Effect Of Acupressure On Chemotherapy-induced Nausea And Vomiting,Quality Of Life,and Anxiety In Patients With Lung Cancer

BackgroundLung cancer is one of the most common malignant tumors in our country.According to the diagnosis standard of lung cancer in China(Edition in 2015),the first-line chemotherapy for advanced non-small cell lung cancer and small cell lung cancer is still dominated by platinum,belonging to the moderately to highly emetic risk drugs.Chemotherapy-induced nausea and vomiting(CINV)is one of the most common and intolerable side effects in cancer patients.With the use of the advanced antiemetic drugs,some patients still experienced such unpleasant fleeing.Acupressure is one of the non-invasive method of acupoint stimulation,which is easy to learn and suitable for patient's self-care at home.However,the effect of acupressure on chemotherapy-induced nausea and vomiting is unclear.The purpose of this study is to evaluate the effect of acupressure on chemotherapy-induced nausea and vomiting.Objectives(1)To evaluate the effect of acupressure on chemotherapy-induced nausea and vomiting through the literature systematically review.(2)To investigate the effect of acupressure on chemotherapy-induced nausea and vomiting,quality of life and anxiety in patients with lung cancer through randomized controlled trial.Materials and Methods(1)Relevant studies were searched in 6 English databases and 4 Chinese databases,including PubMed,Cochrane Central Register of Controlled Trials(CENTRAL),Web of Science,EMBASE,Science Direct,CINAHL,China Biology Medicine(CBM),Chinese National Knowledge infrastructure(CNKI),Wan Fang and Database for Chinese Technical Periodicals(VIP)from inception to February 2016 for RCTs in accordance with inclusion criteria.Assessment of bias was conducted using Cochrane risk-of-bias tool.Quantitative analysis was performed via RevMan 5.1.(2)120 patients diagnosed as lung cancer in the respiration department of the first affiliated hospital of Nanjing Medical University from February 2016 to April 2017.These subjects were randomly divided into four groups.The intervention groups were treated with the corresponding acupoints(Zusanli,or Neiguan,or both).All the patients were given the same conventional antiemetic drugs.After the discharge,the follow-up time was one week with the use of Wechat or telephone.The main evaluation index including the outcome of FACT-L,SAS,and Index of nausea and vomiting and retching(INVR)scale were recorded.The study period was three cycles of chemotherapy.Results1.Results of the systematic review(1)The meta-analysis showed that acupressure reduced the severity of acute and delayed nausea.No improvement was found in vomiting symptoms.(2)The main acupoint used in the including studies was Neiguan.Only one study used Neiguan and Zusanli as the main acupressure points.The best single and matching acupoints remains unknown.2.Results of the random control study(1)Acupressure could improve the symptoms caused by chemotherapy.The severity of delayed nausea was decreased with the acupressure of Zusanli acupoint.Benefit effect was found on relieving the severity of acute vomiting and delayed nausea,reducing the frequency and experience time of acute and delayed vomiting.Zuanli acupoint may more effective in relieving the severity of delayed nausea compared to Neiguan.(2)Two acupoints combination didn't show a better effect on the symptom control compared to the single one.(3)A lower anxiety level was found in the intervention group.We could not get a definite conclusion whether acupressure lead to a higher quality of life from the present study.ConclusionAcupressure can be recommended as a complementary therapy for the cancer patients experiencing nausea and vomiting caused by chemotherapy.More original researches about improving the compliance of patients are needed in order to get a better effect.