Clinical Intervention Of "Xuanji" Acupuncture On Digestive Tract Reaction After Chemotherapy With Platinum

ObjectivesTo observe the attenuation effect of on digestive tract reaction caused by platinum-based chemotherapy and its influence on the quality of life of patients.MethodsThrough a randomized,two-stage cross-over designcontrolled trial,according to the random digital table,40 subjects were randomly divided into two group,each with 20 cases.The experiment was divided into two stagesand intervals between the two stages.The test planswere A and B;regimen A was the combination of chemotherapy plus western medicine and the combination of the"Xuanji" acupuncture;the method was from the first day of chemotherapy,"XuanJi" acupuncture treatment was performed once a day,every 30 minutes;three days for a course of treatment;regimen B was a routine treatment for chemotherapy plus western medicine,as a blank control group.The first stage,the first groupwas treated with A regimen,the second groupwas treated with B regimen;after the interval 14-21 days,the second stage was started.The design was the opposite of the previous design.That was to say,the treatment order of the first group was the first A regimen followed by the B regimen;the treatment order of the second group was the first B regimen followed by the A regimen.To recorded the degree ofgastrointestinal response during chemotherapy,the quality of life score,blood routine examination before and after treatment,and to compared the changes in the various indicators before and after each stage of treatment;according to WHO and CTCAE on the adverse reaction of chemotherapy,the international classification standards of quality of life scale,to observed the attenuated effect of "XuanJi"acupuncture on gastrointestinal side effects caused by chemotherapy with platinum and its influence on the quality of life of the patients.ResultsFirst,a total of 40 subjects completed the study.Before the treatment,therewas no statistical difference in age,sex,disease,platinum,PS score,chemotherapy frequency and some quality of life itemsbetween the two group(P>0.05).Second,the two groups had different digestive tract toxic reactions(nausea,vomiting,constipation,diarrhea,anorexia,abdominal distention and abdominal pain)after treatment with regimen A and B.The first twenty cases,after treatment of regimen A and B,the digestive tract toxicity was not significantly different(P>0.05).The second twenty cases,after treatment of regimen A and B,in second days,third days of nausea,diarrhea,loss of appetite toxic reactions and second days of vomiting toxicity,there was significant difference(P<0.05);there was no statistically significant differencein constipation,abdominal distension,abdominal pain toxicity(P>0.05).Through the analysis of generalized estimation equations,in the toxicity of nausea,vomiting,diarrhea,anorexia,the toxicity of the regimen A was lower than that of the regimen B(P<0.05).During treatment time,the first day of toxicity was lower than the third day of toxicity in nausea,vomiting,diarrhea,loss of appetite,and constipation toxicity(P<0.05);there was no statistical difference between the second day and the third day(P>0.05).In order,in the case of nausea,the toxicity ofthe first group(first A and B)was lower than that of the second group(first B and A)(P=0.006<0.05).There were no significant difference in vomiting,constipation,diarrhea,anorexia and toxic reaction in different orders and stages(P>0.05).There were no statistically significant differences in the toxicity of abdominal distension and abdominal pain between different orders,stages,regimens and treatment time(P>0.05).Third,two groups of A and B treatment showed different degrees of blood toxicity,there was no significant difference in blood toxicity between the two groups after the treatment of A and B(P>0.05).By generalized estimating equation analysis,there were no statistically significant differences in blood toxicity(white blood cell,neutrophils,platelet)(P>0.05).There were significant differences in hemoglobin toxicity between different stages and stages;the first group(AB)is less toxic than the second group(BA)(P=0.001<0.05);the first stage was less toxic than the second stage(P=0.037<0.05).Forth,in the first stage,there was no statistical difference in the quality of lifebefore and after the treatment ofregimenA of the first group(P>0.05).Before and after treatment of theregimen B of the second group,the quality of life(physical,role,emotional,cognitive,fatigue,insomnia,constipation,diarrhea)was statistically different(P<0.05).In the second stage,there was statistically significant difference in life quality(emotional,social,fatigue,insomnia,constipation)before and after the treatment ofregimen B of the first group((P<0.05).The quality of life(body,role,society,fatigue,and insomnia)was statistically significant before and after treatment of regimen A of the second group(P<0.05).The difference was statistically significantin the insomnia program after treatment of regimenA and B of the first group(P<0.05).The difference in life quality(body,role,emotion,cognition,social,fatigue,insomnia,economy)was statistically significant after treatment of regimen B and A of the second group(P<0.05).The regimen A was significantly better than the B in terms of quality of life.The quality of life in first group(AB)was better than that in second group(BA).After two stages cross variance analysis,there were significant statistical differences in the quality of life among different subjects(P=0.000<0.01).There were significant differences in scores of fatigue item at different stages(P<0.05).There were significant differences in physical,role,emotional,cognitive,social,fatigue,insomnia,and economic items between the regimen A and B(P<0.05).But there were no significant differences in scores of in shortness of breath,constipation and diarrhea items.ConclusionFirst,the "Xuanji" acupuncturecanreduce the digestive tract reaction after the chemotherapy with platinum,especially in nausea,vomiting,diarrhea,anorexia and toxic side effects.And the early combination of "Xuanji"acupuncture is more effective in reducing toxicity.Second,the"XuanJi " acupuncturecan improve the quality of life and improve the clinical symptoms to some extent.In the application of theplatinum-based chemotherapy regimen,the early combination of "Xuanji" acupuncture can achieve the effect of reducing toxicity.Third,for the time being,we have not found that the "Xuanji" acupuncture can prevent hematologic toxicity caused by platinum-based chemotherapy.