温针配合穴位贴敷及药物干预乳腺癌化疗相关性恶心呕吐的临床研究

Clinical study of warming needle combined with acupoint application and drug intervention on breast cancer chemotherapy induced nausea and vomiting

目的观察温针配合穴位贴敷及药物干预乳腺癌化疗相关性恶心呕吐(chemotherapy induced nausea and vomiting,CINV)的临床疗效。方法将110例乳腺癌术后辅助化疗患者随机分为观察组和对照组,每组55例。对照组于化疗前30 min接受静脉滴注注射用盐酸托烷司琼治疗,观察组在对照组基础上于化疗前1 d接受温针配合穴位贴敷治疗。观察两组化疗前后不同时间点恶心、呕吐反应症状评分及血清5-羟色胺(5-hydroxytryptamine,5-HT)水平的变化情况,并比较两组CINV发生率。结果观察组CINV发生率为34.5%,明显低于对照组的56.4%,差异具有统计学意义(P<0.05)。两组化疗后第3 d恶心、呕吐反应症状评分均较同组化疗前显著上升,化疗后第5、7 d恶心、呕吐反应症状评分均较同组化疗第3 d显著下降,差异均具有统计学意义(P<0.05)。观察组化疗后第3、5、7 d恶心、呕吐反应症状评分均明显低于对照组,差异均具有统计学意义(P<0.05)。两组化疗后第7 d血清5-HT水平均较同组化疗前显著上升(P<0.05)。观察组化疗后第7 d血清5-HT水平明显低于对照组,差异具有统计学意义(P<0.05)。结论温针配合穴位贴敷及药物干预能降低乳腺癌CINV的发生率,有助于缓解恶心、呕吐症状,其机制可能与降低5-HT水平有关。

Objective To observe the clinical effect of warming needle combined with acupoint application and drug intervention on breast cancer chemotherapy induced nausea and vomiting(CINV).Method A total of 110 breast cancer patients with postoperative adjuvant chemotherapy were randomly divided into the observation group and the control group,with 55 cases in each group.The control group was treated with intravenous drip of tropisetron hydrochloride for injection 30 minutes before chemotherapy,and the observation group was treated with warm needle combined with acupoint application on the basis of the control group 1 day before chemotherapy.The nausea and vomiting symptom scores and serum 5-hydroxytryptamine(5-HT)levels were observed at different time points before and after chemotherapy,and the incidence of CINV was compared between the two groups.Result The incidence of CINV in the observation group was 34.5%,which was significantly lower than 56.4%in the control group,and the difference was statistically significant(P<0.05).The symptom scores of nausea and vomiting on the 3rd day after chemotherapy in the two groups were significantly higher than those before chemotherapy,and the symptom scores of nausea and vomiting on the 5th and 7th day after chemotherapy were significantly lower than those on the 3rd day of chemotherapy in the same group,and the differences were statistically significant(P<0.05).The symptom scores of nausea and vomiting in the observation group on the 3rd,5th and 7th day after chemotherapy were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).The serum 5-HT levels of the two groups on the 7th day after chemotherapy were significantly higher than those before chemotherapy(P<0.05).The serum 5-HT level of the observation group was significantly lower than that of the control group on the 7th day after chemotherapy,and the difference was statistically significant(P<0.05).Conclusion Warming needle combined with acupoint application and drug intervention can reduce the incidence of CINV in breast cancer,help to relieve nausea and vomiting,and its mechanism may be related to the reduction of 5-HT level.