Clinical Observation On Treatment Of CINV Spleen Deficiency And Dampness Syndrome With Platinum - Containing Moxibustion Combined With Ondansetron

Objective:To observe the influence and evaluate the efficacy and safety of herbs-partition moxibustion on chemotherapy-induced nausea and vomiting (CINV) and chemotherapy-related TCM symptoms of spleen-deficiency and damp-encumbrance syndrome by using herbs-partition moxibustion on CV12 (Zhongwan) and ST36 (Zusanli) on patients accepting platinum-based chemotherapy.Method:64 patients hospitalized for platinum-based chemotherapy in Oncology Department of Guang’anmen Hospital since June 2015 to March 2016 were recruited. All the patients matched the diagnostic criteria and inclusion criteria. Random allocation was taken in the order of visiting to averagely divide 64 patients into two groups:treatment group and control group. Patients in control group received ondansetron for treating CINV while the other half patients received both ondansetron and herbs-partition moxibustion. Nausea and vomiting were observed and recorded on day 1-5, day 7 and chemotherapy-related TCM symptoms of spleen-deficiency and damp-encumbrance syndrome were on day 1, day 3 and day 7 since chemotherapy started. Besides, changes of KPS scale and laboratory indexes including blood routine examination, aminotransferase, creatinine (Cr) and blood urea nitrogen (BUN) were detected before and after receiving treatment.Results:1.The distributions of gender, age, cancer types, body surface area, types of platinum-drugs used and KPS scale before receiving treatment showed no statistical significance between two groups, which means that treatment group and control group were comparable on the baseline.2. The complete response rate and the efficient rate on acute vomiting in treatment group was 66.7% and 93.3% separately, which was higher than 53.1% and 87.5% in control group, but the severity and control of acute vomiting between two groups showed no significant difference (P>0.05). The differences of severity of vomiting between two groups on day 2 and day 3 were statistically significant (P<0.05). The complete response rate and the efficient rate in treatment group against vomiting on day 2 and day 3 was higher than control group, but the difference was not statistically significant (P>0.05).3. The severity of nausea on day 1-4 in two groups showed a statistically significant difference while on day 5 and day 7 was not. The difference of efficient rate against nausea between two groups during the whole observation period was not statistically significant. The mean of nausea duration in treatment group was 1.9 days, which was obviously shorter than 3.16 days in control group, the difference between two groups showed statistical significance (P<0.05).4. The scores of TCM symptoms between two groups on day 1 showed no statistically significant difference while on day 3 and day 7 the difference was significant. Comparison of symptom scores between day 1 and day 3 showed that the symptom scores on day 3 (χ=6.40) was generally lower than scores on day 1 (χ=8.87) in treatment group while the situation in control group was reversed, the scores in control group on day 1 was χ=8.67, and χ=13.38 was on day 3. The scores changes on day 1 and day 3 between two groups had statistically significant difference. Comparison of scores between day 3 and day 7 showed that the scores on day 7 in both treatment group and control group was lower than scores on day 3, the difference was statistically significant. Comparison between day 1 and day 7 showed that the efficient rate on TCM symptoms of treatment group was 86.67%, the CR rate was 33.33%; and the ones in control group were 68.75% and 9.38% separately. The improvement of symptom scores in two groups had statistically significant difference (P<0.05).5. The safety indexes observed including blood routine examination, aminotransferase, Cr and BUN were found no statistically significant difference between treatment group and control group (P>0.05).Conclusion:Herbs-partition moxibustion combined with ondansetron could reduce the severity of delayed vomiting and chemotherapy-induced nausea and shorten the average duration of nausea. Besides, it could decrease the TCM symptom scores of spleen-deficiency and damp-encumbrance syndrome to alleviate chemotherapy-related discomfortable symptoms. Herbs-partition moxibustion combined with ondansetron is safe and effective.