中药穴位贴敷联合托烷司琼治疗肿瘤化疗致临床症状的随机对照研究

A randomized controlled study of TCM acupoint application combined with tropisetron on tumor chemotherapy-induced clinical symptoms

目的观察中药穴位贴敷联合托烷司琼治疗肿瘤化疗致恶心呕吐(CINV)等临床症状疗效。方法将我院90例肿瘤化疗患者采用随机数字表法分为观察组与对照组各45例。对照组患者采用托烷司琼和地塞米松静脉滴注,观察组患者在对照组治疗基础上采用中药穴位贴敷治疗。比较两组患者急性期和延迟期CINV的控制率、恶心和呕吐的发生情况、两组患者的生活质量及化疗1周内不良反应发生率。结果急性期CINV患者有效控制率高于对照组,延迟期CINV患者有效控制率高于对照组(P<0.05);化疗第1~5天观察组恶心发生率均低于对照组(P<0.05),化疗第1天观察组呕吐发生率与对照组差异不显著(P>0.05),化疗第2~5天观察组呕吐发生率低于对照组(P<0.05);两组患者功能领域中躯体、角色、认知、情绪和社会功能评分差异不显著(P>0.05),观察组症状领域中疼痛、呼吸困难、失眠、经济困难评分与对照组比较差异不显著(P>0.05),观察组疲乏、恶心呕吐、便秘、腹泻、食欲减退评分均低于对照组(P<0.05);两组化疗1周内不良反应发生率差异无统计学意义(P>0.05)。结论中药穴位贴敷联合托烷司琼有效地提高迟发性CINV的控制率,降低化疗期间恶心、呕吐的发生率,缓解胃肠道症状,改善患者的生活质量,且安全有效。

Objective To observe the clinical efficacy of TCM acupoint application combined with tropisetron in treatment of chemotherapy-induced nausea and vomiting(CINV)and other clinical symptoms. Methods 90 patients underwent cancer chemotherapy were randomly divided into observation group and control group with 45 cases each. Control group received intravenous infusion of tropisetron and dexamethasone,and observation group received TCM acupoint application on the basis of control group. The adverse reaction rate of patients within 1 week of chemotherapy,control rate of acute and delayed CINV,the occurrence of nausea and vomiting,the quality of life and the incidence of adverse reactions within 1 week of chemotherapy of the two groups were compared. Results The effective control rate of CINV in the acute phase of observation group was higher than control group;the effective control rate of CINV in the delayed phase of observation group was higher than control group(P<0.05);the incidence of nausea in observation group was lower than control group on the first 1~5 days of chemotherapy(P<0.05);the incidence of vomiting in observation group on the 1 st day of chemotherapy was not significantly different from that in control group(P>0.05),and the incidence of vomiting in observation group on the 2~5 days of chemotherapy was lower than that in control group(P<0.05);the physical,role,cognitive,emotional and social function scores of the two groups were not significantly different(P>0.05);the pain,dyspnea,insomnia,and financial difficulties scores of observation group were not significantly different from control group(P>0.05);the scores of fatigue,nausea and vomiting,constipation,diarrhea,and loss of appetite in observation group were lower than those in control group(P<0.05);there was no significant difference in the incidence of adverse reactions within 1 week between the two groups of chemotherapy(P>0.05). Conclusion TCM acupoint application combined with tropisetron can effectively improve the control rate of delayed CINV,reduce the incidence of nausea and vomiting during chemotherapy,relieve gastrointestinal symptoms,and improve the quality of life of patients. The therapeutic schedule is safe and effective.