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经皮穴位电刺激联合帕洛诺司琼对化疗所致恶心呕吐的影响:一项单盲、随机、对照试验。

Effect of transcutaneous electrical acupoint stimulation combined with palonosetron on chemotherapy-induced nausea and vomiting: a single-blind, randomized, controlled trial.

作者信息

Xie Jing, Chen Lei-Hua, Ning Zhou-Yu, Zhang Chen-Yue, Chen Hao, Chen Zhen, Meng Zhi-Qiang, Zhu Xiao-Yan

机构信息

Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.

Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.

出版信息

Chin J Cancer. 2017 Jan 10;36(1):6. doi: 10.1186/s40880-016-0176-1.

Abstract

BACKGROUND

Chemotherapy-induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization (TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation (TEAS) on nausea and vomiting after TACE.

METHODS

A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active-acupuncture (n = 72) or placebo-acupuncture (n = 70) groups using a covariate-adaptive randomization at a ratio of 1:1. The acupoints Hegu (LI4), Neiguan (P6), and Zusanli (ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory (MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.

RESULTS

Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant (all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active-acupuncture group than in the placebo-acupuncture group and continued to decrease over time with treatment (all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active-acupuncture group were slightly lower than those for the placebo-acupuncture group, but the differences were not statistically significant (all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event (P > 0.05).

CONCLUSION

TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy. Trial registration NCT01895010. Registered 21 June 2013.

摘要

背景

化疗引起的恶心和呕吐会对接受静脉输注化疗或经动脉化疗栓塞术(TACE)的患者的生活质量产生不利影响。本研究旨在探讨经皮穴位电刺激(TEAS)对TACE术后恶心和呕吐的临床疗效。

方法

总共142例因原发性或转移性肝癌接受含顺铂TACE治疗的患者,采用协变量适应性随机化按1:1比例分为主动针刺组(n = 72)和假针刺组(n = 70)。每天对合谷穴(LI4)、内关穴(P6)和足三里穴(ST36)进行两次刺激,共6天。通过这些症状的发生率和严重程度评估TEAS对恶心和呕吐的影响。食欲量表和MD安德森症状量表(MDASI)评分作为次要终点,用于评估TEAS对患者食欲和生活质量的影响。同时监测治疗的安全性。

结果

两组之间,TACE术后恶心和呕吐的发生率及严重程度差异均无统计学意义(均P > 0.05)。从TACE术后第二天起,主动针刺组的食欲评分显著低于假针刺组,且随着治疗时间推移持续下降(所有P值均小于0.01)。在第0、1和2天,主动针刺组的平均MDASI评分略低于假针刺组,但差异无统计学意义(均P > 0.05)。两组之间任何不良事件的发生率均无显著差异(P > 0.05)。

结论

TEAS似乎是一种安全有效的疗法,可缓解化疗后患者的胃肠道不适。试验注册号NCT01895010。于2013年6月21日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3547/5223354/27d8c2629bae/40880_2016_176_Fig1_HTML.jpg

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