雖然在第8週時結束試驗,病患持續在日記中記錄她們每天的熱潮紅情況,直到第24週。第24週時,依舊是電子針灸組的熱潮紅分數平均降低最多,依序是假的針灸、安慰劑組、gabapentin組(–8.5 vs –6.1 vs –4.6 vs –2.8;P= .002)。
  
  研究作者、家庭醫學暨社區健康副教授Jun Mao醫師等人寫道,需要以更大型且追蹤期間更久的隨機控制試驗來確認這些初步結果。
  
  一名未參與此次試驗的專家對此篇研究的設計感到印象深刻。
  
  波士頓達那-法柏癌症研究中心、Leonard P. Zakim整合治療中心主任Jennifer Ligibel醫師表示,Mao醫師的團隊建立了一個相當好的控制條件。她表示,藥物治療的選擇也很適當,Gabapentin是我們廣泛使用的藥物;它對癌症患者的熱潮紅有效。
  
  Ligibel醫師本身並未接受過針灸,但是對她服務的波士頓門診進行的治療印象深刻。她表示,我們對一些患者試過多種療法但都失敗,當我們嘗試使用針灸時,得到了相當不同的結果。
  
  Ligibel醫師解釋,我們知道針灸可有效治療癌症相關或治療相關的噁心、神經病變、和疼痛,這些都是癌症存活者常發生的症狀,我們能做的療法其實不多。
  
  Mao曾經參與一篇電子針灸用於乳癌患者、緩解芳香酶抑製劑引起的相關症狀的研究,該篇研究(Cancer. 2014;120:3744-3751)顯示,對於關節疼痛婦女的疲勞、焦慮與憂鬱有臨床相關的改善。
  
  那麼,沒有加上電流的一般針灸也會對熱潮紅有效嗎?
  
  Mao醫師對此不置可否,他表示,很少有研究比較電子針灸是否優於沒有電流的傳統針灸。
  
  不過,他指出,假的針灸組是將針縮回針柄內(就像演戲用的假刀)來假裝針灸,而且還有一定效果。這表示,即使只是輕輕地刺激人體穴位也是會有效果的,但這也可能是安慰劑效應。
  
  實驗室數據也認為電子針灸是真的有用。
  
  Mao醫師表示,針對電子針灸進行了一些基本科學實驗,顯示它在腦中如何釋放與疼痛處置和情緒調節有關的特定神經化學物質。
  
  藉由電子針灸,插入針後操作到「得氣」(表示有酸痛和刺痛的感覺)。研究者解釋,使用一組經皮神經電刺激單元,將兩個針灸點之間用雙向的2 Hz電流連接,這些針留在該處30分鐘。
  
  資料來源: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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