穴位电针刺激联合经皮透药法对恶性肿瘤患者化疗相关性恶心呕吐的干预效果观察  

Effect of electroacupuncture stimulation combined with percutaneous penetration therapy on chemotherapy-induced nausea and vomiting of patients with malignant tumor

作　　者：方森[1] 梁百慧 张洁[1] 尹雨晴 陈燕 FANG Sen;LIANG Bai-hui;ZHANG Jie;YIN Yu-qing;CHEN Yan(College of Nursing,Hunan University of Chinese Medicine,Changsha 410208,China;Hunan College of Chinese Medicine,Zhuzhou 412012)

机构地区：[1]湖南中医药大学护理学院,长沙410208 [2]湖南中医药高等专科学校,株洲412012

出　　处：《北京中医药》2019年第10期973-978,共6页Beijing Journal of Traditional Chinese Medicine

基　　金：老年肿瘤护理研究生培养创新基地(校行研字[2015]12号);湖南省高层次卫生人才“225”工程项目资助(湘卫人发[2013]13号)

摘　　要：目的探讨穴位电针刺激联合经皮透药法对恶性肿瘤患者化疗所致恶心、呕吐反应的作用和对患者化疗后生活功能状态的影响。方法 72例住院接受含顺铂化疗方案化疗的恶性肿瘤患者,随机分为观察组36例和对照组36例。对照组患者予以常规预防性止吐用药;观察组在对照组基础上,采用双侧曲池、内关和足三里穴位电针刺激和经皮透药法(穴位敷贴)治疗,评估干预前和干预后第1、2、3天患者R-INVR评分及化疗后第1、6天患者FLIE评分。结果观察组2例中途撤回知情同意书;对照组脱落病例4例。最终实际纳入病例,观察组34例,对照组32例,共计66例。2组人口学一般特征和临床资料对比,所有指标差异均无统计学意义(P>0.05)。对2组患者恶心发生频次进行比较,结果在第2日(P=0.005)、第3日(P=0.000)具有统计学意义(P<0.05);对2组患者恶心历经时间进行比较,结果在第3日(P=0.000)具有统计学意义(P<0.05);对2组患者恶心严重程度进行比较,结果在第1日(P=0.047)、第2日(P=0.000)、第3日(P=0.000)具有统计学意义(P<0.05);对2组患者呕吐发生频次、呕吐量、严重程度进行比较,结果在第3日(P=0.000)均具有统计学意义(P<0.05);对2组患者干呕发生频次和严重程度进行比较,结果在第2日(P=0.002)、第3日(P=0.000)均具有统计学意义(P<0.05),对2组患者化疗后第1、第6日生活功能指数进行比较,结果第1日(P=0.618)不具有统计学意义(P>0.05),第6日(P=0.000)具有统计学意义(P<0.05)。结论穴位电针刺激联合经皮透药法可以有效缓解恶性肿瘤患者化疗后延迟期恶心、呕吐、干呕反应和改善其生活功能状态,但对缓解化疗后的急性恶心、呕吐和干呕症状效果不明显,也不能完全消除化疗所致恶心呕吐(CINV)对患者的负面影响。Objective To explore the effect of electroacupuncture stimulation combined with percutaneous penetration therapy on chemotherapy-induced nausea and vomiting and its effect on functional living index-emesis after chemotherapy in patients with malignant tumor.Methods Seventy-two patients with malignant tumor received chemotherapy with DDP were randomly divided into experimental group(n=36)and control group(n=36).The control group were given routine prophylactic antiemetic drugs.The experimental group was treated with electroacupuncture stimulation on Qūchí(曲池LI11),Nèiguān(内关PC6),and Zúsānlǐ(足三里ST36)bilaterally and percutaneous penetration therapy(point application)on the basis of control group.The R-INVR scores on the 1 st,2 nd,3 rd day after chemotherapy and FLIE scores on the 1 st and 6 th day after chemotherapy were evaluated.Results 2 cases in the experimental group withdrew their informed consent and 4 cases of shedding cases in control group.Finally,there were 34 cases in the experimental group and 32 cases in the control group,totally 66 cases.There was no significant difference in the general demographic characteristics and clinical baseline data between the two groups(P>0.05).Comparing the frequency of nausea between the two groups,there was significant difference between the two groups(P<0.05)at day 2(P=0.005)and day 3(P=0.000).Comparing the duration of nausea between the two groups,there was significant difference between the two groups(P<0.05)at day 3(P =0.000).Comparing the severity of nausea between the two groups,there was significant difference between the two groups(P<0.05)at day 1(P=0.047)and day 2(P=0.000)and day 3(P= 0.000).Comparing the frequency of retching,the volume of vomiting and the severity of vomiting between the two groups,there was significant difference between the two groups(P<0.05)at day 3(P=0.000).Comparing the frequency and severity of retching between the two groups,there was significant difference between the two groups(P<0.05)at day 2(P = 0.002)and day 3(P

关 键 词：电针 经皮透药法 恶性肿瘤 化疗所致恶心呕吐 生活功能指数 

分 类 号：R73[医药卫生—肿瘤]