Biological Correlates of the Effects of Auricular Point Acupressure on Pain.
Biological Correlates of the Effects of Auricular Point Acupressure on Pain.
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耳穴穴位按压对疼痛影响的生物相关性。
DOI：
10.1016/j.pmn.2022.11.004
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Smith,ThomasJ
中科院分区：
文献类型：
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作者：
Yeh,ChaoHsing;Lukkahatai,Nada;Huang,Xinran;Wu,Hulin;Wang,Hongyu;Zhang,Jingyu;Sun,Xinyi;Smith,ThomasJ
目的探讨耳穴穴位按压缓解疼痛的潜在炎性生物标志物，并考察疼痛强度、干预和炎症生物标志物之间的相关性。设计：二次数据分析。方法综合分析3个试点研究(慢性下腰痛61例，芳香酶抑制剂相关关节痛20例，化疗所致神经病变15例)的炎性生物标志物和患者自报疼痛强度的数据。本文报告了基于每个研究组(慢性下腰痛、癌症疼痛)的受试者内治疗效果(干预前和干预后的评分变化)、组间差异(靶点APA[T-APA]和非靶点APA[NT-APA]从干预前到干预后的评分变化)以及疼痛强度、干预和生物标志物之间的相关性的结果。结果。组内分析(评分从治疗前到治疗后的变化)显示三个生物标志物的变化具有统计学意义：肿瘤坏死因子-α(癌症疼痛，p=0.03)、β-内啡肽(背痛，p=0.04)和IL-2(NT-apa组，p=0.002)。根据对慢性下腰痛患者的组间分析(T-APA与NT-APA)，IL-4的效应大小最大(0.35)，其次是肿瘤坏死因子-α(0.29)。IL-1β与IL-2呈单调正相关。结论和临床意义。目前的研究结果进一步支持炎性生物标志物在APA的止痛作用中的潜在作用。需要更多的工作来全面了解APA治疗慢性疼痛的潜在机制。由于APA简单、廉价、无副作用，可以作为阿片类药物的替代品广泛传播。
PurposeTo identify candidate inflammatory biomarkers for the underlying mechanism of auricular point acupressure (APA) on pain relief and examine the correlations among pain intensity, interference, and inflammatory biomarkers.DesignThis is a secondary data analysis.MethodsData on inflammatory biomarkers collected via blood samples and patient self-reported pain intensity and interference from three pilot studies (chronic low back pain, n=61; arthralgia related to aromatase inhibitors, n=20; and chemotherapy-induced neuropathy, n=15) were integrated and analyzed. This paper reports the results based on within-subject treatment effects (change in scores from pre- to post-APA intervention) for each study group (chronic low back pain, cancer pain), between-group differences (changes in scores from pre- to post-intervention between targeted-point APA [T-APA] and non-targeted-point APA [NT-APA]), and correlations among pain intensity, interference, and biomarkers. Results. Within-group analysis (the change score from pre- to post-APA) revealed statistically significant changes in three biomarkers: TNF-α (cancer pain in the APA group, p=0.03), β-endorphin (back pain in the APA group, p=0.04), and IL-2 (back pain in the NT-APA group, p=0.002). Based on between-group analysis in patients with chronic low back pain (T-APA vs NT-APA), IL-4 had the largest effect size (0.35), followed by TNF-α (0.29). A strong positive monotonic relationship between IL-1β and IL-2 was detected. Conclusions and Clinical Implications. The current findings further support the potential role of inflammatory biomarkers in the analgesic effects of APA. More work is needed to gain a comprehensive understanding of the underlying mechanisms of APA on chronic pain. Because it is simple, inexpensive, and has no negative side effects, APA can be widely disseminated as an alternative to opioids.