耳针治疗肝肿瘤破裂出血介入治疗后顽固性呃逆临床研究

Ear-acupuncture therapy for intractable hiccups in the patients treated with endovascular embolization for bleeding from spontaneous rupture of liver cancer

目的评价耳针治疗肝肿瘤破裂出血介入治疗后顽固性呃逆的疗效。方法将符合入选标准的肝肿瘤破裂出血介入治疗后顽固性呃逆患者60例，采用随机数字表法分为2组，每组30例。对照组采用深呼吸后屏气法结合口服巴氯芬片治疗，观察组采用耳针治疗。2组均治疗5d，随访1周。采用Karnofsky评分评价患者生活质量，记录治疗期间不良反应发生率及随访期间顽固性呃逆的复发率，评价临床疗效。结果观察组总有效率为100％（30／30）、对照组为76．7％（23／30），2组比较差异有统计学意义（X^2=5．822，P=0．016）。治疗期间，对照组不良反应发生率为3313％（10／30）、观察组为6．7％（2／30），2组比较差异有统计学意义（X^2=5．104，P=0．024）。治疗后，观察组Karnofsky评分[（82．1±12．6）分比（55．9±12．4）分，t=-8．1183、对照组Kamofsky评分[（76．5±17．8）分比（61．2±13．6）分，t=3．741]均高于同组治疗前（P〈0．01），但2组治疗后比较差异无统计学意义（t=1．407，P=0．165）。结论耳针可有效缓解肝肿瘤破裂出血介入治疗后顽固性呃逆患者的呃逆症状，疗效优于深呼吸后屏气法结合口服巴氯芬片治疗。

Objective To observe the therapeutic effect of ear-acupuncture therapy for intractable hiccups in the patients treated with endovaseular embolization for bleeding from spontaneous rupture of liver cancer. Methods A total of 60 patients with intractable hiccups after endovascular embolization for bleeding from spontaneous rupture of liver cancer were randomly divided two groups using a random digit table, 30 in each group. The patients in the control group were treated breath holding combined with oral baclofen, and those in the observation group with ear-acupuncture therapy for 5 days, and then both groups were followed up for 1 week. The Karnofsky Performance Status Scale （KPS） was used for quality of life evaluation. The adverse events and recurrence during the treatment and the followed up were recorded. The therapeutic effect was evaluated. Results Total effective rate （100% vs. 76.7%; 2,2=5.822, P=0.016）in the observation group was significantly higher than that in the control group. The rate of adverse events （6.7% vs. 33.3%; X^2=5.104, P=0.024）in the observation group were significantly lower than that in the control group. There was no significant difference in the KPS scores after treatment between the observation group and the control group （82.1 ± 12.6 vs. 76.5 ±17.8; t=1.407, P=0.165）. Conclusions Ear-acupuncture therapy may efficiently alleviate intractable hiccups in patients treated with endovascular embolization for bleeding from spontaneous rupture of liver cancer, and superior to breath holding combined with oral baclofen.