穴位按壓對緩解接受化學治療乳癌病人急性與延遲性噁心嘔吐影響之系統性文獻回顧與臨床應用

A Systematic Review and Clinical Implications of the Effectiveness of Acupressure on Relieving Acute and Delayed Nausea and Vomiting in Patients with Breast Cancer Receiving Chemotherapy

10.6880/TJON.202212_22(2).02

施美玲(Mei-Ling Shih)；寇蕙薐(Hui-Ling Kou)；許麗玉(Li-Yu Hsu)；陳孟君(Meng-Chun Chen)

穴位按壓 ； 乳癌 ； 化學治療 ； 噁心嘔吐 ； Acupressure ； breast cancer ； chemotherapy ； nausea and vomiting

腫瘤護理雜誌

22卷2期（2022 / 12 / 01）

21 - 33

英文

噁心與嘔吐為乳癌病人於化學治療期間最常遭受此症狀之苦，研究指出穴位按壓能改善乳癌病人接受化學治療之噁心與嘔吐，然而穴位按壓部位、按壓時間及急性與延遲性效果，未有一致性，尚需進一步分析並檢視證據與臨床實質的成效。透過系統性文獻回顧及臨床應用，澄清並探討穴位按壓對改善接受化學治療乳癌病人的噁心和嘔吐的成效。搜尋7個資料庫，依符合文獻納入和排除條件後，共納入7篇文獻進行評讀。最後根據實證結果，應用於臨床實務測試，試驗結果發現，經廣義估計方程式中組別與時間交互作用效果，實驗組與對照組二組間噁心嘔吐的成效在第四天達顯著差異（p<.05），實驗組經由穴位按壓後，其噁心與嘔吐症狀，隨著時間呈現明顯改善。本文經由實證結果與臨床測試，顯示穴位按壓對於緩解接受化學治療乳癌病人之延遲性嘔吐足以產生良好成效，再者穴位按壓具實證性、非侵入性及符合經濟效益的輔助療法，運用於臨床實務，除可改善乳癌病人化學治療期間引起延遲性的嘔吐，進而促進此族群身心健康。

Nausea and vomiting are the most common symptoms experienced by patients with breast cancer undergoing chemotherapy. Previous studies showed that acupressure can improve the nausea and vomiting in patients with breast cancer during chemotherapy. However, there was no standardized operations established regarding the acupressure points, duration, acute and delayed effects. To practice and evaluate, evidence is necessary. Through systematic literature review, 7 databases were searched, and 7 studies were included for appraisal after screening through inclusion and exclusion criteria. Finally, empirical results were applied in clinical practice for testing. The result of the generalized estimation equations (GEE) showed that outcome was significantly different in both the experimental and the control groups (p < .05) for the interaction effect of group and time, and the experimental group experienced significantly less nausea and vomiting over time after acupressure. According to the empirical results and clinical tests, acupuncture as an empirical, noninvasive, and economical complementary therapy is applicable to clinical practice for timely relief of the delayed nausea and vomiting of patients with breast cancer.

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