Significant Effect of Acupressure in Elevating Blood Stem Cell Factor During Chemotherapy in Patients With Gynecologic Cancer

10.1097/jnr.0000000000000257

Ya-Wen SHIH；Shun-Fa YANG；Ming-Hsien CHIEN；Ching-Wen CHANG；Vincent H. S. CHANG；Hsiu-Ting TSAI

acupressure ； hematopoietic regulation ； gynecologic cancer ； myelosuppression

The Journal of Nursing Research

26卷6期（2018 / 12 / 01）

411 - 419

英文

Background: Chemotherapy is used mainly to treat and control the progression of gynecological cancer. Bone marrow suppression, one of the adverse side effects of chemotherapy, may decrease immune function, increasing the risk of serious, fatal infections. Purpose: The aims of this study were to evaluate the effectiveness of noninvasive acupressure in preventing and diminishing chemotherapy-induced myelosuppression in patients with gynecologic cancer and to determine whether this effect is associated with the regulation of the expressions of granulocyte-macrophage colony-stimulating factor and stem cell factor (SCF). Methods: In total, 28 women with gynecological cancer were randomly assigned either to the experimental group (n = 10) or to the control group (n = 18). The experimental group received acupressure of 5-minute duration to the Hegu (LI4), Quchi (LI11), Xuehai (SP10), Sanyinjiao (SP6), Taixi (K3), Zusanli (ST36), Taichong (LR3), and Baihui (GV20) points, respectively, three times per day for 6 weeks. The control group did not receive the acupressure intervention. The blood count, including white blood cells, platelets, and hemoglobin, and serum levels for SCF and granulocyte-macrophage colony-stimulating factor were assessed before (pretest) and 6 weeks after (posttest) the participants' first course of chemotherapy. Results: At posttest, blood hemoglobin had significantly decreased from(mean T SD) 11.6 T 2.2 to 10.8 T1.6 mg/dl (p = .03) in the control group. However, no significant pretestYposttest difference in hemoglobin concentration (11.4 T 1.0 vs. 10.9 T 1.1 mg/dl) was detected in the experimental group. Levels of SCF increased significantly between pretest and posttest in both the control group (from 1196.10 T 293.17 to 1325.05 T 253.77 ng/ml; p = .01) and the acupressure group (from 1046.78 T 469.52 to 1387.06 T 310.00 ng/ml; p = .007). In addition, a borderline difference (p = .05) in mean pretest-posttest SCF increase was found between the acupressure group (340.28 T 255.46 ng/ml) and the control group (128.94 T 250.64 ng/ml). Finally, a significant time-dependent interactive effect was found between acupressure and the increased blood level of SCF at posttest (＂ = 211.34, p = .02). Conclusions/Implications for Practice: The findings support that acupressure on specific acupoints increases blood SCF levels significantly, which may help protect chemotherapy patients from experiencing reduced hemoglobin levels and may relieve chemotherapy-induced myelosuppression in patients with gynecologic cancer. This noninvasive approach is suggested for practical implementation in patients undergoing a course of chemotherapy.

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