Non-pharmacological management for chemotherapy-induced nausea and vomiting in patients with cancer:a scoping review

Objective:This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapyinduced nausea and vomiting(CINV).Methods:We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria.Data were then collated according to the types of interventions,measurement tool,and outcomes.Results:The search yielded 2343 records,of which 11 were included.Four categories of non-pharmacological CINV management were made;manipulative and body-based therapy(n=5 studies);mind–body therapy(n=3 studies);biologically based practice(n=1 study),and energy therapy(n=2 studies).Seven different scales were used to measure CINV.Nine studies repor ted improvement in CINV.Conclusions:This scoping review demonstrates the breadth of non-pharmacological management to address CINV.Various types of CINV scales were used to measure CINV severity.The management and scale can be utilized to improve nursing care,par ticularly in cancer care.

Effect of music therapy on chemotherapy-induced nausea and vomiting in gastrointestinal cancer:A systematic review and metaanalysis

BACKGROUND Chemotherapy is the primary treatment for patients with advanced gastrointestinal cancer,but it has many adverse reactions,particularly nausea and vomiting.Music therapy can reduce anxiety symptoms,avoid the response to the human body under various stress conditions through psychological adjustment,and improve the adverse reactions of chemotherapy.AIM To investigate the impact of music therapy on relieving gastrointestinal adverse reactions in chemotherapy for patients with digestive tract cancer by metaanalysis.METHODS EMBASE,PubMed,OVID,WoS,CNKI,CBM,and VIP database were all used for searching relevant literature,and the efficacy after treatment was combined for analysis and evaluation.RESULTS This study included seven articles.The results of meta-analysis indicated that music therapy could reduce the nausea symptom score of patients after chemotherapy[mean difference(MD)=-3.15,95%confidence interval(CI):-4.62 to-1.68,Z=-4.20,P<0.0001].Music therapy could reduce the vomiting symptom score of patients after chemotherapy(MD=-2.28,95%CI:-2.46 to-2.11,Z=-25.15,P<0.0001).Furthermore,music therapy could minimize the incidence of grade I and above nausea or vomiting in patients after chemotherapy(odds ratio=0.38,95%CI:0.26-0.56,Z=-4.88,P<0.0001).Meta-regression analysis found that publication year was not a specific factor affecting the combined results.There was no significant publication bias(P>0.05).CONCLUSION Music therapy can significantly improve the scores of nausea and vomiting symptoms in patients with digestive system cancer during chemotherapy and reduce the incidence of grade I and above nausea and vomiting after chemotherapy,making it an effective psychological intervention method worthy of clinical promotion.

Effect of anesthesia induction with butorphanol on postoperative nausea and vomiting:A randomized controlled trial

BACKGROUND Postoperative nausea and vomiting(PONV)are common complications that affect the recovery and well-being of elderly patients undergoing gastrointestinal laparoscopic surgery.AIM To investigate the effect of butorphanol on PONV in this patient population.METHODS A total of 110 elderly patients(≥65 years old)who underwent gastrointestinal laparoscopic surgery were randomly assigned to receive butorphanol(40μg/kg)or sufentanil(0.3μg/kg)during anesthesia induction in a 1:1 ratio.The measured outcomes included the incidence of PONV at 48 h after surgery,intraoperative dose of propofol and remifentanil,Bruggrmann Comfort Scale score in the postanesthesia care unit(PACU),number of compressions for postoperative patientcontrolled intravenous analgesia(PCIA),and time to first flatulence after surgery.RESULTS The results revealed a noteworthy reduction in the occurrence of PONV at 24 h after surgery in the butorphanol group,when compared to the sufentanil group(T1:23.64%vs 5.45%,T2:43.64%vs 20.00%,P<0.05).However,no significant variations were observed between the two groups,in terms of the clinical characteristics,such as the PONV or motion sickness history,intraoperative and postoperative 48-h total infusion volume and hemodynamic parameters,intraoperative dose of propofol and remifentanil,number of postoperative PCIA compressions,time until the first occurrence of postoperative flatulence,and incidence of PONV at 48 h post-surgery(all,P>0.05).Furthermore,patients in the butorphanol group were more comfortable,when compared to patients in the sufentanil group in the PACU.CONCLUSION The present study revealed that butorphanol can be an efficacious substitute for sufentanil during anesthesia induction to diminish PONV within 24 h following gastrointestinal laparoscopic surgery in the elderly,simultaneously improving patient comfort in the PACU.

Patterns of antiemetic prophylaxis for chemotherapy-induced nausea and vomiting in China

Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.

Intraoperative systemic vascular resistance is associated with postoperative nausea and vomiting after laparoscopic hysterectomy

BACKGROUND The incidence of postoperative nausea and vomiting(PONV)in patients undergoing laparoscopic hysterectomy is very high compared with other surgeries,even when many prophylactic measures have been taken.However,the pathogenesis of PONV is multifactorial.Female sex,a history of motion sickness or PONV,nonsmokers,and perioperative opioid use are the most closely related factors.Among the multiple risk factors,suboptimal gastrointestinal(GI)perfusion may be attributed to some cases of PONV,and increased systemic vascular resistance(SVR)may lead to GI ischemia.The hypothesis of this research was that SVR is related to PONV.AIM To investigate the relationship between SVR and PONV in patients undergoing laparoscopic hysterectomy.METHODS A total of 228 patients who underwent elective laparoscopic hysterectomy were included in this prospective observational study.SVR was monitored using a noninvasive hemodynamic monitoring system.Four indices of SVR,the baseline,mean,area under the curve(AUC),and weighted AUC,were used for analysis.The incidence and severity of nausea and vomiting were evaluated while patients were awake and throughout the intervals from 0 to 2 h,2 to 6 h,and 6 to 24 h starting upon arrival at the post-anesthesia care unit.The associations between various SVR indices and PONV were investigated by logistic regression.P<0.05 was considered statistically significant.RESULTS The incidence of PONV in the study was 56.14%(128/228),and PONV tended to appear within 6 h after surgery.Five variables were significant in univariate analyses,however,only SVR mean[odds ratio(OR)=1.015,95%CI:1.005-1.109,P=0.047]and duration of surgery(OR=1.316,95%CI:1.003-2.030,P=0.012)were associated with PONV after logistic regression analysis.Furthermore,patients with high SVR mean were more likely to suffer from PONV after laparoscopic hysterectomy.On average,patients who developed PONV needed more time to tolerate diet and demonstrated poorer sleep quality on the first night after surgery.CONCLUSION In this study,PONV was a common complication after laparoscopic hysterectomy.SVR was associated with PONV,and high SVR mean was associated with a significantly increased risk of PONV.

The selection rules of acupoints and meridians of traditional acupuncture for postoperative nausea and vomiting:a data mining-based literature study

Background:Postoperative nausea and vomiting(PONV)refers to a problem commonly occurring after surgery.Acupuncture is considered a critical complementary alternative therapy for PONV.The acupoints selection critically determines the efficacy of acupuncture,whereas the selection rules remain unclear.The objective of the present study was to delve into the principles of acupoints selection for PONV using data mining technology.Methods:The clinical trials assessing the acupuncture effect for PONV were searched with the use of computer in PubMed,China National Knowledge Infrastructure,and Chinese Biomedical Database;the time span was confined as 2009–2019.The database of acupuncture prescriptions for PONV was built using Excel 2016;the description and association were analyzed by IBM SPSS modeler 18.Result:Eighty-three relevant literatures were screened out.The number of specific acupoints took up 72.5%of all acupoints;specific acupoints exhibited the frequency taking up 91.30%of the total frequency.As revealed from the result,Neiguan(PC 6),Zusanli(ST 36),Hegu(LI 4),and Zhongwan(CV 12)were most frequently applied,suggesting the tightest associations.Most acupoints were taken from the stomach meridian and pericardium meridian.The common acupoints were concentrated in the lower limbs,chest,as well as abdomen.Conclusion:Data mining acts as a feasible method to identify acupoints selection and compatibility characteristics.As suggested from our study,the acupoints selection for PONV prioritizes specific acupoints and related meridians.The selection and combination of acupoints comply with the theory of traditional Chinese medicine.

Comparative study on effects of dexmedetomidine and dexamethasone on the incidence of postoperative nausea and vomiting in patients undergoing laparoscopic surgery

Objective:To compare the safety and efficacy of dexmedetomidine and dexamethasone for the prevention of postoperative nausea and vomiting(PONV)in patients scheduled for laparoscopic surgery.Methods:A total of 86 female patients were prospectively administered dexmedetomidine 1μg/kg i.v.(the group A,n=43),and dexamethasone 8 mg i.v.(the group B,n=43).The two groups were compared in treatment response,hemodynamic changes,and Numerical Analog Scale(NAS).Besides,the relation of PONV with patient baseline characteristics in the perioperative period was determined as well.Results:Patients in group A had lower PONV scores(t=3.1,P<0.002),less needs for rescue anti-emetics(χ2=0.47,P<0.001),and decreased intraoperative heart rate(t=9.72,P<0.001)and mean arterial pressure(t=7.58,P<0.001)compared to that of group B.Group A reported lower NAS than group B(t=2.66,P<0.001).In addition,we found no relationship between PONV score and rescue anti-emetic requirement,age,or body mass index(P=0.96,P=0.60,P=0.28,respectively).Conclusion:Dexmedetomidine could be used as an effective antiemetic in laparoscopic surgeries,with better efficacy than dexamethasone.Dexmedetomidine not only can reduce PONV but also is effective in postoperative analgesia.

Palonosetron versus Ondansetron as Prophylaxis against Postoperative Nausea and Vomiting (PONV) after Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial

Introduction: Postoperative nausea and vomiting (PONV) are prevalent symptoms after laparoscopic surgeries with an incidence rate of (54% - 79%) in bariatric procedures. Despite its popularity, limited studies assessed the effect of antiemetics for PONV prophylaxis after laparoscopic sleeve gastrectomy (LSG). The aim of this trail is to compare the effectiveness of a single pre-induction intravenous dose of Palonosetron versus Ondansetron for prophylaxis of PONV, 24 hours after LSG. Subjects and Methods: This prospective randomized controlled double-blind parallel-group study was conducted from May till December 2019. Recruited patients were consented and randomized using a closed envelop method into two groups with fifty patients each. The total number of nausea and vomiting attacks in the 24 hours postoperatively was considered as a primary end point. The secondary end points were the frequency of nausea, retching and vomiting attacks in the 24 hours post-surgery. The severity of nausea was evaluated using a 10 cm visual analogue scale (VAS). Results: This RCT included 100 patients divided into 2 groups of 50 patients each. Patients received either 75 mcg Palonosetron (Group I) or Ondansetron 4 mg (group II). Group I had statistically significant fewer episodes of nausea, retching and vomiting in the first 4 hours (P = 0.022) and from 4 to 12 hours (P = 0.024) but not after 12 hours post LSG. Total episodes of nausea, retching and vomiting in 24 hours postoperative were significantly less in group I (P = 0.021). Conclusion: A single dose of intravenous 75 mcg Palonosetron is superior to Ondansetron 4 mg in preventing PONV for patients after LSG.

Auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients:Perspectives from the traditional zang-fu organs and meridians theory

This paper presents the theoretical background of using auricular therapy(AT)for managing chemotherapy-induced nausea and vomiting(CINV)from the perspectives of traditional zang-fu organs and meridian theory.The zang-fu organs of stomach,spleen and liver play a crucial role in regulating the gastrointestinal functions.The chemotherapeutic agents can significantly impede the gastrointestinal functions and subsequently contribute to various gastrointestinal symptoms including nausea and vomiting.Dysfunctions of the stomach,spleen and liver can correspond to specific auricular acupoints,while by stimulating those acupoints,the chaotic Qi movement can be reversed to its normal status,and the hyperactivities of the gastrointestinal system can also be alleviated to reduce the CINV symptoms.Clinical studies based on such theory have well supported the effects of AT on CINV.However,relationships between the traditional theory and the modern medicine understanding of the CINV mechanisms remain unknown and should be further explored in future research.

Validation of different personalized risk models of chemotherapy-induced nausea and vomiting:results of a randomized,double-blind,phase III trial of fosaprepitant for cancer patients treated with high-dose cisplatin

Background:Highly emetogenic chemotherapy induces emesis in cancer patients without prophylaxis.The purpose of this study was to evaluate the efficacy and safety of a fosaprepitant-based triple antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting(CINV)in patients with solid malignant tumors,determine risk factors and externally validate different personalized risk models for CINV.Methods:This phase III trial was designed to test the non-inferiority of fosaprepitant toward aprepitant in cancer patients who were to receive the first cycle of single-day cisplatin chemotherapy.The primary endpoint was complete response(CR)during the overall phase(OP)with a non-inferiority margin of 10.0%.Logistic regression modelswere used to assess the risk factors ofCRand no nausea.To validate the personalized risk models,the accuracy of the risk scoring systems was determined by measuring the specificity,sensitivity and area under the receiver operating characteristic(ROC)curve(AUC),while the predictive accuracy of the nomogram was measured using concordance index(C-index).Results:A total of 720 patients were randomly assigned.CR during the OP in the fosaprepitant group was not inferior to that in the aprepitant group(78.1%vs.77.7%,P=0.765)with a between-group difference of 0.4%(95%CI,-5.7%to 6.6%).Female sex,higher cisplatin dose(≥70 mg/m2),no history of drinking and larger body surface area(BSA)were significantly associated with nausea.The AUC for the acute and delayed CINV risk indexes was 0.68(95%CI:0.66-0.71)and 0.66(95%CI:0.61-0.70),respectively,and the C-index for nomogram CINV prediction was 0.59(95%CI,0.54-0.64).Using appropriate cutoff points,the three models could stratify patients with high-or low-risk CINV.No nausea and CR rate were significantly higher in the low-risk group than in the high-risk group(P<0.001).Conclusions:Fosaprepitant-based triple prophylaxis demonstrated non-inferior control for preventing CINV in patients treated with cisplatin-base chemotherapy.Female cancer patients without a history of alcohol consumption,with larger BSA and received high-dose cisplatin might be more vulnerable to CINV.Three personalized prediction models were well-validated and could be used to optimize antiemetic therapy for individual patients.

Electroacupuncture on PC6 Prevents Opioid-Induced Nausea and Vomiting after Laparoscopic Surgery

Objective： To investigate the treatment time dependence of electroacupuncture （EA） on Neiguan （PC6） for preventing postoperative nausea and vomiting （PONV）. Methods： One hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia （PCA） with Fentanyl, were assigned randomly to three groups using random numbers： a pre-operative EA group （PrEA）, a post-operative EA group （PoEA）, and a non-acupuncture control group （NC）. An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test. Results： The incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery （P〈0.01, P〈0.05）. The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group （P〈0.05）. The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting （P〈0.05）. The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups （P〈0.05）. Conclusions： EA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.

Effect of Transcutaneous Electrical Acupoint Stimulation on Nausea and Vomiting Induced by Patient Controlled Intravenous Analgesia with Tramadol

Objective： To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） on nausea and vomiting （N＆V） induced by patient controlled intravenous analgesia （PCIA） with Tramadol. Methods： Sixty patients who were ready to receive scheduled operation for tumor in the head-neck region and post-operation PCIA, aged 39-65 years, with the physique grades Ⅰ -Ⅱ of ASA, were randomized into two groups, A and B, 30 in each group. The pre-operation medication, induction of analgesia and continuous anesthesia used in the two groups were the same. TEAS on bilateral Hegu （LI4） and Neiguan （PC6） points was intermittently applied to the patients in group A starting from 30 min before analgesia induction to 24 h after operation, and the incidence and score of nausea and vomiting, antiemetic used, visual analogue scores （VAS）, and PCIA pressing times in 4 time segments （0-4, 4-8, 8-12 and 12-24 h after the operation was finished） were determined. The same management was applied to patients in Group B, with sham TEAS for control. Results： The incidence and degree of N＆V, as well as the number of patients who needed remedial antiemetic in Group A were less than those in Group B. The VAS score and PCIA pressing time were lower in Group A than those in Group B in the corresponding time segments respectively. Conclusion： TEAS could prevent N＆V induced by PCIA with Tramadol.

Evaluation of Transcutaneous Electroacupoint Stimulation with the Train-of-four Mode for Preventing Nausea and Vomiting after Laparoscopic Cholecystectomy

Objective： To evaluate the efficacy of transcutaneous electroacupoint stimulation with a train-of-four （TOF） mode for the prevention of postoperative nausea and vomiting （PONV） in the patients undergoing laparoscopic cholecystectomy. Methods： Ninety-six ASA Grade Ⅰ-Ⅱ patients scheduled for laparoscopic cholecystectomy were randomized into Neiguan （P6） electroacupoint stimulation group （treated group） and a placebo control group （placement of electrodes without electroacupoint stimulation）. The anesthetic regimen was standardized by needling at Neiguan on the left side and connecting the TOF peripheral nerve stimulator. The incidence of nausea, vomiting, severity, antiemetic dosage and the degree of pain were assessed at 0, 60, 120 min, and 24 h after surgery. Results： The incidence of nausea and vomiting, the dose of antiemetics and the occurrence of severe nausea were all significantly lower in the treated group compared with the control group and the score for pain was obviously reduced in patients of the treated group at 24 h post-operation （P〈0.05 or P〈0.01）. Conclusion： Transcutaneous electroacupoint stimulation at P6 with the TOF mode could reduce the incidence and severity of nausea and vomiting with analgesic effects.

Prevention of nausea,vomiting and reflux aspiration in two cases of painless hysteroscopy

Objective:To investigate the prevention and management of perioperative nausea and vomiting and reflux aspiration in painless hysteroscopy patients.Methods:The clinical datum of one patient with reflux and postoperative vomiting and another one with a history of multiple postoperative nausea and vomiting during painless hysteroscopy were retrospectively analyzed.Results:In case 1,despite the occurrence of reflux,no significant aspiration or other serious consequences occurred through positive attraction,ondansetron,dexamethasone,droperidol and other drugs and candy treatment,then nausea and vomiting gradually eased.In case 2,due to the reduction of preoperative dosage of sufentanil,prophylactic application of ondansetron,psychological intervention and postoperative candy,no nausea and vomiting occurred during the painless hysteroscopy.The patient recovered quickly with high satisfaction.Conclusion:Patients with a high risk of nausea and vomiting may be ameliorated by positive psychological and drug intervention.Even if patients have intraoperative reflux and postoperative nausea and vomiting,it can be relieved by psychological and drug treatment,and the occurrence of serious complications such as aspiration can be prevented.

Optimizing surgical outcomes for elderly gallstone patients with a high body mass index using enhanced recovery after surgery protocol

BACKGROUND Rehabilitation of elderly patients with a high body mass index(BMI)after cholecystectomy carries risks and requires the adoption of effective perioperative management strategies.The enhanced recovery after surgery(ERAS)protocol is a comprehensive treatment approach that facilitates early patient recovery and reduces postoperative complications.AIM To compare the effectiveness of traditional perioperative management methods with the ERAS protocol in elderly patients with gallbladder stones and a high BMI.METHODS This retrospective cohort study examined data from 198 elderly patients with a high BMI who underwent cholecystectomy at the Shanghai Fourth People's Hospital from August 2019 to August 2022.Among them,99 patients were managed using the traditional perioperative care approach(non-ERAS protocol),while the remaining 99 patients were managed using the ERAS protocol.Relevant indicator data were collected for patients preoperatively,intraoperatively,and postoperatively,and surgical outcomes were compared between the two groups.RESULTS The comparison results between the two groups of patients in terms of age,sex,BMI,underlying diseases,surgical type,and preoperative hospital stay showed no statistically significant differences.However,the ERAS group had a significantly shorter preoperative fasting time than the non-ERAS group(4.0±0.9 h vs 7.6±0.9 h).Regarding intraoperative indicators,there were no significant differences between the two groups of patients.However,in terms of postoperative recovery,the ERAS protocol group exhibited significant advantages over the non-ERAS group,including a shorter hospital stay,lower postoperative pain scores and postoperative hunger scores,and higher satisfaction levels.The readmission rate was lower in the ERAS protocol group than in the non-ERAS group(3.0%vs 8.1%),although the difference was not significant.Furthermore,there were significant differences between the two groups in terms of postoperative nausea and vomiting severity,postoperative abdominal distention at 24 h,and daily life ability scores.CONCLUSION The findings of this study demonstrate that the ERAS protocol confers significant advantages in postoperative outcomes following cholecystectomy,including reduced readmission rates,decreased postoperative nausea and vomiting,alleviated abdominal distension,and enhanced functional capacity.While the protocol may not exhibit significant improvement in early postoperative symptoms,it does exhibit advantages in long-term postoperative symptoms and recovery.These findings underscore the importance of implementing the ERAS protocol in the postoperative management of cholecystectomy patients,as it contributes to improving patients'recovery and quality of life while reducing health care resource utilization.

Application of traditional Chinese medicine acupoint needle embedding combined with emotional nursing in patients with gynecological malignant tumors

BACKGROUND Few relevant literature reports on applying acupoint press-needle embedding combined with emotional nursing in patients with a gynecological malignant tumor.AIM To explore the effect of traditional Chinese medicine acupoint needle embedding combined with emotional nursing on chemotherapy-related nausea and vomiting(CINV),cancer-related fatigue(CRF)and psychological state in patients with gynecological malignant tumors.METHODS Retrospective analysis of the clinical information of 84 patients with gynecological malignant tumors treated in our hospital from August 2020 to December 2022 Led to the development of an observation group(n=42)and a control group(n=42)based on various nursing approaches.Ondansetron hydrochloride injection was administered to the individuals in the control group.However,the observation group received emotional nursing based on the control group and acupoint pressneedle embedding of traditional Chinese medicine.Patients in both groups received the chemotherapy regimen of paclitaxel liposome+carbo-platin/cisplatin.For four weeks,both groups intervened.The CINV grade,quality of life,CRF,psychological status and sleep quality scores of the two groups before and RESULTS After intervention,the degree of CINV in the observation group was significantly better than that in the control group.After intervention,the scores of each dimension and total score of FLIE scale were significantly higher than those in the control group.After intervention,the scores of each dimension and total score of Piper Fatigue Scale were significantly lower than those in the control group(P<0.05).After intervention,the scores of avoidance and yield dimensions in the observation group were significantly lower than those in the control group,and the scores of confrontation dimension were significantly higher than those in the control group(P<0.05).After intervention,the sleep quality score of the observation group was significantly lower than that of the control group,and the Karnofsky Performance Status scale score was significantly higher than that of the control group(P<0.05).CONCLUSION The acupuncture point needle embedding of traditional Chinese medicine combined with emotional nursing can further reduce the incidence of chemotherapy-related nausea and vomiting in patients with gynecological malignant tumors,improve the quality of life and the degree of CRF,alleviate the bad psychological state,adopt a positive way to face the disease and treatment,and improve the quality of sleep and quality of life.

Effect of Jianpi Bushen Sequential Formula on Adjuvant Chemotherapy of Colon Cancer:Study Protocol for a Randomized Controlled Trial

Background The side effects of chemotherapy-induced nausea and vomiting(CINV)and myelosuppression reduce the cancer patients’adherence to chemotherapy.Many Chinese patients choose Chinese medicine(CM)during chemotherapy to reduce side effects;however,the evidence is lacking.The efficacy of a CM herbal treatment protocol,Jianpi Bushen Sequential Formula(健脾补肾续贯方,JBSF)will be evaluated on chemotherapy completion rate among patients with colon cancer.Methods A multi-center double-blind randomized controlled trial(RCT)will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine(CAPEOX).Patients will be randomized 1:1 to receive the JBSF or placebo formula.The primary outcome is the overall chemotherapy completion rate.The secondary outcomes include individual chemotherapy completion rate,4-cycle completion rate of chemotherapy,time to treatment failure,relative dose intensity and treatment toxicity.Follow-up visits will be scheduled before every and after last chemotherapy.Discussion This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer.(Trial registration:Clinical Trials.gov,No.NCT03716518)。

腕踝针对甲状腺结节射频消融术后恶心呕吐的影响:随机对照试验

Objective:To observe the influence of wrist-ankle acupuncture(WAA)on postoperative nausea and vomiting(PONV)undergoing radiofrequency ablation(RFA)in thyroid nodule and its analgesic effect.Methods:A total of 66 patients with thyroid nodule and undergoing RFA were randomized into a WAA group and a sham-acupuncture(SA)group,33 cases in each one.Acupuncture was exerted after the patients entering operation room.In the WAA group,WAA was applied on the bilateral Upper 1,2 and 3 areas.In the SA group,the sham-acupuncture was given on the same areas.In 30 min after needle insertion,the routine RFA started in the patients of the two groups.All the needles were removed when the operation was finished.The proportion of intraoperative sufentanil supplementation,the incidence of24 h PONV and the proportion of intraoperative intravenous injection of urapidil were recorded in the patients of the two groups.Results:In the WAA group,sufentanil was supplemented by 12.90%,obviously less than 36.36%in the SA group.The incidence of 24 h PONV was 9.68%in the WAA group,remarkably lower than 27.27%in the SA group,indicating statistical significances(both P<0.05).The intravenous injection of urapidil was not applied during operation in the two groups,without statistical difference between the groups(P>0.05).Conclusion:Wrist-ankle acupuncture reduces the intraoperative demand of sufentanil in radiofrequency ablation of thyroid nodule and this therapy is preventive for PONV.

针灸治疗化疗后恶心呕吐取穴规律的文献研究

Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treatment for CINV were searched from SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,VIP and Pubmed databases from the establishment to January 3,2021 and the worksheet was set up for the information extraction of acupuncture-moxibustion prescriptions.Using IBM SPSS Statistics 25.0 and SPSS Modeler 18.0 software,cluster analysis and association rule analysis were conducted to explore the rules of acupoint selection.Results:A total of 179 articles were eligible,including 206 acupuncture prescriptions and 64 acupoints.The total use frequency of acupoints was 784 times.The acupoints with the highest use frequency were Zúsānlǐ(足三里ST36),Zhōngwǎn(中脘CV12)and Nèiguān(内关PC6).The commonly used meridians included stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin and bladder meridian of foot-taiyang.The acupoints located on the chest,the abdomen and the lower limbs were mostly selected.Five-shu points and crossing points were highly involved in terms of the specific points.The most common combination was ST36,CV12 and PC6.Conclusion:In treatment of acupuncture for CINV,the acupoints were generally selected from stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin.Front-mu points on the chest and the abdomen,the he-sea points and lower he-sea points in the lower limbs are commonly used.The core acupoint prescription of acupuncture for CINV included ST36,CV12 and PC6.