Acupuncture for chemotherapy-induced neutropenia in patients with gynecologic malignancies: a pilot randomized, sham-controlled clinical trial.
Acupuncture for chemotherapy-induced neutropenia in patients with gynecologic malignancies: a pilot randomized, sham-controlled clinical trial.
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DOI：
10.1089/acm.2008.0589
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发表时间：
2009-07
期刊：
影响因子：
--
通讯作者：
Penson RT
中科院分区：
文献类型：
--
作者：
Lu W;Matulonis UA;Doherty-Gilman A;Lee H;Dean-Clower E;Rosulek A;Gibson C;Goodman A;Davis RB;Buring JE;Wayne PM;Rosenthal DS;Penson RT
本研究的目的是探讨骨髓抑制化疗期间针灸对卵巢癌患者白细胞（WBC）计数和绝对中性粒细胞计数（ANC）的影响。这项研究是一项试点、随机、假对照的临床试验。患者在接受化疗时分别接受主动针刺和假针刺。采用标准化的针刺方案，结合手动和电刺激。治疗频率为每周2-3次，共10次，从第二周期化疗前1周开始。现场是两个癌症患者门诊学术中心。21例新诊断和复发的卵巢癌患者为研究对象。每周评估WBC计数、ANC和血浆粒细胞集落刺激因子（G-CSF）。在调整基线值（8600个细胞/μL，范围：4800 ~ 12000）后，针刺组第三个化疗周期第一天的白细胞中位值显著高于对照组（4400个细胞/μL，范围：2300 ~ 10000）（p = 0.046）。针刺组2-4级白细胞减少的发生率低于假手术组（30% vs 90%; p = 0.02）。然而，在调整基线差异后，中位白细胞最低点、中性粒细胞最低点和恢复ANC均较高，但差异无统计学意义（p = 0.116-0.16）。两组患者血浆G-CSF差异无统计学意义。我们观察到卵巢癌患者在一个化疗周期中WBC值升高的临床相关趋势，这表明针灸可能具有骨髓保护作用。一个更大的试验是必要的，以更明确地确定针灸对化疗引起的中性粒细胞减少的临床重要结果的疗效。
The objective of this study was to investigate the effect of acupuncture administered during myelosuppressive chemotherapy on white blood cell (WBC) count and absolute neutrophil count (ANC) in patients with ovarian cancer. This study is a pilot, randomized, sham-controlled clinical trial. Patients received active acupuncture versus sham acupuncture while undergoing chemotherapy. A standardized acupuncture protocol was employed with manual and electrostimulation. The frequency of treatment was 2–3 times per week for a total of 10 sessions, starting 1 week before the second cycle of chemotherapy. The setting was two outpatient academic centers for patients with cancer. Twenty-one (21) newly diagnosed and recurrent ovarian cancer patients were the subjects. WBC count, ANC, and plasma granulocyte colony-stimulating factor (G-CSF) were assessed weekly. The median leukocyte value in the acupuncture arm at the first day of the third cycle of chemotherapy was significantly higher than in the control arm after adjusting for baseline value (8600 cells/μL, range: 4800–12,000 versus 4400 cell/μL, range: 2300–10,000) (p = 0.046). The incidence of grade 2–4 leukopenia was less in the acupuncture arm than in the sham arm (30% versus 90%; p = 0.02). However, the median leukocyte nadir, neutrophil nadir, and recovering ANC were all higher but not statistically significantly different (p = 0.116–0.16), after adjusting for baseline differences. There were no statistically significant differences in plasma G-CSF between the two groups. We observed clinically relevant trends of higher WBC values during one cycle of chemotherapy in patients with ovarian cancer, which suggests a potential myeloprotective effect of acupuncture. A larger trial is warranted to more definitively determine the efficacy of acupuncture on clinically important outcomes of chemotherapy-induced neutropenia.
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影响因子：
45.3
作者：
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通讯作者：
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影响因子：
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