| Background and purpose:Oxaliplatin,also known as eloxatin,is the third generation of platinum chemotherapy drugs,mainly for the treatment of gastrointestinal tumors.Oxaliplatin has no cross resistance to carboplatin and cisplatin,the degree of myelosuppression and the toxicity of gastrointestinal tract are less than that of other platinum drugs,so it is widely used in clinical practice.Peripheral neurotoxicity can lead to chemotherapy delay,drug reduction or even suspension,affecting the efficacy and survival time,which are the dose limiting toxicity of oxaliplatin.Acupuncture is an important component of Chinese traditional medicine by dredging channels and regulating Zang Fu organs to treat diseases.The neurotoxicity symptoms caused by Oxaliplatin belongs to "arthralgia" category in TCM.Yangming meridian has more Qi and blood,"Neijing" said: " treatment for flaccidity aims at Yangming meridian ".Electroacupuncture stimulates Yangming meridian points to supplement qi and blood and relieve pain through arthralgia.Modern medical research has found that acupuncture can stimulate various nerve fibers to regulate the release of various neurotransmitters,so as to achieve immediate and cumulative analgesic effect,and acupuncture treatment is cheap,safe and non-toxic.In this study,30 patients with gastrointestinal tumors with oxaliplatin chemotherapy were randomly divided into experimental and control groups.The experimental group received conventional chemotherapy plus electro electroacupuncture treatment,while the control group received conventional chemotherapy only.The peripheral neurotoxicity and gastrointestinal function were evaluated after the end of each cycle of chemotherapy.After 3 cycles ofchemotherapy,the KPS(Karnofsky)functional status of the patients was evaluated.To provide clinical exploration for the prevention and treatment of Oxaliplatin neurotoxicity by electroacupuncture stimulation,and to explore the effect of electroacupuncture stimulation on the life quality of the patients.Materials and methods:1.patients with gastrointestinal tumor for the first cycle of oxaliplatin in Dalian Medical University First Affiliated Hospital from September 2017 to February 2018 were selected as the experimental object,using the research methods of parallel control,randomized,opened,randomized.30 patients who meet the criteria were divided into the control group and the experimental group:15 cases in the control group,15 cases in the experimental group.12 cases were female,18 cases were male.At the age of 35-68 years old,the median age was 55 years.14 cases were gastric cancer,16 cases were colorectal cancer.Patients in the experimental group were treated with conventional chemotherapy combined with electroacupuncture for large intestine meridian of hand-Yangming: Hegu,Quchi,Shousanli,stomach meridian of foot-Yangming:Neiting,Zusanli,fenglong.The patients were treated with electroacupuncture within 2 hours after the chemotherapy drug infusion,30 minutes /time and three days for continuous treatment,while the control group received only routine chemotherapy.Two groups of patients were told to avoid contact with cold items,and no other nerve repair treatment intervention.2.After each cycle of chemotherapy,the incidence and degree of neurotoxicity and gastrointestinal function were evaluated.At the same time,the functional status and quality of life were evaluated after 3 cycles of chemotherapy.3.SPSS 17 software was used for statistical analysis.Using chi square test facility for comparative analysis of count data;comparison of measurement data analysis was descripted by the mean±standard deviation(±s);alpha =0.05 as the test level,there existed statistically significant differences when P < 0.05.Result1.For the analysis of the sample data,the data of the experimental group and the control group were balanced.P > 0.05 after the data of sex,age,tumor growth site,tumor stage and chemotherapy plan between the two groups were compared,,the difference was not statistically significant.2.The experimental group in each period after the end of chemotherapy neurotoxicity grading score was significantly lower than the control group(1 cycles: 0+ 0 vs 0.40 + 0.51,P < 0.05;2 cycles: 0.20 + 0.41 vs 1.13 + 0.64,P < 0.05;3 cycle:0.60 + 0.63 vs1.47 + 0.52,P < 0.05),the difference was statistically significant that electroacupuncture treatment can significantly improve the symptoms of patients with peripheral neuropathy.3.There was a significant difference in KPS functional status between the experimental group and the control group after 3 cycles of chemotherapy.(92 + 6.76 vs 81.33 + 8.34,P < 0.05),indicating that electroacupuncture stimulation Yangming Meridian can significantly improve the functional state and quality of life of patients during chemotherapy.4.The scores of vomiting and diarrhea after each cycle of chemotherapy in the experimental group and the control group were as follows:Vomiting symptom score:the difference between the experimental group and control group was statistically significant in vomiting symptom score after 2 and 3cycle of chemotherapy:(2 cycles:0.33 + 0.49 vs 1.13 + 0.52,P < 0.05;3 cycle: 0.73 +0.70 vs 1.40 + 0.51,P < 0.05);there was no significant difference in vomiting symptom score comparison after 1 cycle(1 cycle: 0.13 + 0.35 vs 0.47 + 0.52,P >0.05).Diarrhea symptom score: there was no significant difference between the experimental group and the comparison group in diarrhea symptom score in each period after the end of chemotherapy:(1 cycle: 0 + 0 vs 0.20 + 0.41,P > 0.05;2 cycle:0 + 0 vs 0.27 + 0.60,P > 0.05;3 cycle: 0 + 0 vs 0.27 + 0.60 P > 0.05).The results showed that electroacupuncture therapy had a therapeutic effect on vomiting induced by chemotherapy,but had no obvious therapeutic effect on the symptoms of diarrhea caused by chemotherapy.ConclusionElectroacupuncture stimulation of Yangming Meridian can significantly improve the symptoms of peripheral neurotoxicity induced by oxaliplatin,improving the functional state of patients during chemotherapy and the symptoms of vomiting,but it has no obvious effect on diarrhea symptoms caused by chemotherapy. |
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