Correlation Between Different Syndromes And Chemotherapy-induced Nausea And Vomiting In 285 Patients With Advanced Lung Adenocarcinoma

Objective:To observe the incidence and severity of nausea and vomiting caused by chemotherapy in patients with advanced lung adenocarcinoma treated with first chemotherapy,and to explore the correlation between nausea and vomiting caused by chemotherapy and TCM syndromes in patients with advanced lung adenocarcinoma,so as to provide a multidimensional perspective for the prevention and treatment of CINV,and provide valuable reference for more precise prevention and care of CINV in clinical TCM.Methods:In this study,a prospective study was conducted to collect 290 patients with advanced lung adenocarcinoma who were treated with TP or AP regimen for the first time from December 2018 to January 2020 in the Department of Oncology,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine.Outpatients were treated with out-of-hospital chemotherapy and met the inclusion and exclusion criteria.All patients were classified according to TCM syndromes.Antiemetic regimen was given 30 minutes before chemotherapy,and patients in the inpatient department were intervened in advance.Nausea and vomiting,including incidence,severity and concomitant symptoms,were collected by face-to-face form filling on the 1st and 2nd day after chemotherapy,by telephone on the 6th day after chemotherapy and on the1 st,2nd and 6th day after chemotherapy in outpatients at 9am.Results:1.A total of 290 patients were included in this study,5 dropped out cases,and285 patients finally completed the study.50-59 years old was the age group with high incidence of advanced lung adenocarcinoma;there was no statistical difference between AP and TP chemotherapy patients(P > 0.05);there was no statistical difference in the number of IVA and IVB stage patients(P > 0.05).2.Advanced lung adenocarcinoma is mainly divided into four syndromes,77 ofwhich are qi-deficiency,phlegm-dampness type,accounting for 27.01%;99 of which are yin-deficiency,heat-toxicity type,accounting for 34.73%;83 of which are Qi-Yin Deficiency type,accounting for 29.12%;26 of which are qi-blood stasis type,accounting for 9.12%.3.There were 169 patients with advanced lung adenocarcinoma who developed CINV,accounting for 59.2% of the total population.Among them,there were 51 patients with qi-deficiency,phlegm-dampness type,with an incidence of 66.2%;49patients with yin-deficiency,heat-toxicity type,with an incidence of 49.4%;57patients with Qi-Yin deficiency,with an incidence of 68.6%;and 12 patients with qi-blood stasis type,with an incidence of 46.1%.The incidence of CINV in different syndromes was statistically significant(P < 0.05).4.Chemotherapy-induced nausea and vomiting were classified into 1-5 grades.There were significant differences in the classification of CINV between Qi-deficiency and phlegm-dampness type,Qi-yin deficiency and Yin-deficiency,heat-toxicity type and Qi-blood stasis type(P < 0.05).There was no significant difference in the grade of CINV between Qi-deficiency and phlegm-dampness type and Qi-yin deficiency type,Yin-deficiency and heat-toxicity type and Qi-blood stasis type(P > 0.05).5.Concomitant symptoms: The main concomitant symptoms after chemotherapy were fatigue,constipation,diarrhea and headache.There was no statistical difference in the incidence of concomitant symptoms among the syndromes(P > 0.05).6.There were 94 rescued cases,and the number of rescued cases with four syndrome types was statistically different(P < 0.05)by Chi-square test.Conclusion: 1.In this study,the incidence and severity of nausea and vomiting caused by chemotherapy in patients with different syndromes of lung adenocarcinoma treated with first chemotherapy were observed,and the correlation between nausea and vomiting caused by chemotherapy in advanced lung adenocarcinoma and TCM syndromes was explored.2.In this study,285 patients with lung adenocarcinoma were counted for TCMsyndrome differentiation,nausea and vomiting.The results showed that Yin deficiency,heat and toxicity were the main syndromes of advanced lung adenocarcinoma.Qi deficiency,phlegm-dampness and Qi-Yin Deficiency were the high-incidence syndromes of nausea and vomiting after chemotherapy for advanced lung adenocarcinoma,and the degree was also more serious.The four syndromes of advanced lung adenocarcinoma have the highest incidence of fatigue after chemotherapy.3.This study provides a multi-dimensional perspective for the prevention and treatment of CINV,and provides a theoretical reference for the precise prevention and treatment and nursing of advanced lung adenocarcinoma CINV using traditional Chinese medicine.