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化疗放疗期间接受针刺、假针刺或标准护理的患者的呕吐:一项随机对照研究。

Emesis in patients receiving acupuncture, sham acupuncture or standard care during chemo-radiation: A randomized controlled study.

作者信息

Widgren Ylva, Enblom Anna

机构信息

The Social Rehabilitation Unit, Sundsvall Municipality and Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.

Region of Östergötland, Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden.

出版信息

Complement Ther Med. 2017 Oct;34:16-25. doi: 10.1016/j.ctim.2017.07.003. Epub 2017 Jul 10.

Abstract

OBJECTIVE

To study nausea, vomiting and need for rescue antiemetics in patients receiving antiemetic acupuncture, sham acupuncture or standard care during concomitant chemotherapy during pelvic radiotherapy.

METHODS

In total, 68 patients participated (75% women, mean age 56 years, 53% had gynecological, 43% colorectal, and 4% other cancer types). Fifty-seven of them were blinded randomized to verum (n=28) or sham (n=29) acupuncture, median 10 sessions. During the study period of four weeks, the patients daily registered their nausea, vomiting and consumption of antiemetics. They were compared to a reference group (n=11) receiving standard care only, who delivered these data once (after receiving mean 27Gy radiotherapy dose).

RESULTS

More patients in the sham acupuncture group (17 of 20; 85%, p=0.019, RR 1.81, CI 1.06-3.09) consumed antiemetics, compared to the verum acupuncture group (8 of 17; 47%). In the standard care group, 7 of 11 (63%) consumed antiemetics. The verum acupuncture treated patients experienced lower intensity of nausea than the other patients (p=0.049). There was a non-significant tendency that more patients receiving either sham acupuncture or standard care experienced nausea (21 of 31; 68%) than patients receiving verum acupuncture (9 of 17; 53%: p=0.074, RR 1.58, CI 0.91-2.74).

CONCLUSION

Patients treated with verum acupuncture needed less antiemetics and experienced milder nausea than other patients. Our study was small and many analyses lacked statistical power to detect differences; we welcome further sham-controlled efficacy studies and studies regarding the role of non-specific treatment components for experiencing antiemetic effects of acupuncture.

摘要

目的

研究在盆腔放疗期间同步化疗时接受止吐针刺、假针刺或标准护理的患者的恶心、呕吐情况以及使用急救止吐药的必要性。

方法

共有68名患者参与研究(75%为女性,平均年龄56岁,53%患有妇科癌症,43%患有结直肠癌,4%为其他癌症类型)。其中57名患者被随机分为真针刺组(n = 28)或假针刺组(n = 29),接受中位数为10次的针刺治疗。在为期四周的研究期间,患者每天记录自己的恶心、呕吐情况以及止吐药的使用情况。将他们与仅接受标准护理的参考组(n = 11)进行比较,参考组仅在接受平均27Gy放疗剂量后提供一次这些数据。

结果

与真针刺组(17名中的8名;47%)相比,假针刺组中有更多患者(20名中的17名;85%,p = 0.019,相对危险度1.81,可信区间1.06 - 3.09)使用了止吐药。在标准护理组中,11名患者中有7名(63%)使用了止吐药。接受真针刺治疗的患者恶心程度低于其他患者(p = 0.049)。接受假针刺或标准护理的患者中经历恶心的患者(31名中的21名;68%)比接受真针刺的患者(17名中的9名;53%)更多,这一趋势无统计学意义(p = 0.074,相对危险度1.58,可信区间0.91 - 2.74)。

结论

接受真针刺治疗的患者比其他患者需要更少的止吐药,且恶心程度较轻。我们的研究规模较小,许多分析缺乏检测差异的统计效力;我们欢迎进一步的假对照疗效研究以及关于非特异性治疗成分在针刺止吐作用中作用的研究。

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