Dibble Suzanne L, Luce Judy, Cooper Bruce A, Israel Jill, Cohen Misha, Nussey Brenda, Rugo Hope
Institute for Health and Aging, School of Nursing, University of California, San Francisco, USA.
Oncol Nurs Forum. 2007 Jul;34(4):813-20. doi: 10.1188/07.ONF.xxx-xxx.
PURPOSE/OBJECTIVES: To compare differences in the chemotherapy-induced nausea and vomiting (CINV) among three groups of women (acupressure, placebo acupressure, and usual care) undergoing chemo-therapy for breast cancer.
A multicenter, longitudinal, randomized clinical trial throughout one cycle of chemotherapy.
Ten community clinical oncology programs associated with the M.D. Anderson Cancer Center and nine independent sites located throughout the United States.
160 women who were beginning their second or third cycle of chemotherapy for breast cancer treatment and had moderate nausea intensity scores with their previous cycles.
Subjects were randomized to one of three groups: acupressure to P6 point (active), acupressure to SI3 point (placebo), or usual care only. Subjects in the acupressure group were taught to apply an acupressure wrist device by research assistants who were unaware of the active acupressure point. All subjects completed a daily log for 21 days containing measures of nausea and vomiting and recording methods (including antiemetics and acupressure) used to control these symptoms.
Acute and delayed nausea and vomiting.
No significant differences existed in the demographic, disease, or treatment variables among the treatment groups. No significant differences were found in acute nausea or emesis by treatment group. With delayed nausea and vomiting, the acupressure group had a statistically significant reduction in the amount of vomiting and the intensity of nausea over time when compared with the placebo and usual-care groups. No significant differences were found between the placebo and usual-care groups in delayed nausea or vomiting.
Acupressure at the P6 point is a value-added technique in addition to pharmaceutical management for women undergoing treatment for breast cancer to reduce the amount and intensity of delayed CINV.
Acupressure is a safe and effective tool for managing delayed CINV and should be offered to women undergoing chemotherapy for breast cancer.
目的/目标：比较三组接受乳腺癌化疗的女性（穴位按压组、安慰剂穴位按压组和常规护理组）在化疗引起的恶心和呕吐（CINV）方面的差异。
一项贯穿化疗一个周期的多中心、纵向、随机临床试验。
与MD安德森癌症中心相关的10个社区临床肿瘤项目以及遍布美国的9个独立地点。
160名开始接受乳腺癌治疗第二或第三个化疗周期且前一周期恶心强度评分为中度的女性。
将受试者随机分为三组之一：按压内关穴（P6点，有效组）、按压后溪穴（SI3点，安慰剂组）或仅接受常规护理。穴位按压组的受试者由不了解有效穴位的研究助理指导使用穴位按压腕带。所有受试者连续21天完成每日日志，记录恶心和呕吐情况以及用于控制这些症状的方法（包括止吐药和穴位按压）。
急性和延迟性恶心与呕吐。
各治疗组在人口统计学、疾病或治疗变量方面无显著差异。治疗组在急性恶心或呕吐方面未发现显著差异。对于延迟性恶心和呕吐，与安慰剂组和常规护理组相比，穴位按压组随着时间推移呕吐量和恶心强度有统计学显著降低。安慰剂组和常规护理组在延迟性恶心或呕吐方面未发现显著差异。
对于接受乳腺癌治疗的女性，除药物治疗外，按压内关穴（P6点）是一种可减少延迟性CINV的量和强度的附加技术。
穴位按压是管理延迟性CINV的一种安全有效的工具，并应提供给接受乳腺癌化疗的女性。
