Acupuntura nos pacientes com doença falciforme em vigência de dor
Data
2022-01-14
Autores
Morais, Stela Cezarino 
Orientadores
Figueiredo, Maria Stella
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Verificar o benefício da acupuntura na variação da intensidade da dor relatada pelos pacientes com Doença falciformes e avaliar a redução do consumo de analgésicos. Métodos: Trata-se de um estudo prospectivo, randomizado, intervencionista, não duplo-cego com pacientes adultos com Doença falciforme. Os pacientes foram acompanhados no Ambulatório de Anemia Hereditária da Escola Paulista de Medicina (UNIFESP). De junho de 2016 a março de 2019, todos os pacientes que referiram dor durante a consulta de rotina foram convidados a participar. Após o aceite do paciente e a assinatura do termo de consentimento, foram randomizados em dois grupos: a) Grupo de Medicação (GM) – medicados com analgésicos de acordo com intensidade de dor e b) Grupo de acupuntura (GA) -submetidos a uma sessão de 15 min de acupuntura com o uso de microssistemas. Ambos os grupos receberam as mesmas prescrições de analgésico para levar para casa e um diário de dor de 14 dias para preencher. Uma comparação quantitativa da melhora da dor foi realizada em 15 min após a intervenção (medicação ou acupuntura), e diariamente durante os 14 dias seguintes. Esse projeto teve a aprovação do Comitê de Ética em Pesquisa da UNIFESP. Resultados: Quarenta e dois pacientes concordaram em participar, 26 (61,9%) no GA e 16 (38,1%) no GM. Ambos os grupos foram semelhantes à idade, uso de hidroxiureia, localização da dor, duração da dor, dor crônica, se a dor foi considerada uma crise vaso-oclusiva, se qualquer medicamento aliviou completamente a dor previamente, e contraindicação analgésica de drogas. Comparando-se com GM, o GA apresentou: a) melhora expressiva da dor após 15 min da intervenção (p<0,001), e ao final do primeiro dia (p=0,029); b) mais pacientes com redução da dor ≥ 2 de intensidade nos 15 min após a intervenção (96,2% vs. 58,3%) (p=0,008); c) a tendência de ter mais pacientes com redução da dor ≥ 2 ao final do primeiro dia (50,0% vs. 20%) (p=0,069); d) menor consumo de analgésicos até 7 e até 14 dias (p=0,008 e 0,034, respectivamente). Discussão e Conclusões: Este estudo mostrou que a acupuntura foi uma terapia complementar eficaz à medicação na redução da intensidade da dor em pacientes com Doença falciforme. No tratamento com acupuntura, os microssistemas são caracterizados por serem mais facilmente ensinados e aprendidos. Esse aprendizado fácil associado ao fato de terem melhorado diferentes tipos de dor dos pacientes torna esse resultado muito promissor. Consideramos também que sua aplicação pode ter impacto na redução do consumo de medicamentos analgésicos.
Objective: To verify the benefit of acupuncture in pain intensity reported by sickle cell patients and to evaluate the reduction in analgesic consumption. Methods: This was a prospective, randomized, interventional, non-double-blind study with adult patients with Sickle Cell Disease (SCD). The patients were followed at Hereditary Anemia Outpatient Clinic, Escola Paulista de Medicina (Federal University of São PauloUNIFESP). From June 2016 to March 2019, every patient who referred pain during the routine appointment was invited to participate. After the patient’s agreement and signing of the consent form, they were randomized into two groups: a) Medication group – medicated with analgesics according to pain intensity and b) Acupuncture Group (AG) – submitted to one 15-minute session with microsystems acupuncture points. Both groups received the same prescriptions of painkiller to take home and a 14-day pain diary to fill. A quantitative comparison of pain improvement was realized at 15 minutes pos intervention (medication or acupuncture) and daily for the following 14 days. This project had the approval of the Research Ethics Committee of UNIFESP. Results: Forty-two patients agreed to participate, 26 (61.9%) in the AG and 16 (38.1%) in the MG. Both groups were similar as to age, hydroxyurea use, pain localization, pain duration, chronic pain, if the pain was considered a vaso-occlusive crisis, if any medication completely relieved the pain before, and analgesic drug contraindication. Comparing with MG, the AG showed: a) expressive pain improvement after 15 minutes of the intervention (p<0.001), and at the end of the first day (p=0.029); b) more patients with pain reduction ≥ 2 in the 15 minutes after the intervention (96.2% vs. 58.3%) (p=0.008); c) a tendency to have more patients with pain reduction ≥ 2 at the end of the first day (50.0% vs. 20%) (p=0.069); d) a lower consumption of analgesics up to 7 and up to 14 days (p=0.008 and 0.034, respectively). Discussion and Conclusions: This study showed that acupuncture was an effective complementary therapy to medication in reducing pain intensity in sickle cell patients. In acupuncture treatment, microsystems are characterized by being more easily taught and learned. This easy learning associated with the fact that they have improved different kinds of patients' pain makes this result very promising. We considered also that its application may have an impact on reducing the consumption of analgesic medications.
Objective: To verify the benefit of acupuncture in pain intensity reported by sickle cell patients and to evaluate the reduction in analgesic consumption. Methods: This was a prospective, randomized, interventional, non-double-blind study with adult patients with Sickle Cell Disease (SCD). The patients were followed at Hereditary Anemia Outpatient Clinic, Escola Paulista de Medicina (Federal University of São PauloUNIFESP). From June 2016 to March 2019, every patient who referred pain during the routine appointment was invited to participate. After the patient’s agreement and signing of the consent form, they were randomized into two groups: a) Medication group – medicated with analgesics according to pain intensity and b) Acupuncture Group (AG) – submitted to one 15-minute session with microsystems acupuncture points. Both groups received the same prescriptions of painkiller to take home and a 14-day pain diary to fill. A quantitative comparison of pain improvement was realized at 15 minutes pos intervention (medication or acupuncture) and daily for the following 14 days. This project had the approval of the Research Ethics Committee of UNIFESP. Results: Forty-two patients agreed to participate, 26 (61.9%) in the AG and 16 (38.1%) in the MG. Both groups were similar as to age, hydroxyurea use, pain localization, pain duration, chronic pain, if the pain was considered a vaso-occlusive crisis, if any medication completely relieved the pain before, and analgesic drug contraindication. Comparing with MG, the AG showed: a) expressive pain improvement after 15 minutes of the intervention (p<0.001), and at the end of the first day (p=0.029); b) more patients with pain reduction ≥ 2 in the 15 minutes after the intervention (96.2% vs. 58.3%) (p=0.008); c) a tendency to have more patients with pain reduction ≥ 2 at the end of the first day (50.0% vs. 20%) (p=0.069); d) a lower consumption of analgesics up to 7 and up to 14 days (p=0.008 and 0.034, respectively). Discussion and Conclusions: This study showed that acupuncture was an effective complementary therapy to medication in reducing pain intensity in sickle cell patients. In acupuncture treatment, microsystems are characterized by being more easily taught and learned. This easy learning associated with the fact that they have improved different kinds of patients' pain makes this result very promising. We considered also that its application may have an impact on reducing the consumption of analgesic medications.