Objective: To observe the efficacy of acupuncture on symptom burden in patients with gastric cancer during adjuvant chemotherapy after gastrectomy.
Methods: A total of 58 patients were randomized into a high-dose acupuncture group (19 cases, 5 cases dropped off), a low-dose acupuncture group (20 cases, 6 cases dropped off) and a control group (19 cases, 2 cases dropped off). Conventional chemotherapy and antiemetic treatment were adopted in the control group. On the basis of the treatment in the control group, acupuncture was applied 7 times each chemotherapy cycle for totally 21 times in the high-dose acupuncture group, and 3 times each chemotherapy cycle for totally 9 times in the low-dose acupuncture group. Baihui (GV 20), Zusanli (ST 36), Neiguan (PC 6), etc. were selected in the two acupuncture groups, as well as back-shu points selected by the meridian heat sensing technique. Electroacupuncture was connected to ipsilateral Zusanli (ST 36) and Neiguan (PC 6), with continuous wave, 2 Hz in frequency for 20 min. The Edmonton symptom assessment system (ESAS) score was observed on day 1-7, 14, and 21 of each cycle of chemotherapy respectively in the 3 groups.
Results: The symptom burden was worst within 7 days of each cycle of chemotherapy in the 3 groups. After the 3rd chemotherapy cycle, the total score of ESAS in the low-dose acupuncture group was lower than the control group (P<0.05), the total score and the scores of feeling of non-well being, pain and shortness of breath of ESAS in the acupuncture group (the high-dose acupuncture group combined with the low-dose acupuncture group) were lower than the control group (P<0.05).
Conclusion: Acupuncture shows promising effect in controlling symptom burden during adjuvant chemotherapy in gastric cancer patients after gastrectomy.
目的：观察针刺对胃癌患者术后辅助化疗期间症状负荷的影响。方法：将58例胃癌术后辅助化疗患者随机分为高频组（19例，脱落5例）、低频组（20例，脱落6例）和对照组（19例，脱落2例）。对照组予常规化疗及止呕处理。在对照组治疗基础上，高频组每个化疗周期针刺7次，共21次；低频组每个化疗周期针刺 3次，共9次，均穴取百会、足三里、内关等穴，并根据经络热度感测法选取背俞穴，同侧足三里和内关连接电针，予连续波，频率2 Hz，留针20 min。分别于每个化疗周期第1~7天、第14天和第21天观察各组患者埃德蒙顿症状评估系统（ESAS）评分。结果：3组患者均以每个化疗7 d内的症状负荷最重。第3个化疗周期后，低频组患者ESAS总分低于对照组（P<0.05），针刺组（高频组合并低频组）患者ESAS总分及健康感觉不佳、疼痛、气急症状评分均低于对照组（P<0.05）。结论：针刺可有效控制胃癌患者术后辅助化疗期间症状负荷。.
Keywords: acupuncture; adjuvant chemotherapy; frequency of treatment; gastric cancer; randomized controlled trial (RCT); symptom burden.