Objective: To compare the clinical efficacy of heat-sensitive moxibustion combined with tropisetron hydrochloride and tropisetron hydrochloride alone in the treatment of chemotherapy-induced nausea and vomiting (CINV).
Methods: Sixty CINV patients were randomly divided into an observation group and a control group, 30 cases in each group.The control group was treated with tropisetron hydrochloride. On the basis of the treatment in the control group, heat-sensitive acupoints were explored at Zhongwan (CV 12), Shenque (CV 8), Qihai (CV 6), Guanyuan (CV 4), Shangwan (CV 13), Xiawan (CV 10), Jianli (CV 11) and bilateral Zusanli (ST 36), Neiguan (PC 6), Tianshu (ST 25), Liangmen (ST 21) areas in the observation group，and heat-sensitive moxibustion was applied at heat-sensitive acupoints. The treatment started from the day of chemotherapy in both groups, once a day for 7 days. The occurrence and severity of nausea and vomiting after chemotherapy were recorded after each treatment on the 1st to 7th days of chemotherapy in the two groups, the complete remission rate was evaluated. The KPS score, quality of life scale score before and after treatment and incidence of myelosuppression were compared between the two groups.
Results: On the 2nd to 4th days of chemotherapy, the incidence and severity of nausea and vomiting in the observation group were lower than those in the control group (P<0.05), the complete remission rates of nausea and vomiting were higher than those in the control group (P<0.05). After treatment, the KPS score in the observation group was higher than those before treatment and in the control group (P<0.05). After treatment, the scores of emotional function and overall health status in the observation group were higher than those before treatment and in the control group (P<0.05), the scores of fatigue, pain, insomnia, loss of appetite and diarrhea were lower than those before treatment and in the control group (P<0.05). The incidence of myelosuppression in the observation group was 20.0% (6/30), which was lower than 46.7% (14/30) in the control group (P<0.05).
Conclusion: Heat-sensitive moxibustion combined with tropisetron hydrochloride can effectively reduce nausea and vomiting after chemotherapy in patients with malignant tumor, improve the quality of life, relieve the myelosuppression caused by chemotherapy drugs.
目的：比较热敏灸联合盐酸托烷司琼与单纯盐酸托烷司琼治疗化疗相关性恶心呕吐（CINV）的临床疗效。方法：将60例CINV患者随机分为观察组和对照组，每组30例。对照组予盐酸托烷司琼治疗，观察组在对照组治疗基础上于中脘、神阙、气海、关元、上脘、下脘、建里，双侧足三里、内关、天枢、梁门穴区探寻热敏腧穴行热敏灸治疗，两组治疗均从化疗当天开始，每天1次，治疗7 d。记录化疗第1~7天每次治疗结束后两组患者恶心呕吐的发生情况及严重程度，并统计完全缓解率。比较两组患者治疗前后Karnofsky功能状态（KPS）评分、生命质量测定量表评分及骨髓抑制发生率。结果：化疗第2~4天，观察组患者恶心呕吐发生情况及严重程度低于对照组（P<0.05），恶心呕吐完全缓解率高于对照组（P<0.05）。治疗后，观察组KPS评分高于治疗前（P<0.05），且高于对照组（P<0.05）。治疗后，观察组患者情绪功能、总体健康状况评分高于治疗前（P<0.05）及对照组（P<0.05），疲乏、疼痛、失眠、食欲不振、腹泻评分低于治疗前（P<0.05）及对照组（P<0.05）。观察组患者骨髓抑制发生率为20.0%（6/30），低于对照组的46.7%（14/30，P<0.05）。结论：热敏灸联合盐酸托烷司琼能有效减轻恶性肿瘤患者化疗后出现的恶心呕吐等症状，提高CINV患者生命质量，对化疗药物所导致的骨髓抑制有一定的缓解作用。.
Keywords: chemotherapy-induced nausea and vomiting; heat-sensitive moxibustion; quality of life; randomized controlled trial (RCT); tropisetron hydrochloride.