电子止吐仪干预治疗吗啡缓释片所致恶心呕吐的临床疗效被引量：2

Clinical observation of electronic antiemetic acupuncture on the prevention from nausea and vomiting induced by sustained-release morphine

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摘要目的探讨电子止吐仪干预改善吗啡缓释片所致恶心呕吐等消化系统不良反应的临床疗效。方法选取癌痛程度为中重度的恶性肿瘤患者80例,随机分成对照组和观察组,每组40例,两组患者治疗前均无明显消化系统症状。对照组单独服用吗啡缓释片,观察组服用吗啡缓释片的同时持续使用电子止吐仪,比较治疗1周内两组患者在恶心、呕吐、便秘、卡氏功能状态（KPS）评分、疲劳、焦虑及食欲等方面的差异。结果观察组和对照组第1-7天Ⅱ-Ⅳ度恶心呕吐的发生率分别为2.5%对7.5%、5.0%对20.0%、5.0%对22.5%、7.5%对25.0%、10.0%对27.5%、0.0%对7.5%及0.0%对5.0%,两组第2-5天各天恶心呕吐的发生率差异均具有统计学意义（P〈0.05）;因恶心呕吐反应明显,对照组停药2例,观察组无停药病例。观察组和对照组的便秘发生率、KPS评分改善率、疲劳改善率、焦虑改善率及食欲改善率分别为67.5%和72.5%、57.5%和22.5%、52.5%和25.0%、62.5%和35.0%及52.5%和27.5%（P〈0.05）,除便秘发生率外,两组上述各项指标发生率组间差异均有统计学意义（P〈0.05）。结论电子止吐仪可显著改善吗啡缓释片所致恶心呕吐等不良反应,提高患者的生存质量,且未见新增其他严重不良反应。 Objective To explore the effect of electronic antiemetic acupuncture on preventing from nausea and vomiting induced by sustained-release morphine. Methods A total of 80 cases patients were randomly divided into control group and observation group （40 cases for each group）. All these patients had no gastrointestinal symptoms before therapy. The control group was treated with sustained-release morphine, and the observation group was treated with sustained-release morphine in combination with electronic antiemetic acupuncture. The differences of nausea and vomiting, constipation, Karnofsky performance status （KPS） score, fatigue, anxiety and appetite between two groups were evaluated in the first week. Results The incidence of nausea and vomiting （grades 2 to 4） from the 1st day to the 7th day of the observation group and control group were 2.5% vs 7.5%, 5.0% vs 20.0 %, 5.0% vs 22.5%, 7.5% 5.0% respectively. There were statistical differences between two vs 25.0%, 10.0% vs 27.5%, 0.0% vs 7.5% and 0.0% vs groups from the 2nd day to the 5th day （P〈0.05）. There were 2 patients in control group withdrew the test because of serious nausea and vomiting adverse reaction, and there was no patient withdrew in observation group. The incidence of constipation, the improvement rate of KPS score, fatigue, anxiety and appetite between the two groups were 67.5% vs 72.5%, 57.5% vs 22.5%, 52.5% vs 25.0%, 62.5% vs 35.0% and 52.5% vs 27.5% respectively. The differences were significant except constipation incidence （P〈0.05）. Conclusion The electronic antiemetic acupuncture can alleviate the adverse reaction of sustained-release morphine such as nausea and vomiting, and improve quality of life of cancer patients. There is no serious adverse reaction.