腹针防治含顺铂方案化疗所致恶心、呕吐疗效观察

Therapeutic Observation of Abdominal Acupuncture in Preventing Nausea and Vomiting Caused by Cisplatin-based Chemotherapy

目的观察腹针疗法防治含顺铂化疗方案所致恶心、呕吐的临床疗效。方法选取30例拟接受至少2周期含顺铂方案化疗的住院患者,实行自身前后交叉对照方法,采用信封法分为观察组和对照组。观察组采用腹针加盐酸托烷司琼,对照组单用盐酸托烷司琼,记录两组患者化疗第1～6天的消化道反应(恶心、呕吐的程度)、化疗后其他不良反应及化疗前后血常规、肝肾功能等检查结果。结果恶心控制方面观察组有效率明显高于对照组;观察组较对照组在化疗第2～5天出现恶心的程度明显偏轻(P<0.05),尤其在化疗第4、第5天有统计学差异(P<0.01)。呕吐控制方面观察组有效率明显高于对照组;观察组较对照组在化疗第3～5天出现呕吐的程度明显偏轻(P<0.05),尤其在化疗第4、第5天有统计学差异(P<0.01)。两组患者治疗后血常规、肝肾功能相比无明显差异。结论腹针疗法联合盐酸托烷司琼可有效减轻含顺铂化疗方案所致的恶心及迟发型呕吐。暂时没有发现腹针疗法有防治骨髓抑制及保护肝肾功能作用。

Objective To observe the clinical efficacy of abdominal acupuncture in preventing nausea and vomiting caused by cisplatin-based chemotherapy. Method Thirty inpatients preparing to receive cisplatin-based chemotherapy for at least 2 cycles were divided into an observation group and a control group （by envelop concealing method） to conduct a self-controlled crossover study. The observation group was intervened by abdominal acupuncture together with Tropisetron hydrochloride, and the control group was by Tropisetron hydrochloride only. From the chemotherapy day 1 to day 6, the gastrointestinal reactions （nausea and vomiting）, other adverse reactions to chemotherapy, as well as blood routine, liver and kidney function examinations before and after treatment were recorded. Result Regarding the control of nausea, the observation group had significantly higher effective rate compared to the control group; the Chi-square test showed that the observation group had significantly milder nausea degree compared to the control group during chemotherapy day 2 and day 5 （P^0.05）, especially on day 4 and day 5 （P〈0.01）. About the control of vomiting, the observation group had a significantly higher effective rate than the control group; the Chi-square test showed that the observation group had a significantly milder vomiting degree compared to the control group during chemotherapy day 3 and day 5 （P〈0.05）, especially on day 4 and day 5 （P〈0.01）. There were no significant differences in comparing the blood routine, liver and kidney function examinations between the two groups after treatment. Conclusion Abdominal acupuncture plus Tropisetron hydrochloride can effectively reduce nausea and delayed vomiting caused by cisplatin-based chemotherapy. So far, there is no evidence to show that abdominal acupuncture can prevent bone marrow suppression or protect liver and kidney functions.