止吐膏穴位贴敷辅助治疗化疗后恶心呕吐的临床观察

Clinical Observation of Acupoint Application of Antiemetic Cream in the Treatment of Chemotherapy-induced Nausea and Vomiting

目的：观察止吐膏穴位贴敷辅助治疗化疗后恶心呕吐的临床疗效。方法：选取Ⅱ/Ⅲ期非小细胞肺癌接受紫杉醇＋顺铂（TP）化疗方案化疗的患者90例,按抽签法随机分为止吐膏组、甲氧氯普胺组和对照组各30例。对照组于化疗前30 min常规静脉注射盐酸昂丹司琼8 mg;止吐膏组在此基础上,于化疗第1~4天用药前30 min加用止吐膏穴位贴敷;甲氧氯普胺组在对照组治疗基础上,于化疗第1~4天用药前30 min加用甲氧氯普胺穴位注射。观察3组患者化疗过程中和化疗结束后3 d的临床疗效。结果：止吐膏组（93.33%）和甲氧氯普胺组（90.00%）化疗后恶心呕吐总控制率明显高于对照组（66.67%）,差异有统计学意义（P〈0.01或P〈0.05）;止吐膏组（90.00%）和甲氧氯普胺组（83.33%）化疗后中医证候总有效率明显高于对照组（60.00%）,差异有统计学意义（P〈0.01或P〈0.05）。止吐膏组与甲氧氯普胺组疗效相当,差异无统计学意义（P〉0.05）,但甲氧氯普胺组有8例患者诉注射部位胀痛明显,基本能耐受。结论：止吐膏穴位贴敷联合静脉注射昂丹司琼治疗Ⅱ/Ⅲ期非小细胞肺癌化疗后恶心呕吐的疗效明显、操作简便,无痛苦、瘢痕和后遗症,患者更易接受。

OBJECTIVE：To observe the clinical efficacy of acupoint application of antiemetic cream in the treatment of chemotherapy-induced nausea and vomiting. METHODS：90 cases of non-small cell lung cancer（NSCLC）（stage Ⅱ to Ⅲ）treated by chemotherapy（taxol＋cisplatin）were randomly divided into antiemetic cream group,Weifuan group and control group,with 30 cases in each groupby drawing lots. Control group was given intravenous injection of ondansetron hydrochloride 8 mg 30 min before chemotherapy;antiemetic cream group was additionally given acupoint application of antiemetic cream 30 min before medication on first-forth day on the basis of control group;Weifuan group was additionally given acupoint injection of metoclopramide（brand name：Weifuan）30 min before medication on first-forth day on the basis of control group. The clinical efficacy of 3 groups were observed during and 3 days after chemotherapy. RESULTS：After chemotherapy,the total control rates of antiemetic cream group（93.33%）and Weifuan group（90.00%）were apparently higher than the control group（66.67%）,with statistical significance（P〈0.01 or P〈0.05）;The total effective rates of TCM syndrome in antiemetic cream group（90.00%）and Weifuan group（83.33%）were apparently higher than in control group（60.00%）,with statistical significance（P〈0.01 or P〈0.05）. Therapeutic efficacy of antiemetic cream group was similar to Weifuan group,without any statistical significance（P〉0.05）. However,8 patients had obviously pain at the injection site in Weifuan group,but tolerated to the drugs basically. CONCLUSIONS：The acupoint application of antiemetic cream combined with intravenous injection of ondansetron is effective and easy to operate in the treatment of nausea and vomiting induced by chemotherapy for stage Ⅱ to Ⅲ of NSCLC without pain,scar and sequela,and easy to be accepted by patients.