Effects of transcutaneous electrical nerve stimulation on physical symptoms in advanced cancer patients receiving palliative care
Effects of transcutaneous electrical nerve stimulation on physical symptoms in advanced cancer patients receiving palliative care
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DOI：
10.1097/mrr.0000000000000386
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发表时间：
2020-03
影响因子：
1.7
通讯作者：
J. Nakano;Koji Ishii;Takuya Fukushima;Shun Ishii;K. Ueno;E. Matsuura;K. Hashizume;Satoru Morishita;Koji Tanaka;Y. Kusuba
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文献类型：
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作者：
J. Nakano;Koji Ishii;Takuya Fukushima;Shun Ishii;K. Ueno;E. Matsuura;K. Hashizume;Satoru Morishita;Koji Tanaka;Y. Kusuba
经皮电神经刺激（TENS）主要用于疼痛，但可能对各种其他身体症状有用，包括恶心，疲劳，呼吸困难和便秘。然而，很少有研究使用TENS治疗晚期癌症患者的身体症状。在这项交叉试验中，我们评估了TENS对20名接受姑息治疗的晚期癌症住院患者疼痛和其他身体症状的影响。对于5天洗脱期之间的5天阶段，患者接受TENS或非TENS。TENS在四个点进行：背部中心主要用于恶心和呼吸困难，背部与疼痛起源相同的皮节水平（100 Hz），以及两个踝关节用于便秘（10 Hz）。记录疼痛强度和各阶段使用的阿片类药物总剂量。使用欧洲癌症研究与治疗组织（EORTC）生活质量问卷核心15姑息治疗（QLQ-C15-PAL）评价身体症状。在TENS阶段前后记录血液学和生化数据。TENS显著降低了平均疼痛和阿片类药物补救剂量的总数。TENS倾向于改善恶心和食欲不振，但不能改善便秘。对血液学和生化参数无影响。使用TENS可以安全地改善晚期癌症患者的疼痛，恶心和食欲不振。虽然它不能用作阿片类药物和其他药物治疗的替代品，但它可能有助于支持姑息治疗。
Transcutaneous electrical nerve stimulation (TENS) is primarily used for pain, but might be useful for various other physical symptoms, including nausea, fatigue, dyspnea, and constipation. However, few studies have used TENS for treating the physical symptoms of patients with advanced cancer. In this crossover trial, we assess the effects of TENS on pain and other physical symptoms in 20 in-patients with advanced cancer receiving palliative care. For 5-day phases between wash out periods of 5 days, patients received TENS or non-TENS. TENS was delivered at four points: the center of the back for mainly nausea and dyspnea, on the back at the same dermatomal level as the origin of the pain (100 Hz), and on both ankle joints for constipation (10 Hz). The intensity of pain and the total opioid dose used during phases were recorded. Physical symptoms were evaluated using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 15 Palliative Care (QLQ-C15-PAL). Hematological and biochemical data were recorded before and after the TENS phase. The average pain and total number of opioid rescue doses were significantly reduced by TENS. TENS tended to improve nausea and appetite loss, but not constipation. There were no effects on hematological and biochemical parameters. Use of TENS could safely improve pain, nausea, and appetite loss in patients with advanced cancer. Although it cannot be used as a substitute for opioids and other pharmaceutical treatment, it may be useful to support palliative care.