针灸改善中晚期宫颈癌同步放化疗患者恶心呕吐的效果观察

目的探讨针灸对中晚期宫颈癌同步放化疗患者恶心呕吐的改善效果。方法选取2016年8月至2019年2月间陕西省汉中市中心医院收治的行同步放化疗的96例中晚期宫颈癌患者,根据放化疗期间采用的缓解恶心呕吐的方法不同进行分组,不采用恶心呕吐相关干预治疗的32例患者纳入空白组,采用托烷司琼治疗的32例患者纳入对照组,采用针灸治疗的32例患者纳入治疗组。比较三组患者恶心呕吐治疗效果、营养状态、体力状态、心理状态及安全性。结果化疗5d后,空白组、对照组和治疗组恶心呕吐治疗总有效率为50.0%、75.0%和87.5%,治疗组总有效率最高,对照组与治疗组均高于空白组,差异均有统计学意义(均P<0.05);对照组与治疗组总有效率比较,差异无统计学意义(P>0.05)。化疗后,空白组患者白蛋白较化疗前降低,对照组和治疗组的淋巴细胞计数均较化疗前升高,差异均有统计学意义(均P<0.05)。化疗后,对照组与治疗组的白蛋白及淋巴细胞水平均高于空白组,治疗组淋巴细胞计数高于对照组,差异均有统计学意义(均P<0.05)。化疗期间,三组患者体力状态评分呈先降后升趋势,焦虑评分呈先升后降趋势,组内差异有统计学意义(P<0.05);对照组与治疗组化疗6d、14d和21d的体力状态评分均高于空白组,焦虑评分低于空白组,差异均有统计学意义(均P<0.05);治疗组化疗14d的体力状态评分高于对照组,焦虑评分低于对照组,差异均有统计学意义(均P<0.05)。三组患者化疗前后均进行心电图、血常规及肝肾功能等检查,均正常。对照组与治疗组患者均出现不同程度的不良反应,未进行特殊处理,均自行缓解;对照组与治疗组患者不良反应发生率均低于空白组,治疗组不良反应发生率低于对照组,差异均有统计学意义(均P<0.05)。结论针灸能有效改善中晚期宫颈癌同步放化疗导致的恶心呕吐,使患者在治疗期间保持良好的营养状况和体力状态,调节心理状态,有较好的安全性。

Effectiveness of acupuncture and moxibustion in improving nausea and vomiting in patients with advanced cervical cancer on concurrent chemoradiotherapy

Objective To observe the effectiveness of acupuncture and moxibustion on improving nausea and vomiting in patients with advanced cervical cancer treated by concurrent chemoradiotherapy.Methods Ninety-six patients with advanced cervical cancer who received concurrent chemoradiotherapy were selected at Hanzhong Central Hospital between August 2016 and February 2019.They were randomly assigned to a non-intervention group,a tropisetron group(control group)and an acupuncture and moxibustion group(treatment group)with 32 patents in each group.The treatment effectiveness of the therapies for nausea and vomiting,nutritional status,physical and psychological status and safety were compared among the three groups.Results At 5d after the chemotherapy,the overall effectiveness rate of treatment for nausea and vomiting was 50.0%,75.0%and 87.5%,respectively in the non-intervention group,control group and treatment group,which was significantly higher in treatment group than in the control group and the non-intervention group(all P<0.05).However,there was no statistically significant difference in the overall effectiveness rate between the control group and the treatment group(P>0.05).After chemotherapy,the albumin level was significantly low in the non-intervention group compared with before chemotherapy(P<0.05).Lymphocyte count increased in the treatment group and the control group(all P<0.05).After chemotherapy,the albumin level and lymphocyte count were higher in the treatment group and the control group than in the non-intervention group(all P<0.05).Lymphocyte count was higher in the treatment group than in the control group(P<0.05).During the chemotherapy,the physical status showed a trend from decline to rise.Scores of anxiety showed a trend from rise to decline.There was significant difference among the three groups(all P<0.05).Scores of physical status were higher in the treatment group and the control group than in the non-intervention group and scores of anxiety were lower in the treatment group and the control group than in the non-intervention group at 6,14 and 21 d(all P<0.05).At 14 d,physical status was higher in the treatment group than in the control group and anxiety was lower in the treatment group than in the control group(all P<0.05).Electrocardiogram,routine blood and renal function tests showed good the results.Adverse reactions occurred in both the treatment group and the control group and they disappeared spontaneously without treatment.The incidence of adverse reactions were lower in the treatment group and the control group than in the non-intervention group(all P<0.05).Moreover,the incidence of adverse reactions were lower in the treatment group than in the control group(P<0.05).Conclusion Acupuncture and moxibustion can effectively improve nausea and vomiting caused by concurrent chemoradiotherapy for advanced cervical cancer.It can maintain good nutritional status,physical status and psychological status during the treatment,and it shows better safety than western medicine.