隔藥灸聯(lián)合昂丹司瓊治療含鉑方案CINV脾虛濕困證的臨床觀察
發(fā)布時(shí)間：2019-02-22 21:29
【摘要】：目的：通過(guò)隔藥灸接受含鉑方案化療患者的中脘、足三里穴位,觀察隔藥灸對(duì)化療所致惡心嘔吐、脾虛濕困證中醫(yī)相關(guān)癥狀的影響；探討隔藥灸對(duì)含鉑方案化療所致惡心嘔吐的療效改善情況及安全性評(píng)價(jià)。方法：選取自2015年6月至2016年3月于中國(guó)中醫(yī)科學(xué)院廣安門醫(yī)院腫瘤科住院化療、符合已制定的診斷及納入標(biāo)準(zhǔn)的患者64例,按就診先后順序隨機(jī)分成單用昂丹司瓊止吐治療的對(duì)照組和在對(duì)照組基礎(chǔ)加用隔藥灸治療的治療組,兩組各32例。觀察記錄患者化療第1-5天、第7天的惡心嘔吐情況以及患者治療第1天、第3天、第7天的脾虛濕困證中醫(yī)相關(guān)癥狀,并觀察治療前后患者KPS評(píng)分及血常規(guī)、轉(zhuǎn)氨酶等實(shí)驗(yàn)室指標(biāo)變化情況。結(jié)果：1.兩組患者治療前在性別、年齡、病種、體表面積、所用鉑類藥物種類和治療前KPS評(píng)分上的差異均無(wú)統(tǒng)計(jì)學(xué)意義,即兩組在基線水平上是一致的,具有可比性；2.治療組對(duì)急性嘔吐的完全控制率及止吐有效率分別為66.7%、93.3%,均高于對(duì)照組的53.1%、87.5%,但兩組患者對(duì)急性期嘔吐嚴(yán)重程度及控制情況差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；化療第2、3天,兩組化療所致嘔吐的嚴(yán)重程度差異具有統(tǒng)計(jì)學(xué)意義(P0.05),隔藥灸組對(duì)嘔吐的完全控制率及有效率均高于對(duì)照組,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)；3.化療第1-4天,兩組患者化療所致惡心程度差異有統(tǒng)計(jì)學(xué)意義(P0.05),在第5、7天則無(wú)統(tǒng)計(jì)學(xué)意義。整個(gè)觀察期內(nèi),兩組間對(duì)惡心程度的有效率均未見明顯差異；治療組患者的惡心持續(xù)時(shí)間平均為1.90天,明顯短于對(duì)照組的3.16天,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；4.化療第1天,兩組患者中醫(yī)相關(guān)癥狀積分差異無(wú)統(tǒng)計(jì)學(xué)意義,化療第3、7天,兩組患者積分差異顯著；第1、3天癥狀積分相比：治療組化療第3天癥狀積分(χ=6.40)普遍較化療第1天(χ=8.87)降低,而對(duì)照組第1天積分χ=8.67,第3天積分χ=13.38,兩組患者第1、3天前后積分變化差異具有統(tǒng)計(jì)學(xué)意義；第3、7天癥狀積分相比：兩組患者化療第7天中醫(yī)相關(guān)癥狀總積分較第3天均有所下降,差異具有統(tǒng)計(jì)學(xué)意義；治療第1、7天對(duì)比,治療組對(duì)中醫(yī)相關(guān)癥狀的有效率為86.67%,完全緩解率為33.33%；而對(duì)照組的有效率及完全控制率分別為68.75%和9.38%,兩組積分改善情況的差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。5.兩組所觀察的血常規(guī)、轉(zhuǎn)氨酶、肌酐及尿素氮等安全性指標(biāo)在治療前后的變化差異無(wú)統(tǒng)計(jì)學(xué)意義(P均大于0.05)。結(jié)論：隔藥灸聯(lián)合昂丹司瓊能夠降低遲發(fā)性嘔吐及化療所致惡心的嚴(yán)重程度,并明顯縮短平均惡心持續(xù)時(shí)間；能夠降低化療后脾虛濕困證相關(guān)中醫(yī)癥狀積分,緩解化療后某些相關(guān)的不適癥狀；并具有一定療效及安全性。
[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.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.5
本文編號(hào)：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.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R246.5
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