Efficacy and safety of transcutaneous electrical acupoint stimulation and acupressure in alleviating chemotherapy-related adverse reactions in female patients with breast cancer: a randomized clinical trial

Background: Common adverse reactions to breast cancer chemotherapy (nausea, vomiting, sleep disorders, anxiety, depression) are often suboptimally managed. These symptoms undermine patients's quality of life and reduce chemotherapy adherence. Two non-invasive Traditional Chinese Medicine (TCM) interventions-transcutaneous electrical acupoint stimulation (TEAS) and acupressure have demonstrated efficacy in alleviating such discomforts, data on their effectiveness and dynamic therapeutic characteristics throughout the full chemotherapy course remain insufficient. Method: multiple comparisons, supplemented by intention-to-treat (ITT) analysis and per-protocol set (PPS) analysis. Results: Main time effect: With the progression of chemotherapy cycles, the risk of delayed chemotherapy-induced nausea and vomiting (delayed CINV) significantly increased; patients' anxiety levels were higher in the early stage of chemotherapy cycles and showed a downward trend after the 3rd cycle. Main intervention effect: TEAS significantly improved patients' quality of life(QOL), while acupressure primarily alleviated psychological symptoms such as anxiety and depression. Interaction effect: The therapeutic effect of TEAS was cumulative, exerting more pronounced benefits in reducing the risk of delayed CINV, improving sleep quality, and relieving delayed nausea during the mid-to-late stages of chemotherapy (cycles 3-4); acupressure achieved optimal anxiety relief in the early stage (cycle 1) and progressively alleviated delayed nausea and enhanced QOL throughout the treatment course. Conclusion: TEAS and acupressure exhibit dynamic and distinct effects in mitigating adverse reactions in breast cancer patients undergoing chemotherapy. TEAS is more suitable for the comprehensive improvement of physical symptoms and QOL during the mid-to-late stages of chemotherapy, while acupressure is preferred for early anxiety relief and gradual improvement of psychosomatic symptoms throughout the treatment. These findings provide a reference for the development of individualized non-invasive clinical intervention strategies. Clinical trial registration: https://www.chictr.org.cn/, identifier ChiCTR2300077667.