针刺联合5-HT受体拮抗剂对乳腺癌化疗急性胃肠道反应的影响

发布时间：2018-07-21 12:26

【摘要】：目的:通过观察乳腺癌患者化疗后12h、24h的恶心呕吐程度、胃肠中医症状、血浆胃动素水平的变化情况,评价针刺联合5-HT受体拮抗剂与使用5-HT受体拮抗剂相比,对乳腺癌化疗相关的急性胃肠道副反应程度的影响,探讨针刺联合5-HT受体拮抗剂是否能更好地改善化疗相关的急性胃肠道副反应。方法:采用随机对照的研究试验设计方法,将接受含蒽环类药物化疗的乳腺癌患者40例随机分为治疗组和对照组。治疗组20例,使用针刺+5-羟色胺受体拮抗剂;对照组20例,使用五羟色胺受体拮抗剂。疗效的评价方法:观察两组在化疗后12h、24h的恶心、呕吐的程度、胃肠疾病中医症状积分及化疗前、化疗后24h血浆胃动素的水平,比较两组上述指标的变化差异,综合评价针刺联合5-羟色胺受体拮抗剂对乳腺癌化疗后胃肠道的影响。安全性的评价:通过评估患者对针刺相关的疼痛耐受情况、晕针等严重不适症状发生情况等评价治疗的安全性。结果:(1)恶心:化疗后,两组均无发生Ⅲ度恶心,化疗后12h,治疗组发生0～Ⅰ度恶心的比例为30%,对照组为15%,差异有统计学意义(p0.05);化疗后24h,两组恶心程度较化疗后12h均普遍降低,两组内前后比较,差异有统计学意义(p0.05),化疗后24h,治疗组0～Ⅰ度恶心所占比例高达95%,明显高于对照组75%,经统计分析,差异有统计学意义(p0.05)。(2)呕吐:化疗后两组均无发生Ⅲ度呕吐,化疗后12h,治疗组发生0～Ⅰ度呕吐的比例为95%,对照组为80%,差异有统计学意义(p0.05);化疗后24h,治疗组约80%的患者呕吐达到完全控制(0度),仅有5%的患者还出现Ⅱ度呕吐,而对照组尚有15%患者出现Ⅰ度呕吐,15%患者出现Ⅱ度呕吐,经统计分析,两组差异有统计学意义(p0.05),两组内比较,化疗后24h两组呕吐完全控制率(0度)均较化疗后12h明显上升,差异有统计学意义(p0.05)。(3)胃肠疾病中医症状:化疗后12h的胃肠疾病中医症状积分,治疗组为56.889±13.438分,对照组为49.167±8.644分,两组相比,对照组低于治疗组,但差异无统计学意义(P0.05);化疗后24h,治疗组为24.667±10.205分,对照组为39.111± 11.054分,两组相比,对照组高于治疗组,差异有统计学意义(P0.05);治疗组与对照组各个胃肠疾病中医症状评分差值的比较,其中胃脘痞满、胃脘疼痛、胸胁疼痛、少腹胀痛、食欲减退、食后腹胀、早饱、口渴不欲饮、肢体困重、大便稀溏、便秘、烦躁易怒这11个症状差值差异有统计学意义(P0.05)。(4)血浆胃动素水平:针刺前与针刺后24h血浆胃动素水平差异无统计学意义(p0.05)。结论:(1)针刺联合5-HT受体拮抗剂能更快、更好地控制化疗相关的急性恶心、呕吐。(2)针刺可以改善化疗期间的胃肠道中医症状,尤其对胃脘痞满、胃脘疼痛、胸胁疼痛、少腹胀痛、食欲减退、食后腹胀、早饱、口渴不欲饮、肢体困重、大便稀溏、便秘、烦躁易怒这11个症状改善程度较明显。(3)针刺对血浆胃动素水平影响不明显。
[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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