内关穴按压改善癌症病人化疗相关性恶心、呕吐效果的Meta分析

Effect of neiguan acupoint pressure on improving chemotherapy-induced nausea and vomiting in cancer patients:a Meta analysis

[目的]系统评价内关穴按压对缓解癌症病人化疗引起恶心、呕吐症状的临床疗效。[方法]计算机检索Medline、EMbase、Cochrane Library、CINAHL、Web of Science、中国生物医学数据库、万方数据库、中国知网和重庆维普中文科技期刊数据库,检索时间为建库至2018年12月4日,收集内关穴按压缓解癌症病人化疗引起恶心、呕吐症状的随机对照试验研究,采用Revman5.3软件进行统计学分析。[结果]共纳入11篇文献,涉及癌症化疗病人606例;Meta分析结果显示,与对照组相比,试验组内关穴按压能有效改善癌症病人化疗引起的恶心症状的严重程度[MD=-1.75,95%CI(-2.95,-0.55),P=0.004]、呕吐症状严重程度[MD=-1.10,95%CI(-1.87,-0.33),P=0.005]、恶心症状发生频率[MD=-0.84,95%CI(-1.37,-0.31),P=0.002]、呕吐症状发生频率[MD=-0.64,95%CI(-1.24,-0.05),P=0.03]和干呕发生频率[MD=-0.31,95%CI(-0.53,-0.09),P=0.006];而在改善干呕症状的严重程度[MD=-0.40,95%CI(-0.90,0.10),P=0.12]和呕吐症状经历时间[MD=-0.52,95%CI(-1.21,0.17),P=0.14]方面效果不明显。[结论]当前证据表明,内关穴按压能改善癌症病人化疗引起恶心、呕吐症状严重程度,降低恶心、呕吐和干呕的发生频率,但在改善干呕严重程度和呕吐经历时间方面效果不明显。

Objective:To systematically evaluate the clinical effect of neiguan acupoint pressure on improving chemotherapy-induced nausea and vomiting in cancer patients.Method:The RCTs related to effect of neiguan acupoint pressure on improving chemotherapyinduced nausea and vomiting in cancer patients,were searched in Medline,EMbase,Cochrane Library,CINAHL,Web of Science,CBM,Wanfang Database,CNKI,VIP Database by computer.The retrieval time was from the establishment of the database to 4 December2018.Revman5.3 software was adopted for statistical analysis.Results:A total of 11 RCTs were included,involving 606 cancer patients undergoing chemotherapy.Meta analysis results showed that,compared with the control group,neiguan acupoint pressure could effectively alleviate the severity of nausea caused by chemotherapy in cancer patients[MD=-1.75,9%CI(-2.95,-0.55),P=0.004],the severity of vomiting symptoms[MD=-1.10,95%CI(-1.87,-0.33),P=0.005],the frequency of nausea[MD=-0.84,0.12,95%CI(-1.37,-0.31),P=0.002],frequency of vomiting symptoms[MD=-0.64,95%CI(-1.24,-0.05),P=0.03]and retching frequency[MD=0.31,95%CI(0.53,-0.09),P=0.006).There were no significant differences between the two groups in severity of retching symptoms[MD=-0.40,95%CI(-0.90,0.10),P=0.12]and duration time of vomiting symptoms[MD=-0.52,95%CI(-1.21,0.17),P=0.14].Conclusions:Current evidences showed that neiguan acupoint pressure could improve the severity of nausea and vomiting symptom,decrease the frequency of nausea,retching and vomiting in cancer patients undergoing chemotherapy.But there was no significant difference in improving the severity of retching and the duration time of vomiting.