经皮穴位电刺激(TEAS)与穴位按压对缓解 乳腺癌患者术后疼痛的有效性研究

A Study on the Effectiveness of Transcutaneous Electrical Acupoint Stimulation (TEAS) versus Acupressure in Alleviating Postoperative Pain in Breast Cancer Patients

摘要: 目的：本研究旨在系统评估经皮穴位电刺激(Transcutaneous Electrical Acupoint Stimulation, TEAS)与手法穴位按压作为多模式镇痛辅助手段，对缓解乳腺癌患者术后疼痛、改善焦虑情绪的有效性及安全性，并比较两种非药物干预措施的优劣。方法：采用单中心、前瞻性、随机对照的设计。将105例择期乳腺癌手术患者按1:1:1随机分为TEAS干预组(T组)、穴位按压组(A组)和空白对照组(C组)。所有患者接受标准术后护理方案，干预组在术后2 h、24 h、48 h接受相应干预。主要结局指标为术后2 h、24 h、48 h视觉模拟评分(Visual Analogue Scale, VAS)，次要结局包括医院焦虑和抑郁量表(Hospital Anxiety and Depression Scale, HADS)评估患者心理压力、不良反应发生情况。结果：最终105例患者完成研究。在疼痛控制方面，术后各时间点T组与A组VAS评分均显著低于C组(P < 0.01)。T组在术后早期(2 h、24 h)的VAS评分显著低于A组(P < 0.05)。在焦虑改善方面，干预组术后医院焦虑和抑郁量评分显著低于C组(P < 0.01)。T组与A组均表现出良好的耐受性。结论：TEAS能显著缓解乳腺癌术后疼痛与焦虑，效果优于穴位按压；穴位按压亦有一定镇痛抗焦虑作用。两种非药物干预均可作为安全有效的术后辅助镇痛手段。

Abstract: Objective: This study aims to systematically evaluate the effectiveness and safety of Transcutaneous Electrical Acupoint Stimulation (TEAS) and manual acupressure as adjuncts to multimodal analgesia in alleviating postoperative pain and improving anxiety in breast cancer patients, and to compare the advantages and disadvantages of these two non-pharmacological interventions. Methods: A single-center, prospective, randomized controlled design was adopted. A total of 105 patients scheduled for elective breast cancer surgery were randomly assigned in a 1:1:1 ratio to the TEAS intervention group (Group T), the acupressure group (Group A), or the blank control group (Group C). All patients received standard postoperative care protocols. The intervention groups received corresponding interventions at 2 hours, 24 hours, and 48 hours postoperatively. The primary outcome measures were Visual Analogue Scale (VAS) scores at 2 hours, 24 hours, and 48 hours postoperatively. Secondary outcomes included psychological stress assessed by the Hospital Anxiety and Depression Scale (HADS), and the incidence of adverse reactions. Results: All 105 patients completed the study. Regarding pain control, VAS scores in both Group T and Group A at all postoperative time points were significantly lower than those in Group C (P < 0.01). Group T showed significantly lower VAS scores than Group A in the early postoperative period (2 h, 24 h) (P < 0.05). Regarding anxiety improvement, postoperative HADS scores in the intervention groups were significantly lower than those in Group C (P < 0.01). Both Group T and Group A demonstrated good tolerance. Conclusion: TEAS can significantly alleviate postoperative pain and anxiety in breast cancer patients, with effects superior to those of acupressure; acupressure also exhibits certain analgesic and anti-anxiety effects. Both non-pharmacological interventions can serve as safe and effective adjunctive analgesic modalities for postoperative management.