【作者】 刘丹；

【导师】 钟少文；

【作者基本信息】 广州中医药大学 ， 中西医结合临床（专业学位）， 2014， 硕士

【摘要】 目的：本试验观察薄氏腹针对乳腺癌化疗后急性胃肠道副反应的影响。希望通过此前瞻性随机对照试验研究,证明薄氏腹针治疗化疗后急性胃肠道副反应的有效性、安全性,并推广至整个化疗期,开展“未病先防”,助其康复。对象与方法：本研究设计为前瞻性临床随机对照实验。病例均来自2013.2-2014.2在广东省中医院乳腺科病区接受化疗的乳腺癌患者。140例患者按照1：1的比例随机分为治疗组和对照组。对照组在患者出现急性胃肠道反应时给予常规处理,出现呕吐予盐酸格拉司琼注射液(宁波市天衡制药有限公司生产)3mg稀释于20mL0.9%NS后静脉注射,治疗后每日出现3次或3次以上呕吐者继续使用盐酸格拉司琼针(3mg／次)静脉注射,并记录；出现腹泻,予易蒙停(西安杨森制药)口服,起始4mg,以后每4小时2mg口服,每天总量不超过16mg；出现便秘,予四磨汤口服液(湖南汉森制药厂提供)口服,每日3次,每次20m1。治疗组在常规处理的基础上加用腹针治疗(汉医牌汉医针灸针1.5寸针),留针30分钟,每日2次,3天为1疗程。通过过不同的治疗方法,观察腹针对化疗所致的急性胃肠道副反应治疗的有效性。结果：1.恶心程度和呕吐程度统计,在治疗第1、2、3天,恶心程度的比较,对照组高于治疗组,差异有统计学意义(P<0.05)。在治疗第1、2天,治疗组呕吐程度较对照组下降,差异有统计学意义(P<0.05)。2.止吐有效率方面,经统计,治疗组止吐达到CR(完全缓解)的例数较对照组多,腹针治疗对提高止吐完全缓解率有优势。3.食欲方面,治疗第3天,食欲完全正常者所占比例明显较对照组高,经检验,治疗第3天两组间差异有统计学意义(P<0.05)4.便秘评分方面,治疗组在治疗第1、2、3天便秘症状评分较对照组低,差异有统计学意义(P<0.05)。治疗3天后,便秘达到临床痊愈的比例较对照组高,经检验,两组间差异有统计学意义(P<0.05)。5.腹泻评分方面,治疗组在治疗第2、3天腹泻症状评分较对照组低,差异有统计学意义(P<0.05)。治疗3天后,治疗组显效率、有效率与对照组相似,差异没有统计学意义(P>0.05)。结论：腹针治疗可减轻恶心程度和呕吐程度,提高止吐完全缓解率,并且可改善患者食欲。腹针治疗可减低患者便秘症状评分,并可有效提高乳腺癌化疗相关性便秘的治愈率。腹针治疗可减轻腹泻症状评分,但对止泻有效率的提高没有明显优势。更多还原

【Abstract】 ObjectiveThis experiment observes the influence of acute gastrointestinal side effects after breast cancer chemotherapy which was cured by Bo’s Abdomen Acapuncture. Hoping that we can prove the effective and safety of acute gastrointestinal side effects treated by Bo’s Abdominal Acapuncture by this prosective randomised controlled trial, so that we could extended it to the entire period of chemotherapy, carry out the "prevention of disease" and help their rehabilitation.MethodsThis study was a prospective, randomized, controlled clinical trial. Th e patients came from the Guangdong Provincal Hospital.of2013.2-2014.2br east cancer patients who was planned to take the chemotherapy. A total of140patients were randomly divided into two groups:the control group an d the treatment group. The control group was treated by normal treatment w hen they had acute gastrointestinal side effects, which would gived Granis etron hydrochloride when they have vomiting, and continue give them it if they vomiting three times a day or more;and give them imodium if they hav e diarrhea;and give them Simotang oral liquid if they have constipation. T he treatment group was treated by normal treatment and Bo’s Abdominal Aca puncture. Using the WHO toxicity grading criteria and the anticancer drug toxicity evaluation criteria to observed the effective of acute gastroint estinal side effects treated by Bo’s Abdominal Acapuncture through differ ent treatments.Results1. Statistic the degree of nausea on the three days of treatment, The treatment group were were decreased significantly compared with the cont rol group, which had statistical significance (P<0.05). The degree of vo miting, On the first and second day of treatment, the degree of treatment group were significantly lower than those before therapy2. Statistic the effective of anti-nausea, The anti-nausea in the Tre atment group to CR (complete response)is more cases than in the control group. That shows it has an advantage to improve anti-nausea complete re mission rate through Bo’s Abdomen Acapuncture therapy.3. Statistic the appetite of patients, the proportion of patients wit h completely normal appetite is significantly higher than the control gr oup after three days treatments, the results with Rank sun test showed wh ich had statistical significance (P<0.05)4. Statistic the score of constipation, the score of two groups which had greatly reduced in the first, second and the third day, and the treatm ent group decreased greatly than the control group. The results with Rank sun test showed which had a significant difference. The rate of constipa tion clinical cured was significantly higher than the control group aft er three days treatment,the results with Rank sun test showed which had statistical significance (P<0.05)5. Statistic the score of diarrhea, the score of two groups which had greatly reduced in the second and the third day, and the treatment group decreased greatly than the control group. The results with Rank sun test showed which had a significant difference. The effective of the treatment group was same to the control group after three days treatment, which ha d no statistical significance by Rank sun test (P>0.05). So there was no difference in efficacy in the treatment of diarrhea with normal treatmen t plus Abdominal Acapuncture.ConelusionAbdominal Acapuncture could reduced the degree of nausea and vomiting, and enhanced the effective of antiemetic, Abdominal Acapuncture also could improved the patients’appetite. Abdominal Acapuncture could reduced the s core of constipation, which can effectively improved the cure rate of chem otherapy-induced constipation of breast cancer. Abdominal Acapuncture coul d reduced the score of diarrhea, but which has no advantage in improving the efficiency of diarrhea.更多还原