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经皮电针刺激防治化疗所致恶心呕吐的效果及机制。

Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting.

机构信息

Division of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China ; Division of Gastroenterology, Sixth People's Hospital of Shaoxing, Shaoxing 312000, China.

Division of Gastroenterology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.

出版信息

Evid Based Complement Alternat Med. 2014;2014:860631. doi: 10.1155/2014/860631. Epub 2014 Aug 31.

Abstract

Nausea and vomiting are one of the major complications of chemotherapy for cancers. The aim of this study is to investigate the emetic effects and mechanisms involving serotonin and dopamine of needleless transcutaneous electroacupuncture (TEA) at Neiguan (PC6) and Jianshi (PC5) on chemotherapy-induced nausea and vomiting in patients with cancers. Seventy-two patients with chemotherapy were randomly divided into sham-TEA group (sham-TEA, n = 34) and TEA group (n = 38). TEA was performed at PC 6 and PC 5 (1 h, bid) in combination with granisetron. Sham-TEA was delivered at nonacupoints using the same parameters. We found the following. (1) In the acute phase, the conventional antiemetic therapy using Ondansetron effectively reduced nausea and vomiting; the addition of TEA did not show any additive effects. In the delayed phase, however, TEA significantly increased the rate of complete control (P < 0.01) and reduced the nausea score (P < 0.05), compared with sham-TEA. (2) TEA significantly reduced serum levels of 5-HT and dopamine in comparison with sham-TEA. Those results demonstrate that needleless transcutaneous electroacupuncture at PC6 using a watch-size digital stimulator improves emesis and reduces nausea in the delayed phase of chemotherapy in patients with cancers. This antiemetic effect is possibly mediated via mechanisms involving serotonin and dopamine.

摘要

恶心和呕吐是癌症化疗的主要并发症之一。本研究旨在探讨内关(PC6)和间使(PC5)无针经皮电刺激(TEA)对癌症患者化疗引起的恶心和呕吐的止吐作用及其涉及 5-羟色胺和多巴胺的机制。72 例化疗患者随机分为假 TEA 组(假 TEA,n = 34)和 TEA 组(n = 38)。TEA 与格拉司琼联合应用于 PC6 和 PC5(1 h,bid)。假 TEA 采用相同参数在非穴位进行。我们发现:(1)在急性期,使用昂丹司琼的常规止吐治疗有效减轻了恶心和呕吐;但加用 TEA 并没有显示出任何附加效果。然而,在延迟期,与假 TEA 相比,TEA 显著增加了完全控制率(P < 0.01)和降低了恶心评分(P < 0.05)。(2)与假 TEA 相比,TEA 显著降低了血清 5-HT 和多巴胺水平。这些结果表明,使用手表大小的数字刺激器进行内关 PC6 的无针经皮电刺激可改善癌症患者化疗后延迟期的呕吐,并减轻恶心。这种止吐作用可能是通过涉及 5-羟色胺和多巴胺的机制介导的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae2b/4164144/ec388dd322bb/ECAM2014-860631.001.jpg

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