Avaliação do uso da tens sobre o ponto de acupuntura PC6 em mulheres com câncer de mama: um ensaio clínico randomizado

Abstract

The aim of this study was to evaluate the influence of TENS, applied at the PC6 acupuncture point, on the modulation of symptoms of nausea, vomiting, anxiety and ingestion of antiemetics associated with antineoplastic chemotherapy in women with CM diagnosis. A randomized clinical trial was conducted in which 31 women were divided into two groups: 16 in the placebo group (PG) and 15 in the treatment group (TG). As eligibility criteria were included women with indication for neoadjuvant or adjuvant QT, of high and moderate emetogenic potential, aged between 35 and 65 years and who signed the Free and Informed Consent Term. Women who had central nervous system metastasis, a diagnosis of Carpal Tunnel Syndrome referred by the patient, those who were unable to receive electrostimulation in the upper limb due to skin integrity conditions or who had decreased sensitivity under the electrodes were excluded), in addition to those who were not performing the first QT treatment, and those who presented cognitive deficits. The research was published in the Brazilian Registry of Clinical Trials (ReBEC) under number RBR-4ccv6f. In order to delineate the profile of the volunteers, a sociodemographic, clinical history and oncological treatment questionnaire was used. To evaluate the occurrence of N / V, the Multinational Association of Supportive Care in Cancer (MASCC) Antiemesis Tool (MAT) was used; for the monitoring of symptoms, the Edmonton Symptom Assessment System (ESAS) questionnaire was used, and the Beck Anxiety Inventory (IAB) was used to assess the level of anxiety. The researchers were separated into the roles of therapist and evaluator. The therapist applied the TENS protocol, while the evaluator, blinded to procedures and group randomization, applied the questionnaires. The TENS-FESHTM model was applied before infusion of the chemotherapy drugs for 30 minutes in a reserved room at the HUSM QT outpatient clinic. The volunteers were submitted to a single application of TENS in each cycle of QT with high and moderate emetogenic power. Statistical analyzes were performed using the Test T for continuous variables and Fisher's Exact test for the categorical variables, and finally Friedman's ANOVA to compare the groups throughout the chemotherapy cycles. For all tests the alpha significance level of 5% was adopted. There was no difference between the groups regarding the characterization variables of the sample. The GP showed an improvement over TG in the symptoms of nausea in 24h (0.017) and 48h (0.043) after the administration of the second cycle of chemotherapy. The physiotherapeutic approach with the use of TENS in the studied sample had no effect on the control of N / V symptoms and anxiety caused by the treatment of antineoplastic chemotherapy, as well as on antiemetic intake.