SI-TEAS intervention eases cancer-related fatigue, improves cell immunity

Somatosensory interaction transcutaneous electrical acupoint stimulation (SI-TEAS), an emerging traditional Chinese medicine nursing practice, is effective in relieving cancer-related fatigue (CRF) and improving a tumour patient’s cell immunity, a study has found.

“CRF involves very complex neurophysiological processes and is closely related to neurotransmitters at different levels in the central nervous system,” the researchers said. [Nurs Open 2022;9:851-855; Am J Clin Oncol 2021;44:137-142]

CRF patients were equally assigned to receive SI-TEAS, acupressure, or sham acupressure treatments five times a week. Using the Piper Fatigue Scale, the researchers measured the fatigue levels of patients in the three groups at baseline and after 4 and 8 weeks of treatment. The cell immunity of patients was determined by detecting the T-lymphocyte subsets and NK cells.

A total of 300 patients were enrolled, of which 279 went through the independent rehabilitation study, including 94 in the SI-TEAS group, 92 in the acupressure group, and 93 in the sham acupressure group. [Am J Clin Oncol 2022;45:316-324]

Statistically different group changes were observed during the baseline period and at various time points after weeks 4 and 8 in intergroup comparisons of fatigue degree and cell immunity.

Specifically, the SI-TEAS group showed the highest reduction in behavioural, sensory, emotional, and cognitive dimensions of fatigue and the total score, followed by the acupressure group. On the other hand, the sham acupressure group showed no significant changes.

The SI-TEAS group also had the greatest increase in the absolute counts of CD3⁺ T cells, CD4⁺ T cells, CD8⁺ T cells, CD4⁺/CD8⁺ T cells, and NK cells, followed by the acupressure group. Again, the sham acupressure group did not exhibit any significant change.

CRF pathogenesis

“The occurrence of fatigue is closely related to the growth of cancer cells and decreases in the inflammatory factors and in the haemoglobin level of the body itself,” the researchers said. [Support Care Cancer 2022;30:3733-3744; BMJ Support Palliat Care 2021;22:2-7; J Acupunct Meridian Stud 2019;12:84-89; Am J Clin Oncol 2020;43:857-860]

“TEAS intervention can facilitate the release of endorphins and enkephalins from the brain to regulate the nervous, endocrine, and immune systems bidirectionally,” they added. [Integr Med Res 2020;12:100600; Brain Behav Immun 2020;88:88-96]

A 2017 study by Hou and colleagues applied TEAS to lung cancer patients following chemotherapy. The results revealed that the intervention effectively alleviated CRF. This finding supported that of the current study. [J Thorac Dis 2017;9:1959-1966]

“However, this is only a preliminary trial. Large-scale randomized trial studies incorporating appropriately larger sample sizes and longer follow-ups are needed to confirm the findings,” the researchers said.

“In addition, the application effects of SI-TEAS on treating other diseases may also be another interesting topic that warrants further investigations,” they noted.

Based on traditional Chinese medicine philosophy, CRF is a type of “consumptive disease” or “asthenic disease.” Its pathogenesis can be summed up as “damaged viscera and constitution caused by a struggle between the vital energy and the pathogenic factor,” according to the researchers.