| Objective: Through the mining of relevant literature on osteosarcoma chemotherapy at home and abroad,the characteristics of chemotherapy regimen for osteosarcoma were summarized,and the optimized regimen was sought to provide reference for clinical rational drug use.The umbilical cord therapy combined with acupoint application was compared with conventional antiemetic drugs,and the clinical efficacy of this method on nausea and vomiting caused by chemotherapy was analyzed,so as to alleviate the discomfort symptoms of patients during chemotherapy.Improve quality of life and compliance.Methods: Chinese and English literatures on osteosarcoma chemotherapy were searched by computer from CNKI,Wanfang Data Service Platform,VIP database,Pub Med and Embase from January 1,2005 to December 31,2021.According to the inclusion and exclusion criteria,the information of the screened chemotherapy drugs and regimens for osteosarcoma was input into Microsoft Excel software,a database was established,and the occurrence frequency of various drugs and regimens,as well as the corresponding histological necrosis rate,complications and efficacy of each regimen were classified and statistically analyzed.SPSS27.0 software was used for cluster analysis of the selected drugs.SPSSModeler18.0software was used to analyze the association rules of drugs to find the potential relationship between drugs.Osteosarcoma patients receiving DIA chemotherapy in the 960 Hospital of PLA from October 2020 to December 2022 were selected and divided into traditional Chinese medicine group(umbilical therapy + Yongquan acupoint application)and western medicine group(antiemesis drugs).Self-cross-controlled trial was conducted to collect the data of nausea,vomiting and decreased appetite during hospitalization.SPSS27.0 statistical software was used to process the collected data by the rank sum test method,and the conclusion was drawn.Results: 1.Through data analysis,a total of 26 Chinese articles and19 English articles were included,involving 9 kinds of chemotherapy drugs,which appeared 14,384 times in total.There were 12 kinds of chemotherapy regimens and 4376 times in total.The most frequently used drugs included methotrexate(MTX)3118 times,cisplatin(DDP)4181 times,doxorubicin(ADM)4068 times and IFO 576 times;High frequency schemes include MAPI(MTX+DDP+ADM+IFO)scheme 1614 times,MAP(MTX+DDP+ADM)scheme 1363 times and DIA(DDP+ADM+IFO)scheme 646 times,AP(DDP+ADM)scheme 384 times,MMAI(MTX+ADM+IFO)scheme 116 times.2.Three clustering groups were obtained by high-frequency drug cluster analysis,among which group 2(MTX,ADM,DDP)had the highest frequency.Association rule analysis of 9 chemotherapy drugs showed that 6 drug pairs were obtained,involving 3 core drug combinations,namely ADM-DDP,ADM-MTX and ADM-MTX-DDP.3.The rate of tumor histological necrosis ≥90%(390/655)was higher when MAPI was used before surgery.4.The complication rate of MAP and other chemotherapy regimens was compared,and the hemotoxicity,nausea and vomiting,cardiotoxicity were lower than those of the other four regimens,the difference was statistically significant(P<0.01).5.After the application of cisplatin,the effective rate of acute vomiting was compared between the two groups.The effective rate of the umbilical therapy combined with acupoint application group was 87.1%,that of the western medicine group was 70.1%,and that of the Chinese medicine group was higher.6.On days 2-5 after cisplatin administration,the effective rate of delayed vomiting in the Chinese medicine group was higher than that in the western medicine group,and there was a statistical difference between the two groups(P<0.05).7.The rank sum test was used to compare the nausea effect on the 1st to 5th day after cisplatin administration.From the 2nd day,the effect of the Chinese medicine group was significantly better than that of the Western medicine group treated with Western medicine alone.The results showed that there was a statistically significant difference between the two groups on days 2-5(P<0.05).Conclusion: 1.Chemotherapy for osteosarcoma is still based on methotrexate(MTX),cisplatin(DDP),doxorubicin(ADM)and IFO(IFO).Multiple chemotherapy regimens based on the above drugs have similar curative effects.Postoperative MAP protocol can reduce the incidence of complications.2.Umbilical therapy combined with Yongquan Point Chinese medicine patch can significantly reduce the number of nausea and vomiting after cisplatin application in osteosarcoma patients,improve the control rate of acute vomiting and delayed vomiting,improve the quality of life of patients,effectively complete the routine cycle of chemotherapy,and improve the survival rate. |
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