电针耳迷走神经防治化疗后恶心呕吐的疗效观察

目的 :观察电针耳迷走神经防治恶性肿瘤患者化疗后恶心、呕吐(CINV)的临床疗效。方法 :将40例患者随机分为两组,对照组19例,治疗组21例。对照组在化疗开始前30 min一次性缓慢静脉注射盐酸帕洛诺司琼注射液,治疗组在此基础上针刺及电针双侧耳迷走神经点,比较两组对化疗后恶心、呕吐的有效率;采用化疗药物不良反应分级标准(NCI-CTCAE)参考评分表评定两组化疗药物不良反应的发生率,测定和比较两组化疗前后血清5-羟色胺(5-HT)的变化。结果:化疗第3天治疗组治疗恶心的有效率为66.67%,对照组为26.32%,治疗组治疗呕吐的有效率为76.19%,对照组为31.58%,两组比较差异均有统计学意义(P0.01)。治疗组化疗药物不良反应少于对照组。治疗组化疗后血清5-HT浓度与化疗前相比有所下降(P0.01),而对照组有所增加(P0.01)。结论:电针耳迷走神经联合盐酸帕洛诺司琼对恶性肿瘤患者化疗后恶心、呕吐有较好的防治作用,并且可以降低化疗药物的不良反应。其机制可能是通过降低外周血中5-HT的浓度来实现的。

Effect Observation of the Auricular Vagus Nerve Stimulation by Electroacupuncture in Prevention and Treating Chemotherapy-Induced Nausea and Vomiting in Cancer Patient

Objective:To observe the clinical efficacy of the vagus nerve acupoint stimulation by electroacupuncture to prevent and treat the chemotherapy-induced nausea and vomiting in cancer patient. Methods:There were 40 patients randomly divided into two groups,the control group with 19 patients,and the treatment group with 21 patients. In the control group patients were given slow intravenous injection of palonosetron hydrochloride 30 minutes before the chemotherapy. The treatment group was given the same treatment and the auricular vagus nerve stimulation by electroacupuncture on 2 ears. The efficiency of the two methods for treating the nausea and vomiting were compared after the chemotherapy;the incidence rate of adverse reaction for the chemotherapy evaluated in the two groups using the National Cancer Institute Common Terminology Criteria for Adverse Events(NCI-CTCAE). The concentration of the serum 5-serotonin(5-HT) of the two groups were detected and compared before and after the chemotherapy. Result:The effective rate for the treatment of nausea on the third day of the chemotherapy in the treatment group was66.67% and in the control group was 26.32%,and the effective rate for treating vomiting in the treatment group at the same day was 76.19% and in the control group was 31.58%,with significantly statistical differences(P<0.01). The adverse reaction in the treatment group was less than the control group. The concentration of the serum 5-HT of the treatment group after the chemotherapy decreased compared with the concentration before the chemotherapy(P<0.01) and the concentration increased after the chemotherapy in the control group(P <0.01). Conclusion:The auricular vagus nerve stimulation by electroacupuncture combined with using palonosetron hydrochloride showed better effect on preventing and treating the nausea and vomiting after chemotherapy and reduced the adverse reaction of the chemotherapy drugs. The effect might be achieved through reducing the concentration of the serum 5-HT.