艾灸联合健胃止呕方穴位贴敷辅助治疗胃肠道恶性肿瘤患者化疗相关性恶心呕吐的效果观察

Observation on the Effect of Moxibustion Combined with Acupoint Application of Jianwei Zhiou Prescription as An Adjuvant Therapy for Chemotherapy-Induced Nausea and Vomiting in Patients with Gastrointestinal Malignant Tumors

目的观察艾灸联合健胃止呕方穴位贴敷辅助治疗胃肠道恶性肿瘤患者化疗相关性恶心呕吐(CINV)的效果。方法采用随机数字表法将2021年9月至2024年6月接受化疗的92例胃肠道恶性肿瘤患者分为观察组46例(后脱落1例)和对照组46例。对照组化疗前予阿扎司琼、倍他米松、甲氧氯普胺治疗,观察组在此基础上提前1 d加用艾灸及健胃止呕方穴位贴敷治疗。比较2组患者化疗前及化疗后24、48、72 h Karnofsky评分、中医症候积分、恶心呕吐指数评估量表(R-INVR)评分、简单厌食量表评分以及化疗不良反应发生情况。结果化疗24、48 h后,2组Karanofsky评分均较治疗前下降,对照组下降更明显(P<0.01);化疗72 h后对照组Karanofsky评分较化疗前下降,观察组无明显变化,且观察组高于对照组(P<0.01)。化疗24、48、72 h后2组中医症候积分总体均较化疗前升高,但观察组相对更低(P<0.01)。观察组化疗后24、48及72 h R-INVR评分低于对照组,简单厌食量表评分均高于对照组(P<0.01)。2组患者化疗后骨髓抑制、肝肾功能损伤发生率比较差异无统计学意义(P>0.05)。结论艾灸联合健胃止呕方穴位贴敷辅助治疗可有效缓解胃肠道恶性肿瘤患者CINV症状。

Objective To observe the effect of moxibustion combined with acupoint application of Jianwei Zhiou prescription in the treatment of chemotherapy-induced nausea and vomiting(CINV)in patients with gastrointestinal malignancies.Methods A total of 92 patients with gastrointestinal malignancies who received chemotherapy from September 2021 to June 2024 were divided into observation group(n=46,including 1 patient who dropped out afterwards)and control group(n=46)by random number table method.The control group was treated with Azasetron,Betamethasone and Metoclopramide before chemotherapy,and the observation group was supplemented with moxibustion and acupoint application of Jianwei Zhiou prescription at 1 d before chemotherapy.The Karanofsky score,Traditional Chinese medicine(TCM)syndrome score,the Rhodes Index of Nausea,Vomiting and Retching(R-INVR)scale score,simple anorexia scale score before and at 24 h,48 h,and 72 h after chemotherapy and the incidence of chemotherapy-induced adverse reactions were compared between the two groups.Results At 24 h and 48 h after chemotherapy,Karanofsky scores in the two groups were decreased compared with those before treatment,and the decrease in the control group was more obvious(P<0.01).At 72 h after chemotherapy,the Karanofsky score of the control group was lower than that before chemotherapy,while the observation group had no significant change;the score was higher in the observation group than in the control group(P<0.01).At 24 h,48 h and 72 h after chemotherapy,the TCM syndrome scores in the two groups were higher than those before chemotherapy,but the scores in the observation group were lower(P<0.01).The scores of R-INVR at 24 h,48 h and 72 h after chemotherapy in the observation group were lower than those in the control group,and the scores of simple anorexia scale were higher than those in the control group(P<0.01).There was no significant difference in the incidence of myelosuppression and liver and kidney function injury between the two groups after chemotherapy(P>0.05).Conclusion Moxibustion combined with Jianwei Zhiou prescription can effectively relieve CINV symptoms in patients with gastrointestinal malignancies.