The Effect of Electroacupuncture Therapy on Pain, Plasma β-Endorphin, and Quality of Life of Stage III Cervical Cancer Patients: A Randomized Control Trial

Abstract

Background: Pain is a major complaint in cancer patients and a global problem that requires medical attention, including pain in cervical cancer. Although pharmacotherapy has been used for the treatment of cancer pain, there are still around 40% cannot be treated only with pharmacotherapy. Objectives: To determine the effects of electroacupuncture (EA) on pain in stage III cervical cancer patients. Methods: Twenty-eight stage III cervical cancer patients were divided into two groups (14 treatments and 14 controls) with randomized control trial design. The treatment group received EA with a frequency of 2/20-25 Hz at points of ST36, SP6, LI4 and LR3 for 30 minutes, while the control group did not receive EA. Both groups were given paracetamol and codeine at the same dose. Assessment was carried out by measuring pain scale (VAS), plasma β-endorphin levels, and quality of life/QoL (EORTC QLQ-C30) before and after therapy. Results: The average reduction in VAS in the treatment group (2.71 ± 1.14) compared to the control group (0.71 ± 1.33; p < 0.001), average increase in plasma β-endorphin levels in the treatment group (88.57 ± 52.46 pg/ml) compared to the control group (12.86 ± 56.76 pg/ml; p = 0.001), and in QoL, there were significant differences in symptom improvement between the treatment and control groups in the domain of fatigue, pain, insomnia and overall QoL (p < 0.05). Conclusion: Medical therapy combined with EA decreased pain scale, increased plasma β-endorphin levels, and improved the QoL for stage III cervical cancer patients.

Electroacupuncture for the treatment of cancer pain: a systematic review and meta-analysis of randomized clinical trials

“…Zusanli (ST36), Hegu (LI4), Sanyinjiao (SP6), and the extraordinary point Siguan were the most frequently used acupoints. Eleven studies reported “deqi” ( 21 , 23 – 26 , 29 – 32 , 34 , 36 ), a sensation of needling perceived as soreness, numbness, or distension, which is usually achieved by manipulating acupuncture needles to obtain the desired therapeutic effect, and seven other studies did not mention this effect ( 20 , 22 , 27 , 28 , 33 , 35 ). In most studies, patients were treated for 30 min per session.…”

“…The duration of time patients received electroacupuncture treatment ranged from 1 to 12 weeks. In terms of electroacupuncture waveforms, six studies used disperse dense wave ( 20 , 26 , 27 , 33 – 35 ), four studies used continuous waves ( 30 – 32 , 36 ), and one study used only dense waves ( 28 ), with the remaining trials not specified; in terms of electroacupuncture frequency, it ranged from 2 hz to 100 hz, in terms of applying electroacupuncture current intensity, only a few studies specifically reported the intensity of the current used ( 27 , 31 , 35 , 36 ), most of the other trials stated the maximum intensity within the patients’ tolerance.…”

“…Of the 17 RCTs included, 7 RCTs did not describe problems associated with the randomization process ( 20 – 22 , 26 , 31 – 33 ). 7 RCTs used a table of random numbers ( 27 – 30 , 34 – 36 ), Mao et al performed randomization by a secure system with full allocation hiding ( 23 ), and Wong et al used a computer-generated random sequence ( 25 ).…”

“…Eight RCTs reported exit or withdrawal information appropriately ( 21 – 24 , 26 , 30 , 35 , 36 ), however, missing data were not addressed, so they were rated as high risk of bias in the attrition bias evaluation. Eight trials did not have missing data ( 20 , 25 , 28 , 29 , 31 – 34 ). One trial did not report the presence or absence of missing data and was judged to be at uncertain risk ( 27 ).…”

“…Of the 17 RCTs included, 6 RCTs reported that their study teams pre-defined the study protocol and were therefore evaluated as low risk in reporting bias ( 20 , 21 , 23 , 24 , 27 , 33 ). 4 RCTs did not report the full study protocol and were therefore judged to be at high risk ( 25 , 30 , 35 , 36 ).…”