不同时间窗针灸干预对化疗相关性恶心呕吐症状的影响——一项自身交叉对照研究报告

Effects of acupuncture and moxibustion at different times on the nausea and vomiting induced with chemotherapy: a self cross control study

目的:探讨不同时间窗针灸干预对化疗药物相关性恶心呕吐(CINV)症状的影响。方法:将80例接受顺铂方案化疗曾出现恶心呕吐症状患者分为AB组与BA组,采用自身交叉对照设计,AB组第1周期化疗间歇期给予针灸干预,化疗期无针灸干预;第3周期化疗间歇期无针灸干预,化疗期给予针灸干预。BA组第1周期和第3周期针灸干预时机与AB组相反。两组第2周期均不予针灸干预,作为针灸治疗洗脱期。比较不同时间窗针灸干预后化疗期呕吐发生例数、恶心呕吐干呕量表(R-INVR)积分及患者满意度与依从性情况。结果:化疗期第1、2天,间歇期接受针灸干预患者较化疗期接受干预的患者呕吐症状发生例数少(均P<0.05),但用药第3天后的连续4 d,发生呕吐例数差异无统计学意义(均P>0.05);化疗期干预与间歇期干预比较R-INVR积分差异均无统计学意义(均P>0.05),但分值有降低趋势;患者更满意于间歇期针灸干预(P<0.05)。结论:化疗间歇期针灸干预有降低顺铂化疗方案引发呕吐症状的预防意义,且患者依从性和满意度高;化疗期针灸干预具有潜在改善患者恶心呕吐不适症状治疗意义。

Objective To investigate acupuncture-moxibustion intervention during the different times for chemotherapy-induced nausea and vomiting（CINV） symptoms. Methods Eighty patients received cisplatin chemotherapy with nausea and vomiting were assigned into an AB group and a BA group. Self cross control study was carried out. In the AB group, acupuncture and moxibustion were used during the intermission and there were no acupuncture-moxibustion during chemotherapy period in the first chemotherapy cycle; acupuncture and moxibustion were not applied during the intermission and acupuncture-moxibustion intervention were used during chemotherapy in the third cycle of chemotherapy. The intervention times were different correspondingly in the BA group. Acupuncture and moxibustion were not used to in the second cycle of elution period. The vomiting incidence, nausea, vomiting and retching scale（R-INVR）, patient satisfaction and compliance during different chemotherapy times after acupuncture and moxibustion intervention were compared. Results On the first and second days of chemotherapy, the nausea incidences of patients treated with acupuncture and moxibustion during the intermittent period was less than those during chemotherapy period（both P〈0.05）, but continuous 4 days after the third day of chemotherapy, the numbers had no significant difference（all P〉0.05）. The scores of R-INVR were not significantly different between intervention in the chemotherapy period and intermittent period（P〉0.05）, with decreasing trend. The patients were more satisfied with acupuncture and moxibustion in the intermittent period（P〈0.05）. Conclusion Acupuncture and moxibustion in the intermittent period can prevent vomiting induced by the chemotherapy of cisplatin, with satisfaction and compliance. Acupuncture and moxibustion intervention during chemotherapy period have the potential to improve nausea and vomiting.