斡旋针法治疗铂类药物导致的临床恶心呕吐的临床研究

发布时间：2018-04-03 12:25

本文选题：化疗　切入点：恶心　出处：《广州中医药大学》2016年硕士论文

【摘要】：目的：在人类同肿瘤的斗争史中,化疗因其较好的效果一直扮演着举足轻重的角色。但是在杀灭癌细胞的过程中,化疗药物会产生许多的副反应。其中恶心、呕吐和食欲下降,均为临床上面极为多见的胃肠道反应。这些会造成恶性肿瘤患者生活质量的下降、并且对化疗产生恐惧情绪,甚至于最后中断了化疗。在临床上,含铂类药物的化疗方案被广泛应用,但使用这类药物所导致的胃肠道反应,却给患者的生活造成极多的不便,成为化疗过程中的一大阻碍。在现阶段,西医针对化疗所引起的恶心、呕吐,采用托烷司琼等一类5-羟色胺受体拮抗剂,在预防和治疗方面,明显取得了一定的效果。但是仍存在着极大的发展空间。本课题通过观察“斡旋针法”治疗铂类药物导致恶心呕吐临床疗效,旨在为临床治疗化疗后呕吐找到一种更为简便有效的方法。方法：本课题根据已制定的要求共收集病例60例,采用简单随机法平均分为治疗组和对照组,各30例。两组均给予西药托烷司琼止呕治疗和西药临床常规处理。治疗组在此基础上以“斡旋针法”：右心门、右足三里、左太冲、左太白的顺序进行针刺治疗,每日1次7天为一个疗程,化疗第一天开始治疗。一个疗程结束后根据已设定的症候评分表对每位受试者的相关症状进行评分记录并进行统计比较分析,得出结论。结果：1、治疗前,经分析,两组受试者在年龄、性别、化疗具体方案、KPS评分、体重上均无明显差异(P＞0.05),两组具可比性。2、治疗结束后,发现斡旋针法治疗组在呕吐积分明显小于对照组,具有统计学意义(P＜0.05),而且斡旋针法组在呕吐总天数和止呕药总量上也优于对照组(P＜0.05)。对比斡旋针法组化疗前后kps评分和体重发现其变化不大,二者差异不具有统计学意义(P＞0.05),说明斡旋针法组病人在化疗前后状态稳定。而对照组,对比观察前后KPS评分和体重后发现(P＜0.05),说明化疗前后对照组并没有稳定病人的基本情况,相较之于化疗前病人的状态明显变差。结论：斡旋针法可以明显的改善化疗患者恶心呕吐的症状,并且减少病人化疗期间呕吐药的使用,减少病人呕吐的天数。还以可以稳定病人化疗前后的基本状态,使病人平稳的度过化疗期。
[Abstract]:Objective: chemotherapy has been playing an important role in the history of human's struggle against tumor because of its good effect.But in the process of killing cancer cells, chemotherapeutic drugs can produce many side effects.Nausea, vomiting and loss of appetite are the most common clinical gastrointestinal reactions.These can lead to a decline in the quality of life of patients with malignant tumors, and fear of chemotherapy, which eventually ends in discontinuation of chemotherapy.Chemotherapeutic regimens containing platinum drugs are widely used in clinic, but the gastrointestinal reaction caused by the use of these drugs has caused a lot of inconvenience to patients' lives, which has become a major obstacle in the course of chemotherapy.At the present stage, Western medicine in response to chemotherapy induced nausea, vomiting, tropisetron and other 5-hydroxytryptamine receptor antagonists, in the prevention and treatment, obviously achieved certain results.But there is still great room for development.In order to find a more simple and effective method for the treatment of vomiting after chemotherapy, the clinical efficacy of "mediation acupuncture" in the treatment of nausea and vomiting caused by platinum drugs was observed.Methods: a total of 60 cases were collected according to the requirements and were divided into treatment group (n = 30) and control group (n = 30).Both groups were given tropisetron antiemetic therapy and routine treatment of western medicine.On this basis, the treatment group with "good offices acupuncture": right heart door, right Zusanli, Zuo Taichong, Zuo Taibai acupuncture treatment, 7 days a day as a course of treatment, the first day of chemotherapy began treatment.At the end of a course of treatment, the symptoms of each subject were recorded and compared according to the set symptom score table, and the conclusion was drawn.Results: before treatment, there was no significant difference in age, sex, KPS score and body weight between the two groups before treatment (P > 0.05), and there was no significant difference between the two groups (P > 0.05). After the treatment, there was no significant difference between the two groups (P > 0.05). After the treatment, there was no significant difference between the two groups.It was found that the score of vomiting in the treated group was significantly lower than that in the control group (P < 0.05), and the total number of days of vomiting and the total amount of antiemetic drugs in the treated group were also better than those in the control group (P < 0.05).The difference of kps score and weight before and after chemotherapy was not statistically significant (P > 0.05), which indicated that the state of the patients in the mediation acupuncture group was stable before and after chemotherapy.In the control group, KPS score and body weight were compared before and after observation (P < 0.05), which indicated that the control group had no basic condition of stable patients before and after chemotherapy, and the state of the control group was obviously worse than that of the patients before and after chemotherapy.Conclusion: mediation acupuncture can significantly improve the symptoms of nausea and vomiting in patients with chemotherapy, reduce the use of vomiting drugs during chemotherapy, and reduce the number of days of vomiting.Also can stabilize the patient before and after the basic state of chemotherapy, so that the patient smoothly through the chemotherapy period.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.5

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