针刺在NP方案治疗非小细胞肺癌患者中对延迟性恶心呕吐的控制

Clinical research of acupuncture treatment in the prevention of delayed nausea and vomiting induced by NVB and CDDP for the treatment of NSCLC

背景与目的恶心和呕吐是非小细胞肺癌患者化疗过程中最难以忍受的副反应之一,高选择性5-HT3受体阻滞剂对于急性期恶心呕吐的控制比较满意,但对延迟性恶心呕吐的控制较差,针刺是我国的传统疗法,具有疗效可靠,花费少,简单易行的特点。本次研究为了观察针刺在NP方案治疗非小细胞肺癌患者对延迟性恶心呕吐的影响。方法采用随机、双盲、自身交叉对照研究方法,治疗NSCLC患者26例,AB组盐酸恩丹西酮+地塞米松+针刺(第1周期)→盐酸恩丹西酮+地塞米松(第2周期);BA盐酸恩丹西酮+地塞米松(第1周期)→盐酸恩丹西酮+地塞米松+针刺(第2周期)。结果加用针刺治疗对延迟性恶心的控制d1-6分别为96.15%、96.15%、76.92%、84.62%、92.31%和100.00%;不加针刺组为100.00%、76.92%、57.69%、34.62%、65.38%和76.92%(d2-6,P<0.05)。呕吐的控制加用针刺治疗d1-6分别为96.15%、100.00%、88.46%、84.62%、100.00%和100.00%;不加用针刺治疗为100.00%、92.31%、73.08%、53.85%、76.92%和92.31%(d3-5,P<0.05)。结论针刺配合止吐治疗可以显著降低NSCLC患者的延迟性恶心呕吐的发生率。

Background and purpose： Nausea and vomiting were the most common side effects of chemotherapy and they are difficult to control especially in terms of delayed nausea and vomiting induced by CDDP. Acupuncture treatment is popularly the traditional medical method used in China, being economic and easy to carry out. This research is to study the role of acupuncture treatment in the prevention of NP regimen induced delayed nausea and vomiting. Methods： 26 patients with NSCLC were enrolled into a randomized double blind crossover trial. The patients received either hydrochloride ondostrone ＋ Dexm ＋ acupuncture treatment（ the first cycle of chemotherapy） →hydrochloride ondostrone ＋ Dexm （ the second cycle of chemotherapy） （ defined as AB group） or hydrochloride ondostrone ＋ Dexm （ the first cycle of chemotherapy） →hydrochloride ondostrone ＋ Dexm ＋ acupuncture treatment （ the second cycle of chemotherapy） （ defined as BA group）. Resuits： Twenty six patients were evaluated. The complete controls of nausea for the AB group with acupuncture treatment were 96.15%, 96.15%, 76.92%, 84.62%, 92.31% and 100.00% for day 1-6, respectively, for the BA group without acupuncture treatment were 100.00%, 76.92%, 57.69%, 34.62%, 65.38% and 76.92%, respectively. There were statistically difference in terms of the control of nausea for day 3-5（ P 〈 0.05）. The complete controls of vomiting for the AB group were 96. 15%, 100.00%, 88.46%, 84.62%, 100.00% and 100.00% for day 1-6, respectively, for the BA group were 100.00%, 92.31%, 73.08%, 53.85%, 76.92% and 92.31%, respectively. There was also statistically difference in terms of the control of vomiting for day 2-6 （ P 〈0.05）. Conclusions： The results imply that acupuncture treatment may decrease occurrences of delayed nausea and vomiting induced by CDDP ＋ NVB in the treatment of NSCLC.