Evaluation of therapeutic effect of transcutaneous electrical acupoint stimulation on bone metastasis pain and its influence on immune function of patients

Tai, Jia-Bin; Liu, Hong; Ma, Meng-En; Xu, Jia; Fang, Jing; Jiang, Yunshan

doi:10.21037/apm-19-434

Cited by 6 publications

(18 citation statements)

References 16 publications

(15 reference statements)

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“…The needle retention time, the number of sessions, duration, and acupuncture point varied with acupuncture types; for details, see Table 1 . Eleven studies ( 34 – 39 , 41 – 45 ) compared acupuncture plus control treatment with control treatment, one study ( 40 ) compared wrist-ankle acupuncture treatment alone with analgesic therapy, and the remaining one ( 46 ) compared TEAS with the combination of analgesic therapy and sham TEAS. Pain intensity as a primary outcome was used to evaluate the effect of acupuncture; VAS and NRS were the most frequently used measurement tools for pain intensity.…”

Section: Resultsmentioning

confidence: 99%

“…Pain intensity as a primary outcome was used to evaluate the effect of acupuncture; VAS and NRS were the most frequently used measurement tools for pain intensity. Five studies ( 36 , 40 , 44 – 46 ) reported VAS scores, seven studies ( 35 , 37 – 39 , 41 – 43 ) reported NRS scores, and in addition, one study ( 34 ) appraised the pain intensity by BPI scores. In terms of reference outcomes, eight studies ( 35 , 37 – 39 , 41 – 43 , 45 ) reported a pain relief rate, one study ( 34 ) measured the changes in the frequency of breakthrough pain, and two studies ( 37 , 39 ) measured the analgesic onset time and analgesia duration after acupuncture treatments.…”

Section: Resultsmentioning

confidence: 99%

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Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis

Yan

MuRong²,

Huo³

et al. 2022

Front. Pain Res.

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BackgroundCancer-induced bone pain (CIBP) is a special type of cancer pain and lacks safe and effective treatments. Acupuncture is a potentially valuable treatment for CIBP, studies evaluating the effect of acupuncture on CIBP have increased significantly, but the safety and efficacy of acupuncture to control CIBP remains controversial.ObjectiveTo provide the first meta-analysis to evaluate the safety and efficacy of acupuncture in CIBP management.Data SourcesCNKI, CBM, Wanfang, VIP Database, PubMed, Embase, and Cochrane Library were searched from their inception until 1 June 2022.Study SelectionRCTs with primary bone tumor patients or other types of primary cancer companied by bone metastases as the research subjects and to evaluate the efficacy of acupuncture treatment alone or combined with the control treatment were included. Meanwhile, RCTs should choose the pain score as the primary outcome and pain relief rate, frequency of breakthrough pain, analgesic onset time, analgesia duration, quality of life, and adverse events as reference outcomes.Data Collection and AnalysisWe designed a data-extraction form that was used to extract key information from the articles. Data extraction study evaluation was conducted independently by two reviewers, and a third reviewer would resolve any disagreements. The risk of bias was assessed by the Cochrane Collaboration's tool for assessing the risk bias. The quality of the evidence for main outcomes was evaluated by the GRADE system. Mean differences (MD), relative risk (RR), and 95% confidence intervals (CIs) were calculated. The forest plots were performed using the Review Manager Software (5.3 version). Subgroup analysis was used to investigate the possible sources of potential heterogeneity. Descriptive analysis was performed in case of unacceptable clinical heterogeneity.ResultsThirteen RCTs (with 1,069 patients) were included, and all studies were at high risk of bias owing to lack of blinding or other bias. Eleven studies evaluated the effectiveness of acupuncture as a complementary therapy, and showed that acupuncture plus control treatment (compared with control treatment) was connected with reduced pain intensity (MD = −1.34, 95% CI −1.74 to −0.94; Q < 0.1; I2 = 98%, P < 0.01). Subgroup analyses based on acupoints type partly explain the potential heterogeneity. The results also showed that acupuncture plus control treatment (compared with control treatment) was connected with relieving pain intensity, increasing the pain relief rate, reducing the frequency of breakthrough pain, shortening analgesic onset time, extending the analgesic duration, and improving the quality of life. We have no sufficient evidence to prove the effectiveness of acupuncture alone. Four RCTs reported only adverse events related to opioids' side effects. Evidence was qualified as “very low” because of low methodological quality, considerable heterogeneity, or a low number of included studies.ConclusionAcupuncture has a certain effect as a complementary therapy on pain management of CIBP, which not only mitigates the pain intensity but also improves the quality of life and reduces the incidence of opioids' side effects, although the evidence level was very low. In future, a larger sample size and rigorously designed RCTs are needed to provide sufficient evidence to identify the efficacy and safety of acupuncture as a treatment for CIBP.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis

Yan

MuRong²,

Huo³

et al. 2022

Front. Pain Res.

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“…Dysfunction of the HPA axis is thought to be primarily responsible for psychological/behavioral symptoms (pain sensitivity, depression, and fatigue) [ 38 ]. An RCT showed that TAES treatment can increase the serum levels of IL-2 and IFN- γ , and decreased IL-4 secretion and return the aforementioned cellular immune factors to the preoperative control value at a faster rate [ 39 ]. These results suggest that TAES can reduce postoperative immune dysfunction by changing the expression of Th1/Th2 cell-associated cytokines [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…An RCT showed that TAES treatment can increase the serum levels of IL-2 and IFN- γ , and decreased IL-4 secretion and return the aforementioned cellular immune factors to the preoperative control value at a faster rate [ 39 ]. These results suggest that TAES can reduce postoperative immune dysfunction by changing the expression of Th1/Th2 cell-associated cytokines [ 39 ]. Simultaneously, some preclinical studies have also shown that TEAS can attenuate cognitive deficits by inhibiting neuronal peroxide reactions in hippocampus tissue and inflammation of the central and peripheral nervous systems [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Transcutaneous Electrical Acupoint Stimulation for Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials

Wang

Shi

Yang

et al. 2022

Pain Research and Management

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Objective. This meta-analysis aims to evaluate the effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) in treating post-operative pain. Methods. This meta-analysis was registered in PROSPERO (CRD42021286753). We searched PubMed, Embase, and the Cochrane Library for relevant randomized controlled trials (RCTs) about TEAS in treating postoperative pain that were published before November 2021. The primary outcome was visual analogue scale (VAS) within 24 h after surgery. The secondary outcomes included postoperative opioid analgesic drug consumption and the occurrence of adverse reactions within the postoperative 24–72 h. Adverse reactions included dizziness, nausea, and vomiting. Continuous variables were analyzed using mean difference (MDs) or standardized mean difference (SMDs) and 95% CIs. Relative risk (RR) and 95% CI were used for dichotomous data. The data were pooled and analyzed by RevMan 5.4 and STATA15.0 software. Results. Seventeen trials with 1375 participants were included. The current results suggested that application of TEAS showed obvious superiority in reducing VAS scores (SMD = −1.51, 95% CI = −2.20∼−0.82, I2 = 96%). Subgroup analysis was performed according to open surgery and minimally invasive surgery. VAS scores were decreased after surgery at 24 h (SMD = −0.84, 95% CI = −1.07∼−0.6, I2 = 96%; SMD = −0.88, 95% CI = −1.02∼−0.75, I2 = 96%). The incidence of postoperative dizziness and nausea and vomiting was significantly lower in the TEAS group within postoperative 24–72 h (RR = 0.48, 95% CI = 0.34∼0.68, I2 = 0%; RR = 0.66, 95% CI = 0.44∼1.01, I2 = 69%; and RR = 0.49, 95% CI = 0.24∼1.00, I2 = 51%). Postoperative opioid analgesics were also reduced in the TEAS group within 72 h after surgery (SMD = −2.10, 95% CI = −3.37∼−0.82, I2 = 96%). Conclusions. TEAS can reduce postoperative pain as well as the incidence of dizziness, nausea, and vomiting and the number of analgesics used after surgery. TEAS is a reasonable modality to incorporate into a multimodal management approach for postoperative pain.

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“…Furthermore, approximately two-thirds of bone metastases result in pain, with majority of these cases being moderate to severe pain. This significantly reduces the quality of life of patients and affects their sleep, mood, and general daily life (11), which may lead to reduced compliance. Notably, tumor cells themselves do not destroy bone tissue, they do by expressing an inflammation molecule, such as nuclear factor kappa-B (NF-κB), which binds to its receptor activator of nuclear factor-κB/receptor activator of nuclear factor-κB ligan (RANK/RANKL), thereby activating the downstream pathway (12).…”

Section: Discussionmentioning

confidence: 99%

Effect of palliative microwave ablation on metastatic osseous pain: a single-center retrospective study

Yang

Ren²,

Bian

et al. 2021

Ann Palliat Med

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Background: Bone is among the most common metastasis sites in patients with advanced cancer.Approximately two-thirds of bone metastasis results in pain, the majority of which is moderate to unbearable pain, which seriously affects the quality of life of patients. With the development of ablation techniques, microwave ablation (MWA) has great potential to eliminate the pain caused by bone metastasis. This study aimed to evaluate the efficacy and safety of image-guided (computed tomography-guided) percutaneous MWA for metastatic osseous pain.Methods: This is a retrospective study involving 18 patients with cancer-related pain caused by osseous or soft tissue metastasis in the First Affiliated Hospital of Soochow University from June 2015 to October 2020.All patients (14 men and 4 women; mean age 60.2 years) underwent image-guided percutaneous palliative MWA. A paired-sample t-test was used to compare the changes in Numeric Rating Scale (NRS) score and dosage of morphine preoperatively and postoperatively (at 24 h, 3 days, and 14 days after MWA). In addition, we assessed the level of pain relief according to the patients' subjective feelings. Results:The paired-samples t-test showed that the NRS score (6.83±0.92 vs. 1.67±0.97, P<0.05) and dosage of morphine (85.56±17.23 vs. 32.78±4.61, P<0.05) were significantly decreased at 3 days after MWA. At 14 days after MWA, the NRS score (6.83±0.92 vs. 0.94±0.87, P<0.05) and dosage of morphine (85.56±17.23 vs. 10.56±8.73, P<0.05) were also markedly decreased. Moreover, according to the patients' subjective feeling, 88.89% patients had pain relief postoperatively, while the remaining patients had no progress.Conclusions: Image-guided (Computed Tomography-guided) percutaneous MWA can effectively relieve pain, thus improving the quality of life in patients with osseous metastasis. MWA is a feasible, safe, and effective treatment for pain caused by bone metastasis.

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Evaluation of therapeutic effect of transcutaneous electrical acupoint stimulation on bone metastasis pain and its influence on immune function of patients

Cited by 6 publications

References 16 publications

Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis

Acupuncture as a Complementary Therapy for Cancer-Induced Bone Pain: A Systematic Review and Meta-Analysis

Efficacy and Safety of Transcutaneous Electrical Acupoint Stimulation for Postoperative Pain: A Meta-Analysis of Randomized Controlled Trials

Effect of palliative microwave ablation on metastatic osseous pain: a single-center retrospective study

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