目的 探究温通针刺中脘联合常规针刺对胃癌(脾胃虚寒证)化疗后恶心呕吐的预防效果.方法 选取2018年1月-2020年12月到医院就诊的脾胃虚寒证胃癌化疗患者162例为研究对象,采用随机数字表法将其分为观察组和对照组各81例.两组患者均行DCF胃癌化疗治疗,给予对照组常规胃癌化疗护理,在对照组的基础上给予观察组温通针刺中脘联合常规针刺干预.比较两组患者治疗前及治疗14d时的中医证候积分、营养状况评价[患者主观整体营养状况量表(PG-SGA)]、生活质量[癌症患者生命质量测定量表(EORTC-QLQ-30)]及治疗14d时的恶心呕吐发生率和呕吐程度;并记录两组患者治疗期间化疗毒性反应发生情况.结果 两组患者治疗14 d时的胃脘胀痛、恶心呕吐、神疲乏力、气短懒言、便溏的证候积分较治疗前均升高,且对照组显著高于观察组(均P＜0.05);治疗14 d时观察组的呕吐程度(Z=3.064,P=0.002)及呕吐发生率(P＜0.05)与对照组相较差异显著;治疗14 d时两组患者的PG-SGA评分较治疗前明显升高,且对照组显著高于观察组(P＜0.05),而观察组患者治疗14 d时的营养状态评价明显优于对照组(Z=1.993,P=0.047);两组患者治疗前的EORTC-QLQ-30功能、总体健康状况及症状评分无明显差异(均P＞0.05),治疗14 d时,观察组患者的功能及总体健康状况评分明显高于对照组(均P＜0.05),而其症状评分显著低于对照组(P＜0.05);治疗期间观察组化疗毒性反应(骨髓抑制、腹泻、免疫功能下降、脱发)的发生率明显低于对照组(P＜0.05).结论 给予胃癌(脾胃虚寒证)进展期DCF化疗患者中医温通针刺中脘联合常规针刺治疗可有效改善其化疗后恶心呕吐症状,延缓其病情发展.

Objective:To evaluate the efficacy and safety of Tiaogan Lipi granules (TGLPG) on postembolization syndrome (PES) induced by transcatheter arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC).Methods:This study was a multi-center, randomized, double-blind, placebo-controlled trial. 124 HCC patients were randomly divided into the experimental group and the placebo group at a 1:1 ratio. In the experimental group, the patients received TGLPG in addition to the standard treatment. And in the control group, the patients received the placebo. The PES was measured as the primary outcome, and traditional Chinese medicine (TCM) symptom scale and quality of life were measured as secondary outcomes. The hematological test, renal function, and electrocardiogram were used as the safety index in clinical trials.Results:There was no significant difference between the two groups at baceline. At postoperative day 7, the TCM scale in the study group was significantly improved compared to that in the control group (P < 0.05). The symptoms of PES, including nausea, fever, and pain, were found to be relieved significantly by TGLPG (P < 0.05).Conclusions:TGLPG may be an effective modality to relieve PES and improve the quality of life in patients with HCC after TACE.

目的:探讨止吐贴联合针刺治疗患者化疗相关恶心呕吐的临床疗效.方法:选取2018年1月～2020年1月确诊恶性肿瘤需行含顺铂、卡铂或奥沙利铂方案化疗的患者共80例,随机分为AB和BA两组,每组40例.AB组在研究阶段第一周期接受止吐贴联合针刺及盐酸托烷司琼治疗,间隔14～21 d后,下一个周期单用盐酸托烷司琼治疗.BA组治疗顺序与AB组相反.将AB组、BA组中采用止吐贴联合针刺治疗时在统计疗效时统称为治疗组(A组),单纯西药治疗时统称为对照组(B组).比较A组、B组患者化疗期间恶心、呕吐程度及生活质量评分.结果:A组化疗期间恶心程度明显减低,化疗第1、3、7天缓解程度均优于B组(P<0.05);A组化疗第1天呕吐程度明显低于B组(P<0.05);A组化疗第1、3天生活质量评分明显优于B组(P<0.05).结论:止吐贴联合针刺治疗可明显减轻患者化疗相关恶心呕吐程度,提高患者生活质量.