隔药灸联合昂丹司琼治疗含铂方案CINV脾虚湿困证的临床观察
发布时间：2019-02-22 21:29
【摘要】：目的：通过隔药灸接受含铂方案化疗患者的中脘、足三里穴位,观察隔药灸对化疗所致恶心呕吐、脾虚湿困证中医相关症状的影响；探讨隔药灸对含铂方案化疗所致恶心呕吐的疗效改善情况及安全性评价。方法：选取自2015年6月至2016年3月于中国中医科学院广安门医院肿瘤科住院化疗、符合已制定的诊断及纳入标准的患者64例,按就诊先后顺序随机分成单用昂丹司琼止吐治疗的对照组和在对照组基础加用隔药灸治疗的治疗组,两组各32例。观察记录患者化疗第1-5天、第7天的恶心呕吐情况以及患者治疗第1天、第3天、第7天的脾虚湿困证中医相关症状,并观察治疗前后患者KPS评分及血常规、转氨酶等实验室指标变化情况。结果：1.两组患者治疗前在性别、年龄、病种、体表面积、所用铂类药物种类和治疗前KPS评分上的差异均无统计学意义,即两组在基线水平上是一致的,具有可比性；2.治疗组对急性呕吐的完全控制率及止吐有效率分别为66.7%、93.3%,均高于对照组的53.1%、87.5%,但两组患者对急性期呕吐严重程度及控制情况差异均无统计学意义(P0.05)；化疗第2、3天,两组化疗所致呕吐的严重程度差异具有统计学意义(P0.05),隔药灸组对呕吐的完全控制率及有效率均高于对照组,但差异无统计学意义(P0.05)；3.化疗第1-4天,两组患者化疗所致恶心程度差异有统计学意义(P0.05),在第5、7天则无统计学意义。整个观察期内,两组间对恶心程度的有效率均未见明显差异；治疗组患者的恶心持续时间平均为1.90天,明显短于对照组的3.16天,差异具有统计学意义(P0.05)；4.化疗第1天,两组患者中医相关症状积分差异无统计学意义,化疗第3、7天,两组患者积分差异显著；第1、3天症状积分相比：治疗组化疗第3天症状积分(χ=6.40)普遍较化疗第1天(χ=8.87)降低,而对照组第1天积分χ=8.67,第3天积分χ=13.38,两组患者第1、3天前后积分变化差异具有统计学意义；第3、7天症状积分相比：两组患者化疗第7天中医相关症状总积分较第3天均有所下降,差异具有统计学意义；治疗第1、7天对比,治疗组对中医相关症状的有效率为86.67%,完全缓解率为33.33%；而对照组的有效率及完全控制率分别为68.75%和9.38%,两组积分改善情况的差异具有统计学意义(P0.05)。5.两组所观察的血常规、转氨酶、肌酐及尿素氮等安全性指标在治疗前后的变化差异无统计学意义(P均大于0.05)。结论：隔药灸联合昂丹司琼能够降低迟发性呕吐及化疗所致恶心的严重程度,并明显缩短平均恶心持续时间；能够降低化疗后脾虚湿困证相关中医症状积分,缓解化疗后某些相关的不适症状；并具有一定疗效及安全性。
[Abstract]:Objective: to observe the effect of drug separated moxibustion on the symptoms of nausea and vomiting induced by chemotherapy, spleen deficiency and dampness stagnation. Objective: to evaluate the efficacy and safety of drug-separated moxibustion on nausea and vomiting induced by chemotherapy with platinum-containing regimen. Methods: from June 2015 to March 2016, 64 patients with chemotherapy in Department of Oncology, Guang'an Men Hospital, Chinese Academy of traditional Chinese Medicine, who met the established criteria for diagnosis and inclusion, were selected. The patients were randomly divided into two groups: the control group treated with ondansetron alone and the control group treated with moxibustion separated by medicine on the basis of the control group with 32 cases in each group. To observe and record the nausea and vomiting of the patients on day 1-5 and day 7 of chemotherapy, and to observe the TCM symptoms of spleen deficiency dampness and stagnation syndrome on day 1, day 3 and day 7 of treatment, and observe the KPS score and blood routine before and after treatment. Changes of laboratory indexes such as transaminase. Results: 1. There were no significant differences in sex, age, disease species, body surface area, type of platinum drugs used and KPS score before treatment between the two groups, that is, the baseline level of the two groups was the same and comparable; 2. The complete control rate and the effective rate of stopping vomiting in the treatment group were 66.7 and 93.3respectively, which were higher than those in the control group (53.1 and 87.5, respectively). However, there was no significant difference in the severity and control of vomiting between the two groups (P0.05). On the 2nd day of chemotherapy, there was a significant difference in the severity of vomiting induced by chemotherapy between the two groups (P0.05). The complete control rate and effective rate of vomiting in the moxibustion group were higher than those in the control group, but the difference was not statistically significant (P0.05). On the 1st to 4th day of chemotherapy, there was a significant difference in the degree of nausea caused by chemotherapy between the two groups (P0.05), but there was no significant difference on the 7th day after chemotherapy (P0.05). During the whole observation period, there was no significant difference in the effective rate of nausea between the two groups; the mean duration of nausea in the treatment group was 1.90 days, which was significantly shorter than that in the control group (3.16 days), the difference was statistically significant (P0.05); 4. On the first day of chemotherapy, there was no significant difference in the scores of TCM related symptoms between the two groups, but on the 3rd day of chemotherapy, there was a significant difference in the scores between the two groups. The symptom score of the treatment group on the 3rd day (蠂 = 6.40) was generally lower than that on the first day of chemotherapy (蠂 = 8.87), while that of the control group on the first day was 8.67, the score on the third day was 13.38, and that on the third day in the treatment group was lower than that on the first day of chemotherapy (蠂 = 8.87). The difference of integral between the two groups before and after 3 days was statistically significant. Symptom score on the 3rd day after 7 days: the total scores of TCM related symptoms on the 7th day of chemotherapy in the two groups were lower than those on the third day, and the difference was statistically significant. After 7 days of treatment, the effective rate of TCM related symptoms in the treatment group was 86.67 and the complete remission rate was 33.33. The effective rate and complete control rate of the control group were 68.75% and 9.38%, respectively. The difference of the improvement of integral between the two groups was statistically significant (P0.05). There was no significant difference in blood routine, transaminase, creatinine and urea nitrogen between the two groups before and after treatment (P > 0.05). Conclusion: moxibustion combined with ondansetron can reduce the severity of delayed vomiting and nausea induced by chemotherapy and shorten the mean duration of nausea. It can reduce the score of TCM symptoms associated with spleen deficiency and dampness after chemotherapy, alleviate some related discomfort symptoms after chemotherapy, and has certain curative effect and safety.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.5
本文编号：2428655
[Abstract]:Objective: to observe the effect of drug separated moxibustion on the symptoms of nausea and vomiting induced by chemotherapy, spleen deficiency and dampness stagnation. Objective: to evaluate the efficacy and safety of drug-separated moxibustion on nausea and vomiting induced by chemotherapy with platinum-containing regimen. Methods: from June 2015 to March 2016, 64 patients with chemotherapy in Department of Oncology, Guang'an Men Hospital, Chinese Academy of traditional Chinese Medicine, who met the established criteria for diagnosis and inclusion, were selected. The patients were randomly divided into two groups: the control group treated with ondansetron alone and the control group treated with moxibustion separated by medicine on the basis of the control group with 32 cases in each group. To observe and record the nausea and vomiting of the patients on day 1-5 and day 7 of chemotherapy, and to observe the TCM symptoms of spleen deficiency dampness and stagnation syndrome on day 1, day 3 and day 7 of treatment, and observe the KPS score and blood routine before and after treatment. Changes of laboratory indexes such as transaminase. Results: 1. There were no significant differences in sex, age, disease species, body surface area, type of platinum drugs used and KPS score before treatment between the two groups, that is, the baseline level of the two groups was the same and comparable; 2. The complete control rate and the effective rate of stopping vomiting in the treatment group were 66.7 and 93.3respectively, which were higher than those in the control group (53.1 and 87.5, respectively). However, there was no significant difference in the severity and control of vomiting between the two groups (P0.05). On the 2nd day of chemotherapy, there was a significant difference in the severity of vomiting induced by chemotherapy between the two groups (P0.05). The complete control rate and effective rate of vomiting in the moxibustion group were higher than those in the control group, but the difference was not statistically significant (P0.05). On the 1st to 4th day of chemotherapy, there was a significant difference in the degree of nausea caused by chemotherapy between the two groups (P0.05), but there was no significant difference on the 7th day after chemotherapy (P0.05). During the whole observation period, there was no significant difference in the effective rate of nausea between the two groups; the mean duration of nausea in the treatment group was 1.90 days, which was significantly shorter than that in the control group (3.16 days), the difference was statistically significant (P0.05); 4. On the first day of chemotherapy, there was no significant difference in the scores of TCM related symptoms between the two groups, but on the 3rd day of chemotherapy, there was a significant difference in the scores between the two groups. The symptom score of the treatment group on the 3rd day (蠂 = 6.40) was generally lower than that on the first day of chemotherapy (蠂 = 8.87), while that of the control group on the first day was 8.67, the score on the third day was 13.38, and that on the third day in the treatment group was lower than that on the first day of chemotherapy (蠂 = 8.87). The difference of integral between the two groups before and after 3 days was statistically significant. Symptom score on the 3rd day after 7 days: the total scores of TCM related symptoms on the 7th day of chemotherapy in the two groups were lower than those on the third day, and the difference was statistically significant. After 7 days of treatment, the effective rate of TCM related symptoms in the treatment group was 86.67 and the complete remission rate was 33.33. The effective rate and complete control rate of the control group were 68.75% and 9.38%, respectively. The difference of the improvement of integral between the two groups was statistically significant (P0.05). There was no significant difference in blood routine, transaminase, creatinine and urea nitrogen between the two groups before and after treatment (P > 0.05). Conclusion: moxibustion combined with ondansetron can reduce the severity of delayed vomiting and nausea induced by chemotherapy and shorten the mean duration of nausea. It can reduce the score of TCM symptoms associated with spleen deficiency and dampness after chemotherapy, alleviate some related discomfort symptoms after chemotherapy, and has certain curative effect and safety.
【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.5
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