小半夏合四君子汤加减联合穴位贴敷防治化疗相关性恶心呕吐的疗效观察

Observation on the curative effect of acupoint application with Xiaobanxia Decoction combined with modified Sijunzi Decoction on the prevention and treatment of chemotherapy-induced nausea and vomiting

目的:观察小半夏联合四君子汤加减穴位贴敷防治化疗引起的恶心、呕吐(CINV)的临床疗效。方法:收集重庆市中医院肿瘤科2021年1月—2022年6月收治的Ⅲ~Ⅳ期使用中、高致吐风险化疗药物的非手术治疗肿瘤患者120例为观察对象,分别为A组、B组,两组患者除使用中、高致吐风险化疗药物治疗外,均使用小半夏联合四君子汤加减穴位敷贴防治CINV,将姜半夏、吴茱萸、党参、茯苓、白术各5 g,研成细末,以生姜汁调配成糊膏状,贴敷于膻中、中脘、天枢、足三里,每日1次,每次使用6 h,从化疗前1 d开始使用直至该化疗周期结束后72 h。分析穴位贴敷防治CINV的效果,主要终点是化疗周期内及化疗后72 h内恶心呕吐分级及完全控制率,安全性是次要终点。结果:A、B两组化疗期间CINV总有效率分别为93.75%、91.67%,化疗后72 h内有效率均为91.67%,远高于文献报道中单纯使用西医常规治疗CINV的总有效率。在化疗周期内、化疗结束后这2个过程中,A组与B组疗效比较,差异均有统计学意义,说明止吐贴对于中致吐风险化疗所致的CINV效果优于高致吐风险化疗所致的CINV。不良反应包括局部皮肤过敏、腹胀、便秘,发生率较低(6.60%)。结论:小半夏联合四君子汤加减穴位贴敷防治CINV疗效确切且安全可靠。

Objective:To observe the clinical curative effect of acupoint application with Xiaobanxia Decoction combined with modified Sijunzi Decoction on the prevention and treatment of chemotherapy-induced nausea and vomiting(CINV).Methods:A total of 120 non-surgical tumor patients in stage III to IV who were treated with chemotherapy drugs with moderate and high emetic risk from January 2021 to June 2022 in the Oncology Department of Chongqing Traditional Chinese Medicine Hospital were collected as the observation objects,including group A and group B,respectively.In addition taking the moderate and high risk of emetic chemotherapy drugs,the two groups of patients were treated with acupoint application with Xiaobanxia Decoction combined with modified Sijunzi Decoction to prevent and treat CINV.Jiangbanxia,Wuzhuyu,Dangshen,Fuling,and Baizhu,with each one 5 g,were ground into fine powder,prepared into paste with ginger juice,and applied to Danzhong,Zhongwan,Tianshu and Zusanli acupoints once a day for 6 h each time,from 1 day before chemotherapy until 72 h after the end of the chemotherapy cycle.The effect of acupoint application in the prevention and treatment of CINV was analyzed.The primary endpoints were nausea and vomiting grade and complete control rate during the chemotherapy cycle and 72 h after completion of chemotherapy,and safety was the secondary endpoints.Results:The total effective rate of CINV in group A and group B during chemotherapy was 93.75%and 91.67%,respectively,and the effective rate within 72 h after chemotherapy was 91.67%,which was much higher than the total effective rate of CINV treated with conventional western medicine alone reported in the literature.During the chemotherapy cycle and after the chemotherapy,there were statistically significant differences in the efficacy between group A and group B,indicating that the effect of antiemetic patch on CINV caused by moderate emetic risk chemotherapy was better than that caused by high emetic risk chemotherapy.Adverse reactions included local skin allergy,abdominal distension and constipation,with a low incidence(6.60%).Conclusion:Acupoint application with Xiaobanxia Decoction combined with modified Sijunzi Decoction is effective and safe in preventing and treating CINV.