Clinical Observation Of Auricular Vagus Nerve Stimulation In The Prevention And Treatment Of Cancer Chemotherapy-induced Nausea And Vomiting

Objective:Explore the clinical efficacy of the auricular vagus nerve stimulation therapy in the prevention and treatment of cancer chemotherapy-induced nausea and vomiting, providing a new method with simple、effective、safe、non-toxic side effects. And it provides the clinical practice foundation to enrich the ear medical and deepen vagus nerve reflex theory furtherly.Methods:Screening qualified patients (KPS score60or higher) in accordance with the random envelope method were randomly divided into auricular needle group and the control group.The control group:only in the first day,30min prior to the use of chemotherapy drugs slow intravenous infusion of the antiemetic Palonosetron hydrochloride and sodium chloride injection5ml (0.25mg) was dissolved in0.9%sodium chloride injection100ml; Auricular acupuncture group:on the basis of the control group treatment, at the same time use electro-acupuncture stimulate Auricular vagus nerve points(ear points,"esophagus","small intestine","stomach") therapy, with Hua Tuo brand disposable1-inch stainless steel acupuncture needles (Note:size0.25*25mm) piercing auricular, depth to keep in the contralateral skin into the ear cartilage without pierced, and then Connecting the HAN electric acupuncture device (Note:Electric pulse type with alternate wave,2seconds a pulse and3seconds no pulse, frequency is25HZ, the current intensity is0.2-0.5mA, in the patients’tolerance, each electric needle time of30minutes, Once a day, three days in a row. In the first day after treatment, the second day, the third day, the two groups of patients in clinical symptoms integral、vomiting control situation were respectively assessed. At the end observe the number of additionl anti-nausea drugs cases, and the blood5-HT density changes were assessed before and after the observation of the two groups of patients. The obtained data use SPSS17.0statistical software processing.Results:(1) comparison of two groups in clinical symptom score:the value of two clinical symptom scores showed an upward trend, but the experiment group integral value lower than the control group in3days(P<0.01).(2) comparison of two groups in vomiting control:Through statistical analysis of the cases by Vomiting control classification, the last2days, the full control cases of auricular acupuncture group were significantly higher (P<0.05or P<0.01); The first day, total efficiency of the vomiting control was no significant difference (P>0.05). The second day’s total efficiency, auricular acupuncture group and the control group were88.89%and64.00%; The third day were81.48%and40.00%, Auricular acupuncture group’s total efficiency was higher (P<0.01).(3) comparison of additional anti-nausea drugs:the experiment group,2cases underwent additional treatment(accounting for7.4%of the total number of cases);6cases in the control group,(24.0%), The difference was not statistically significant (P>0.05).(4) comparison of two group’s serum5-HT levels:The experiment group’s5-HT level was showed a downward trend, while the control group is on the rise. Respective comparison of the two groups’5-HT concentrations before and after observation were statistically significant (p<0.01). The difference of5-HT concentration between two groups after treatment was statistically significant (P<0.05).Conclusion:Electrical stimulation on the ear acupoints related vagus nerve," esophagus".,"small intestine"、"stomach",combined with palonosetron treatment, can effectively improve the clinical symptoms of patients after chemotherapy, improve the total efficiency of the vomiting caused by chemotherapy, and it’s efficacy is superior to the single simple drug treatment.