标题：足三里穴位注射联合5-HT3受体拮抗剂在胃肠道肿瘤化疗相关恶心呕吐患者中的应用

      作者：谢燕东 1，王成 1，樊晴伶 1，张义灵 2    空军军医大学唐都医院消化内科 1、肿瘤科 2，陕西 西安 710038

      卷次： 2019年30卷24期

      【摘要】 目的 探讨足三里穴位注射联合5-羟色胺(5-HT3)受体拮抗剂在胃肠道肿瘤化疗相关恶心呕吐患者中的应用效果。方法 选择2016年5月至2018年5月在空军军医大学唐都医院消化内科治疗的80例胃肠道肿瘤患者为研究对象，按随机数表法将患者分为观察组和对照组各40例。对照组患者使用5-HT3受体拮抗剂治疗，观察组患者在对照组治疗的基础上应用足三里穴位注射治疗，实证患者选取蟾酥注射液，虚症患者选取黄芪注射液。7 d为一个疗程，两组均治疗两个疗程。比较两组患者治疗后的临床疗效、恶心程度、呕吐程度、呕吐持续时间、毒副反应总控制率和不良反应发生率。结果 治疗后，观察组患者的治疗总有效率为92.5%，明显高于对照组的 70.0%，差异有统计学意义(P<0.05)；治疗后，观察组患者恶心、呕吐程度为 0度者 62.5%、1度者 25.0%、2度者7.5%、3度者5.0%，均明显优于对照组的20.0%、5.0%、40.0%、35.0%，差异均有统计学意义(P<0.05)；治疗后，观察组患者的呕吐持续时间为(4.3±1.8) d，明显短于对照组的(12.5±3.9) d，毒副反应总控制率为75.0%，明显高于对照组的40.0%，不良反应总发生率为5.0%，明显低于对照组的25.0%，差异均有统计学意义(P<0.05)。结论 足三里穴位注射联合5-HT3受体拮抗剂治疗胃肠道肿瘤化疗相关恶心呕吐可有效改善患者恶心、呕吐情况，且不良反应少，值得临床推广应用。
      【关键词】 胃肠道肿瘤；化疗；足三里穴位注射；5-羟色胺；疗效
      【中图分类号】 R735 【文献标识码】 A 【文章编号】 1003—6350（2019）24—3166—04

Curative efficacy of Zusanli acupoint injection combined with 5-HT3 receptor antagonist in treatment ofgastrointestinal tumor.
XIE Yan-dong 1, WANG Cheng 1, FAN Qing-ling 1, ZHANG Yi-ling 2. Department ofGastroenterology 1, Department of Oncology 2, Tangdu Hospital of Air Force Military Medical University, Xi'an 710038,Shaanxi, CHINA
【Abstract】 Objective To investigate the application effect of Zusanli acupoint injection combined with 5-hy-droxytryptamine (5-HT3) receptor antagonist in patients with gastrointestinal tumor-associated nausea and vomiting.Methods A total of 80 patients with gastrointestinal tumors, who admitted to Department of Gastroenterology, TangduHospital of Air Force Military Medical University from May 2016 to May 2018, were selected and divided into the ob-servation group and control group according to random number table method, with 40 patients in each group. The con-trol group was treated with 5-HT3 receptor antagonist, and the patients in the observation group were treated with Zusan-li acupoint injection on the basis of the control group, the patients of excess syndrome were treated with bufoni injection,and the patients of deficiency syndrome were treated with astragalus injection. Taking 7 days as a course of treatment,two courses of treatment were performed on both groups. The clinical efficacy, nausea degree, vomiting degree, vomit-ing duration, total control rate of adverse reactions and incidence of adverse reactions were compared between the twogroups. Results After treatment, the total effective rate of the observation group was 92.5%, which was significantlyhigher than 70.0% of the control group (P<0.05); the degree of nausea and vomiting in the observation group showed62.5% of 0 degree, 25.0% of 1 degree, 7.5% of 2 degree, 5.0% of 3 degree, which were significantly better than corre-sponding 20.0%, 5.0%, 40.0%, 35.0% in the control group (P<0.05); the duration of vomiting in the observation groupwas (4.3±1.8) d, which was significantly shorter than (12.5±3.9) d in the control group, the total control rate of ad-verse reactions was 75.0% versus 40.0% in the control group, and the overall incidence of adverse reactions was 5.0%versus 25.0% in the control group (all P<0.05). Conclusion Zusanli acupoint injection combined with 5-HT3 recep-tor antagonist has a significant effect on patients with gastrointestinal tumor chemotherapy-related nausea and vomit-ing, which can effectively improve patients' nausea and vomiting, with few adverse reactions, and is worthy of clinicalapplication.
      【Key words】 Gastrointestinal tumors; Chemotherapy; Zusanli acupoint injection; Serotonin; Curative effect