不同针灸方法治疗化疗所致恶心呕吐临床研究

Clinical Study on Different Acupuncture and Moxibustion Methods for Prevention and Treatment of Nausea and Vomiting Caused by Chemotherapy

目的观察不同针灸方法治疗化疗所致恶心呕吐的疗效。方法 163例患者随机分为电针组、温针灸加电针组、隔姜灸组和对照组4组,分别为42、37、44、40例。各组均行术后辅助联合化疗。3个针灸组分别于化疗前1 d采用电针、温针灸加电针、隔姜灸刺激双侧足三里、内关,每日1次;对照组予盐酸托烷司琼5 mg+生理盐水100 m L,于化疗前30 min静脉点滴,每日1次至化疗结束。观察呕吐次数和程度,检测血清5-羟色胺(5-HT)含量,并进行安全性监测。结果电针组、温针灸加电针组急性呕吐完全控制率及有效控制率均高于隔姜灸组和对照组(P<0.05)。温针灸加电针组延迟性呕吐的完全控制率高于电针组、隔姜灸组、对照组(P<0.05),有效控制率高于隔姜灸组、对照组(P<0.05),电针组与隔姜灸组均高于对照组(P<0.05)。电针组、温针灸加电针组的急性呕吐积分低于隔姜灸组、对照组,差异有统计学意义(P<0.05)。温针灸加电针组延迟性呕吐积分低于其余3组,差异有统计学意义(P<0.05);电针组与隔姜灸组均低于对照组,差异有统计学意义(P<0.05)。化疗后温针灸加电针组血清5-HT含量最低,电针组及隔姜灸组高于温针灸加电针组(P<0.05),但低于对照组(P<0.05)。各组未见明显不良反应。结论不同针灸方法对化疗后急性呕吐、延迟性呕吐的疗效不同。

Objective To observe efficacy of different acupuncture and moxibustion methods for treatment ofnausea and vomiting caused by chemotherapy.Methods One hundred and sixty-three cases were randomly dividedinto electroacupuncture group(42cases),warm acupuncture combined with electroacupuncture group(37cases),ginger moxibustion group(44cases)and control group(40cases).All groups received postoperative adjuvantchemotherapy.Three acupuncture and moxibustion groups received electroacupuncture,warm acupuncture combinedwith electroacupuncture,ginger moxibustion to stimulate bilateral Zusanli(ST36),Neiguan(PC6),respectively,oncea day.The control group was given tropisetron hydrochloride5mg+normal saline100mL,30min beforechemotherapy intravenously,once a day to the end of chemotherapy.The number and degree of vomiting and theserum5-HT content were tested,and the safety test was conducted.Results The complete control rate and effectivecontrol rate of acute vomiting of electroacupuncture group and warm acupuncture combined with electroacupuncturegroup were higher than those of ginger moxibustion group and control group(P<0.05).The complete control rate ofdelayed vomiting in warm acupuncture combined with electroacupuncture group was significantly higher than that ofelectroacupuncture group,ginger moxibustion group and control group(P<0.05);The effective control rate washigher than that of ginger moxibustion group and control group(P<0.05);Electroacupuncture group and Gingermoxibustion group were higher than the control group(P<0.05).The scores of acute vomiting in electroacupuncturegroup and warm acupuncture combined with electroacupuncture group were lower than others(P<0.05).In delayedvomiting,warm acupuncture combined with electroacupuncture group's score was lower than other groups,withstatistical significance(P<0.05);Electroacupuncture group and ginger moxibustion group were lower than that in control groups,with statistical significance(P<0.05).The levels of serum5-HT in electroacupuncture group andginger moxibustion group were higher than warm acupuncture combined with electroacupuncture group(P<0.05),butlower than the control group(P<0.05).No obvious adverse reactions were found in each group.Conclusion Differentacupuncture methods had different clinical effects on acute vomiting and delayed vomiting caused by chemotherapy.