【摘要】：目的:通過觀察乳腺癌患者化療后12h、24h的惡心嘔吐程度、胃腸中醫(yī)癥狀、血漿胃動素水平的變化情況,評價針刺聯(lián)合5-HT受體拮抗劑與使用5-HT受體拮抗劑相比,對乳腺癌化療相關的急性胃腸道副反應程度的影響,探討針刺聯(lián)合5-HT受體拮抗劑是否能更好地改善化療相關的急性胃腸道副反應。方法:采用隨機對照的研究試驗設計方法,將接受含蒽環(huán)類藥物化療的乳腺癌患者40例隨機分為治療組和對照組。治療組20例,使用針刺+5-羥色胺受體拮抗劑;對照組20例,使用五羥色胺受體拮抗劑。療效的評價方法:觀察兩組在化療后12h、24h的惡心、嘔吐的程度、胃腸疾病中醫(yī)癥狀積分及化療前、化療后24h血漿胃動素的水平,比較兩組上述指標的變化差異,綜合評價針刺聯(lián)合5-羥色胺受體拮抗劑對乳腺癌化療后胃腸道的影響。安全性的評價:通過評估患者對針刺相關的疼痛耐受情況、暈針等嚴重不適癥狀發(fā)生情況等評價治療的安全性。結果:(1)惡心:化療后,兩組均無發(fā)生Ⅲ度惡心,化療后12h,治療組發(fā)生0～Ⅰ度惡心的比例為30%,對照組為15%,差異有統(tǒng)計學意義(p0.05);化療后24h,兩組惡心程度較化療后12h均普遍降低,兩組內(nèi)前后比較,差異有統(tǒng)計學意義(p0.05),化療后24h,治療組0～Ⅰ度惡心所占比例高達95%,明顯高于對照組75%,經(jīng)統(tǒng)計分析,差異有統(tǒng)計學意義(p0.05)。(2)嘔吐:化療后兩組均無發(fā)生Ⅲ度嘔吐,化療后12h,治療組發(fā)生0～Ⅰ度嘔吐的比例為95%,對照組為80%,差異有統(tǒng)計學意義(p0.05);化療后24h,治療組約80%的患者嘔吐達到完全控制(0度),僅有5%的患者還出現(xiàn)Ⅱ度嘔吐,而對照組尚有15%患者出現(xiàn)Ⅰ度嘔吐,15%患者出現(xiàn)Ⅱ度嘔吐,經(jīng)統(tǒng)計分析,兩組差異有統(tǒng)計學意義(p0.05),兩組內(nèi)比較,化療后24h兩組嘔吐完全控制率(0度)均較化療后12h明顯上升,差異有統(tǒng)計學意義(p0.05)。(3)胃腸疾病中醫(yī)癥狀:化療后12h的胃腸疾病中醫(yī)癥狀積分,治療組為56.889±13.438分,對照組為49.167±8.644分,兩組相比,對照組低于治療組,但差異無統(tǒng)計學意義(P0.05);化療后24h,治療組為24.667±10.205分,對照組為39.111± 11.054分,兩組相比,對照組高于治療組,差異有統(tǒng)計學意義(P0.05);治療組與對照組各個胃腸疾病中醫(yī)癥狀評分差值的比較,其中胃脘痞滿、胃脘疼痛、胸脅疼痛、少腹脹痛、食欲減退、食后腹脹、早飽、口渴不欲飲、肢體困重、大便稀溏、便秘、煩躁易怒這11個癥狀差值差異有統(tǒng)計學意義(P0.05)。(4)血漿胃動素水平:針刺前與針刺后24h血漿胃動素水平差異無統(tǒng)計學意義(p0.05)。結論:(1)針刺聯(lián)合5-HT受體拮抗劑能更快、更好地控制化療相關的急性惡心、嘔吐。(2)針刺可以改善化療期間的胃腸道中醫(yī)癥狀,尤其對胃脘痞滿、胃脘疼痛、胸脅疼痛、少腹脹痛、食欲減退、食后腹脹、早飽、口渴不欲飲、肢體困重、大便稀溏、便秘、煩躁易怒這11個癥狀改善程度較明顯。(3)針刺對血漿胃動素水平影響不明顯。
[Abstract]:Objective: to observe the changes of nausea and vomiting, gastrointestinal symptoms and plasma motilin levels in patients with breast cancer 12 h after chemotherapy, and to evaluate the effect of acupuncture combined with 5-HT receptor antagonists on 5-HT receptor antagonists. To investigate whether acupuncture combined with 5-HT receptor antagonist can improve the acute gastrointestinal side effects associated with chemotherapy in breast cancer. Methods: 40 breast cancer patients receiving anthracycline chemotherapy were randomly divided into treatment group and control group. Treatment group (n = 20) and control group (n = 20) were treated with 5 hydroxytryptamine receptor antagonist. Methods: to observe the degree of nausea and vomiting at 12h after chemotherapy, the scores of TCM symptoms of gastrointestinal diseases and the plasma motilin levels before and after chemotherapy, and to compare the changes of the above indexes between the two groups. To evaluate the effect of acupuncture combined with serotonin receptor antagonist on gastrointestinal tract after chemotherapy for breast cancer. Safety evaluation: the safety of the treatment was evaluated by assessing the patient's tolerance to acupuncture related pain and the occurrence of severe symptoms such as halo acupuncture. Results: (1) nausea: after chemotherapy, there was no 鈪，

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