中药穴位热熨防治大肠癌术后化疗相关性恶心呕吐的临床观察

Clinical Study on Prevention and Treatment of Postoperative Chemotherapy-induced Nausea and Vomiting in Patients with Colorectal Cancer Treated with Acupoint Hot Pressing with Traditional Chinese Medicine

目的观察中药吴茱萸加小茴香穴位热熨防治大肠癌术后化疗相关性恶心呕吐(CINV)的疗效并探讨其机制。方法将45例大肠癌术后FOLFOX4方案化疗患者随机分为A、B、C 3组,每组15例(观察第1、3、6次化疗,各45例次)。各组均在化疗前给予昂丹司琼注射液8 mg加入0.9%氯化钠注射液100 m L静滴。治疗组(A组)采用吴茱萸加小茴香热熨神阙穴、中脘穴及脐周四穴;第一对照组(B组)化疗前用地塞米松10 mg加0.9%氯化钠注射液20 m L静推;第二对照组(C组)分别在化疗前及化疗后给予地塞米松5 mg单侧交替足三里穴位注射,每日2次。比较3组患者化疗用药第1日和2~3 d恶心呕吐的控制效果(总有效率和完全控制率)及其他不良反应发生率。结果化疗第1日和2~3 d,A组对CINV总有效率及完全控制率均高于B组及C组(P<0.05),A组其他不良反应发生率低于B组及C组(P<0.05)。结论吴茱萸加小茴香穴位热熨疗法防治大肠癌术后急性及迟发性CINV疗效均显著,总有效率及完全控制率高,安全,无创伤,不良反应少。

Objective： To observe the traditional Chinese medicine acupoint Evodia and cumin hot ironing colorectal cancer postoperative chemotherapy related nausea and vomiting（CINV） and explore the effect and mechanism. Methods： 45 patients with colorectal cancer of FOLFOX4 chemotherapy were randomly divided into 3groups,15 cases in each group（to observe 1st,3rd,6th chemotherapy for 45 cases）. Before chemotherapy,3groups were given ondansetron injection 8 mg in 0.9% Sodium Chloride Injection 100 m L intravenous injection.The treatment group（group A） used evodia and cumin to hot press Shenque,Zhongwan and four acupuncture points around umbilicus. Before chemotherapy,the first control group（group B） received dexamethasone 10 mg＋0.9% Sodium Chloride Injection 20 m L static push,and the second control group（C group） were given dexamethasone 5mg unilateral alternate Zusanli acupoint injection,respectively before and after chemotherapy,twice a day. The control effect（total effective and complete control rate） and other adverse reaction rates of the 3 groups were compared on 1 d and 2~3 d. Results： During hemotherapy 1 d and 2~3 d,the total effective rate and complete control rate of chemotherapy related vomiting in group A were higher than that of group B and group C（P 〈0.05）. The incidence of other adverse reactions in group A was lower than that in group B and group C（P 〈 0.05）.Conclusion： Evodia and cumin acupoint hot pressing therapy for prevention and treatment of colorectal cancer postoperative acute and delayed CINV has a significant curative effect. The total effective rate and complete control rate are high and safety,with no trauma and less adverse reactions.