内关穴位按压联合内关穴位生姜贴敷护理对老年恶性肿瘤患者化疗后恶心呕吐及干呕症状的干预效果研究

The Intervention Effect of Ginger Application Plus Acupressure on Neiguan Acupoints on Alleviating Chemotherapy-induced Nausea,Vomiting and Retching in Elderly Cancer Patients

目的探讨内关穴位按压联合内关穴位生姜贴敷护理对老年恶性肿瘤患者化疗后恶心、呕吐及干呕(chemotherapy-induced nausea,vomiting and retching,CINV)症状的干预效果。方法选取2007年1月—2013年12月,在成都军区总医院住院并接受化疗的老年恶性肿瘤患者369例,按是否接受内关穴位按压和内关穴位生姜贴敷护理将其随机分为4组。其中联合干预组、穴位按压组及生姜贴敷组各92例,安慰剂对照组93例。采用R-INVR量表分别对4组患者干预前、干预12 h后及干预24 h后的CINV症状进行评分,得出干预12 h后和干预24 h后的干预效果,并对其进行析因方差分析。结果 4组患者的基线资料和干预前CINV评分比较,差异均无统计学意义(P>0.05)。析因方差分析显示,干预12 h后和干预24 h后,内关穴位按压对干呕症状的主效应有统计学意义(P<0.05),对恶心和呕吐症状的主效应无统计学意义(P>0.05);干预12 h后和干预24 h后,生姜贴敷对恶心和呕吐症状的主效应有统计学意义(P<0.05),对干呕症状的主效应无统计学意义(P>0.05)。结论内关穴位按压可以改善老年恶性肿瘤患者化疗后的干呕症状,内关穴位生姜贴敷可以改善老年恶性肿瘤患者化疗后的恶心和呕吐症状。建议临床医生根据患者具体情况选择护理方法,以提高患者生活质量。

Objective To evaluate the intervention effect of ginger application plus acupressure on Neiguan acupoints on alleviating chemotherapy- induced nausea,vomiting and retching（ CINV） in elderly cancer patients. Methods We enrolled369 elderly patients with cancer who received hospitalized treatment and chemotherapy in Chengdu Military General Hospital from January,2007 to December,2013. We randomly assigned them into four groups： combined intervention group（ n = 92）,ginger application group（ n = 92）,acupressure group（ n = 92） and placebo control group（ n = 93）. R- INVR scale was used to assess CINV symptoms of the four groups before intervention,12 hours later and 24 hours later after intervention. Factorial analysis of variance was conducted on the intervention effect 12 hours and 24 hours later after intervention. Results The comparisons of the baseline data and CINV scores acquired before intervention among the four groups showed no statistic significance（ P〈 0. 05）. Factorial analysis of variance showed that, 12 hours and 24 hours later, there was statistic significance in the main effect of acupressure on Neiguan acupoints on alleviating retching（ P〈 0. 05）, while no statistic significance in the main effect on nausea and vomiting（ P〉 0. 05）; there was statistic significance in the main effect of ginger application on alleviating nausea and vomiting（ P〈 0. 05）,while no statistic significance in the main effect on retching（ P〉 0. 05）. Conclusion Acupressure on Neiguan acupoints could alleviate retching of elderly cancer patients after chemotherapy. Ginger application on Neiguan acupoints could alleviate nausea and vomiting of elderly cancer patients afterchemotherapy. Nursing methods should be chosen according to specific state in patients so as to improve cancer patients＇ living quality after chemotherapy.