非药物干预对癌症化疗致恶心呕吐影响的网状Meta分析  

Effect of non-drug intervention on nausea and vomiting induced by cancer chemotherapy:a network Meta-analysis

作　　者：张英英 乔欣 赵丽丽[2] 汤媛媛 刘芳[2] ZHANG Yingying;QIAO Xin;ZHAO Lili;TANG Yuanyuan;LIU Fang(School of Nursing,Ningxia Medical University,Ningxia 750000 China)

机构地区：[1]宁夏医科大学护理学院,宁夏750000 [2]宁夏回族自治区人民医院

出　　处：《循证护理》2024年第10期1711-1720,共10页Chinese Evidence-Based Nursing

基　　金：2021年宁夏回族自治区重点研发计划项目,编号:2021BEG03053。

摘　　要：目的:采用网状Meta分析不同非药物干预对癌症化疗所致恶心呕吐效果的影响。方法:系统检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、the Cochrane Library、PubMed、Web of Science、EMbase,查找有关非药物干预对癌症化疗所致恶心呕吐效果影响的随机对照试验,检索时限为2013年1月—2023年6月。由2位研究生独立进行文献筛选与资料提取,采用Cochrane质量评价手册对纳入文献进行质量评价,使用Stata 16软件进行网状Meta分析。结果:最终共纳入14项随机对照试验,涉及13种非药物干预方法。网状Meta分析结果显示,在缓解急性期恶心严重程度方面,不同非药物干预措施与常规护理措施比较,以及不同非药物干预措施间比较,差异均无统计学意义(P>0.05),累积概率排序图曲线下面积(SUCRA)显示,生姜粉(SUCRA为85.1%)效果最佳;在缓解延迟性恶心严重程度方面,经皮穴位电刺激联合胃肠起搏和绘画疗法与常规护理比较,差异有统计学意义(P<0.05),经皮穴位电刺激联合胃肠起搏(SUCRA为84.6%)效果最佳;在缓解急性期呕吐发生率方面,耳灸联合腕踝针与常规护理比较,差异有统计学意义(P<0.05),耳灸联合腕踝针(SUCRA为84.6%)效果最佳;在缓解延迟性呕吐发生率方面,吸入性芳香疗法、耳灸联合腕踝针、肌肉放松训练、穴位敷贴联合穴位按摩与常规护理比较,差异有统计学意义(P<0.05),吸入性芳香疗法(SUCRA为83.5%)效果最佳。结论:现有证据表明,生姜粉缓解急性期恶心严重程度效果最佳,经皮穴位电刺激联合胃肠起搏缓解延迟性恶心严重程度效果最佳,耳灸联合腕踝针缓解急性期呕吐发生率效果最佳,吸入性芳香疗法缓解延迟性呕吐发生率效果最佳。由于纳入原始文献数量、质量等因素的限制,本研究结论有待进一步验证。Objective:To investigate the effects of different non-drug interventions on nausea and vomiting induced by cancer chemotherapy using network Meta-analysis.Methods:Randomized controlled trials on the effects of non-drug interventions on nausea and vomiting induced by cancer chemotherapy were retrieved from CNKI,WanFang Database,VIP,CBM,the Cochrane Library,PubMed,Web of Science and EMbase.The search period was from January 2013 to June 2023.Literature screening and data extraction were conducted independently by two graduate students.The Cochrane Quality Evaluation Manual was used to evaluate the quality of the included literatures,and the Stata 16 software was used to perform network Meta-analysis.Results:A total of 14 randomized controlled trials involving 13 non-drug interventions were included in the study.The results of mesh Meta-analysis showed that there was no statistical significance in alleviating the severity of acute nausea between different non-drug interventions and conventional nursing measures,as well as between different non-drug interventions(P>0.05).SUCRA showed that ginger powder(SUCRA 85.1%)had the best effect.In terms of alleviating the severity of delayed nausea,there was a statistically significant difference between percutaneous acupoint electrical stimulation combined with gastrointestinal pacing and painting therapy and conventional nursing(P<0.05),and percutaneous acupoint electrical stimulation combined with gastrointestinal pacing(SUCRA was 84.6%)had the best effect.In terms of alleviating the incidence of acute vomiting,there was a statistically significant difference between ear moxibustion combined with wrist and ankle acupuncture and conventional nursing(P<0.05),and ear moxibustion combined with wrist and ankle acupuncture(SUCRA was 84.6%)had the best effect.In terms of alleviating the incidence of delayed vomiting,there were statistically significant differences between inhalation aromatherapy,ear moxibustion combined with wrist and ankle acupuncture,muscle relaxation training,ac

关 键 词：癌症 化疗 恶心呕吐 非药物性干预 网状Meta分析 循证护理 

分 类 号：R473.73[医药卫生—护理学]