针刺、隔姜灸及温针灸对比格拉斯琼对顺铂类化疗患者不同阶段胃肠反应的影响

目的为对比针灸和药物治疗顺铂类化疗患者的疗效及进一步探索针灸改善恶心呕吐的作用机制。方法采用随机分组方法把符合纳入标准的120例患者分为针刺组、隔姜灸组、温针灸组、对照组(格拉斯琼),然后根据组别进行对应治疗。在治疗期间记录患者的胃肠道反应,并根据严重程度及评分标准进行评分,完成1个疗程的治疗及观察评分后统计分析。结果胃肠不良反应方面,化疗后第1天,对照组患者积分明显少于其他3组(P<0.05);在第3天各组比较差异无统计学意义(P>0.05);第7天,对照组积分明显高于其余3组(P<0.05)。针刺组胃肠不良反应积分高于温针灸组及隔姜灸组(P<0.05),温针灸组与隔姜灸组比较差异无统计学意义(P>0.05)。在患者疼痛方面,化疗后第1、3天3组分别与对照组积分比较,其差异无统计学意义(P>0.05)。第7天,针刺组及温针灸组与对照组比较差异均具有统计学意义(P<0.05),其对患者疼痛的缓解明显优于对照组及隔姜灸组。在患者体质状态及畏寒怕冷方面,从第1天的各组无差异(P>0.05),到第3、7天随着治疗量的增加,3组患者分值均低于对照组(P<0.05)。结论针刺、艾灸及隔姜灸均能改善顺铂类化疗患者胃肠不良反应,减轻患者疼痛,改善患者体质状态及畏寒症状,但是其效果显现需要一定的时间。

Effects of Acupuncture,Ginger-partitioned Moxibustion and Warm Needling Versus Granisetron on Gastrointestinal Reactions in Patients Receiving Cisplatin-based Chemotherapy in Different Stages

Objective To compare the efficacies of acupuncture-moxibustion therapies and medication in treating patients undergoing Cisplatin-based chemotherapy and further explore the mechanism of acupuncture-moxibustion in improving nausea and vomiting.Method One hundred and twenty eligible patients were randomized into an acupuncture group,a ginger-partitioned moxibustion group,a warm needling group and a control group(Granisetron)to receive corresponding treatments.During treatment,patients’gastrointestinal reactions were recorded and scored based on the scoring criteria.The statistical analyses were conducted after 1 course of treatment,observation and scoring.Result About gastrointestinal reactions,on the first day after chemotherapy,the score was significantly lower in the control group than in the other 3 groups(P<0.05),and the differences among the other 3 groups were statistically insignificant(P>0.05);on the 7th day after chemotherapy,the score was significantly higher in the control group than in the other three groups(P<0.05);the score of gastrointestinal reactions was higher in the acupuncture group than in the warm needling group and ginger-partitioned moxibustion group(P<0.05),and the difference between the warm needling group and ginger-partitioned moxibustion group was statistically insignificant(P>0.05).Regarding the pain intensity,the differences comparing the score between the control group and the other 3 groups were statistically insignificant on the first and 3rd days after chemotherapy(P>0.05);on the 7th day,the control group was significantly different from the acupuncture group and the warm needling group(P<0.05);the improvement of pain was more significant in the acupuncture and warm needling group compared with the control group and ginger-partitioned moxibustion group.In the perspective of physical condition and cold aversion,the inter-group differences were statistically insignificant on the first day(P>0.05),and the score was lower in the other 3 groups than in the control group from the 3rd day to the 7th day with the increase of treatment dosage(P<0.05).Conclusion Acupuncture,warm needling and ginger-partitioned moxibustion all can improve the gastrointestinal reactions,reduce pain,and improve the physical condition and cold aversion symptom in patients undergoing Cisplatin-based chemotherapy,though it requires certain time to present the efficacy.