穴位按压联合艾灸减轻顺铂类化疗药物胃肠道反应的临床研究

Clinical study for the efficacy of points acupressure combined with moxibustion in preventing gastrointestinal reactions caused by cisplatin-based chemotherapy

目的：观察穴位按压联合艾灸对减轻顺铂类化疗药物胃肠道反应的疗效。方法将100例行顺铂类药物化疗的恶性肿瘤患者随机分为实验组和对照组各50例。所有患者化疗期间均给予常规抑酸、止吐治疗，实验组同时加用中脘、内关、足三里、合谷穴位按压及艾灸治疗，每日两次，化疗前1d开始，至化疗后3d结束。比较两组患者化疗后胃肠道反应的发生率及症状分级有无差异。结果呕吐情况：实验组患者急性呕吐及延迟性呕吐的发生率均明显低于对照组（P＜0．05），但在呕吐程度构成比方面，用药后1～3 d两组之间未见明显差异（P＞0．05），而4～6 d实验组呕吐程度明显轻于对照组（P＜0．05）；恶心情况：实验组化疗期间恶心的发生率明显低于对照组（P＜0．05），恶心程度也明显轻于对照组（P＜0．05）；食欲情况：实验组化疗期间食欲不振的发生率明显低于对照组（P＜0．05），反应程度也明显轻于对照组（P＜0．05）。结论穴位按压联合艾灸对顺铂类化疗药物引起的胃肠道反应有明显的防治作用，可明显减少化疗后恶心、呕吐及食欲不振等不良反应的发生，临床应用安全有效。

Objective To observe and assess the efficacy of points acupressure combined with moxibustion in pre-venting gastrointestinal reactions caused by cisplatin-based chemotherapy .Method 100 cancer patients with cisplatin-based chemotherapy was selected and randomly divided into experimental group and control group ,50 cases in each group .During chemotherapy period ,conventional acid suppression and anti-nausea treatment were used in both groups ,and the points acupressure combined with moxibustion were used in the experimental group twice a day , from 1 day before chemotherapy to 3 days after treatment .The incidences of gastrointestinal reaction and severity of symptom in two groups was observed and compared .Result The incidence of vomiting both acute phase and delayed phase in experimental group was significantly lower than that of control group （P〈0 .05） .In terms of severity of vomiting ,there was no significant difference between two groups in the first three days （P〉0 .05） ,but the experi-mental group had significant lighter symptom than that of the control group in later three days （P〈0 .05） .The inci-dence and severity of nausea in experimental group was significantly lower than that of control group （P〈0 .05） . The incidence and severity of loss of appetite in experimental group was significantly lower than that of control group （P〈0 .05） .Conclusion The therapy of points acupressure combined with moxibustion is effective and safe for pre-venting gastrointestinal reactions caused by cisplatin-based chemotherapy .It can significantly reduce the incidence of nausea ,vomiting and poor appetite after chemotherapy .