指压法控制和管理化疗相关急性及延迟性恶心的有效性：一项随机对照试验。

The effectiveness of acupressure for the control and management of chemotherapy-related acute and delayed nausea: a randomized controlled trial.

作者信息

Molassiotis Alexander, Russell Wanda, Hughes John, Breckons Matthew, Lloyd-Williams Mari, Richardson Janet, Hulme Claire, Brearley Sarah G, Campbell Malcolm, Garrow Adam, Ryder W David

机构信息

School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.

出版信息

J Pain Symptom Manage. 2014 Jan;47(1):12-25. doi: 10.1016/j.jpainsymman.2013.03.007. Epub 2013 Apr 17.

DOI:10.1016/j.jpainsymman.2013.03.007

PMID:23602325

Abstract

CONTEXT

Both positive and negative results have been reported in the literature from the use of acupressure at the P6 point, providing evidence of highly suggestive but not conclusive results.

OBJECTIVES

To clarify whether acupressure is effective in the management of chemotherapy-related nausea and vomiting.

METHODS

A randomized, three-group, sham-controlled trial was designed. Patients with cancer receiving chemotherapy were randomized to receive standardized antiemetics and acupressure wristbands, sham acupressure wristbands, or antiemetics alone. Primary outcome assessment (nausea) was carried out daily for seven days per chemotherapy cycle over four cycles. Secondary outcomes included vomiting, psychological distress, and quality of life.

RESULTS

Five hundred patients were randomized. Primary outcome analysis (nausea in Cycle 1) revealed no statistically significant differences between the three groups, although nausea levels in the proportion of patients using wristbands (both real and sham) were somewhat lower than those in the proportion of patients using antiemetics-only group. Adjusting for gender, age, and emetic risk of chemotherapy, the odds ratio of lower nausea experience was 1.18 and 1.42 for the acupressure and sham acupressure groups, respectively. A gender interaction effect was evident (P = 0.002). No significant differences were detected in relation to vomiting, anxiety, and quality-of-life measures.

CONCLUSION

No clear recommendations can be made about the use of acupressure wristbands in the management of chemotherapy-related nausea and vomiting as results did not reach statistical significance. However, the study provided evidence of encouraging signals in relation to improved nausea experience and warrants further consideration in both practice and further clinical trials.

TRIAL REGISTRATION

This trial is registered with the ISRCT register, number ISRCTN87604299.

摘要

背景

文献中报道了在P6点使用指压法的阳性和阴性结果，这表明结果具有高度暗示性但并不确凿。

目的

阐明指压法在化疗相关恶心和呕吐管理中是否有效。

方法

设计了一项随机、三组、假对照试验。接受化疗的癌症患者被随机分配接受标准化止吐药和指压腕带、假指压腕带或仅接受止吐药。在四个化疗周期中，每个化疗周期每天进行一次主要结局评估（恶心），持续七天。次要结局包括呕吐、心理困扰和生活质量。

结果

500名患者被随机分组。主要结局分析（第1周期恶心）显示三组之间无统计学显著差异，尽管使用腕带（真实和假）的患者比例中的恶心水平略低于仅使用止吐药的患者比例中的恶心水平。在调整性别、年龄和化疗的致吐风险后，指压组和假指压组恶心体验较低的优势比分别为1.18和1.42。存在明显的性别交互效应（P = 0.002）。在呕吐、焦虑和生活质量测量方面未检测到显著差异。