中国妇幼保健

目的 观察腕踝针联合耳穴埋豆治疗中青年乳腺癌患者化疗相关恶心呕吐(CINV)的效果，研究“脑-胃”机理。方法 选取2021年6月—2024年7月温州市中心医院收治的100例中青年乳腺癌化疗患者，随机分为基础组与双联组，每组50例。基础组患者采用常规止呕干预，观察组患者采用常规止呕干预、腕踝针联合耳穴埋豆干预。比较两组患者干预后CINV程度、急性期与延迟期CINV发生情况、干预前后神经递质指标、胃功能指标及睡眠质量。结果 干预后，双联组与基础组CINV程度比较，差异有统计学意义(P<0.05)。干预后，双联组急性期恶心发生率(30.00%)、呕吐发生率(14.00%)、恶心严重程度[(3.62±0.76)分]及呕吐次数[(3.14±0.91)次]均低于基础组(均P<0.05),延迟期恶心发生率(16.00%)、呕吐发生率(8.00%)、恶心严重程度[(2.56±0.54)分]及呕吐次数[(1.32±0.37)次]均低于基础组(均P<0.05)。干预后，双联组5-羟色胺(5-HT)[(119.14±46.75)ng/ml]、多巴胺(DA)[(102.17±21.19)pg/ml]、去甲肾上腺素(NE)[(368.26±27.54)pg/ml]水平均低于基础组[(145.61±50.38)ng/ml、(115.45±22.62)pg/ml、(384.48±22.18)pg/ml],差异均有统计学意义(t=2.723、3.030、3.243,均P<0.05)。干预后，双联组胃泌素(GAS)[(129.14±11.28)μg/L]、胃动素(MTL)[(172.26±12.31)ng/L]水平均高于基础组[(121.49±10.52)μg/L、(156.23±12.15)ng/L],差异均有统计学意义(t=3.507、6.553,均P<0.05)。干预后，双联组匹兹堡睡眠质量指数评定量表评分均低于基础组(均P<0.05)。结论 腕踝针联合耳穴埋豆治疗能够抑制中青年乳腺癌患者神经递质分泌，促进胃功能恢复，改善症状与睡眠质量。

Objective To observe the effect of wrist and ankle acupuncture combined with auricular point embedding in treatment of chemotherapy-related nausea and vomiting(CINV) in young and middle-aged breast cancer patients, and study "brain-stomach" mechanism.Methods One hundred young and middle-aged breast cancer patients undergoing chemotherapy admitted to Wenzhou Central Hospital from June 2021 to July 2024 were selected and randomly divided into basic group and dual combination group, with 50 cases in each group.The patients in basic group received conventional antiemetic intervention, and the patients in dual combination group received conventional antiemetic intervention and wrist-ankle acupuncture combined with auricular point embedding intervention.The degree of CINV after intervention, the occurrence of CINV in acute and delayed phases, neurotransmitters before and after intervention, gastric function indicators, and sleep quality were compared between the two groups.Results After intervention, there was statistically significant difference in degree of CINV between dual combination group and basic group(P<0.05).After intervention, in acute phase, the incidence rate of nausea(30.00%), the incidence rate of vomiting(14.00%), the severity of nausea [(3.62±0.76) points], and the frequency of vomiting [(3.14±0.91) times] in dual combination group were lower than those in basic group(all P<0.05); in delayed phase, the incidence rate of nausea(16.00%), the incidence rate of vomiting(8.00%), the severity of nausea [(2.56±0.54) points], and the frequency of vomiting [(1.32±0.37) times] in dual combination group were lower than those in basic group(all P<0.05).After intervention, the levels of 5-hydroxytryptamine(5-HT) [(119.14±46.75)ng/ml], dopamine(DA) [(102.17±21.19)pg/ml], and norepinephrine(NE) [(368.26±27.54)pg/ml] in dual combination group were lower than those in basic group [(145.61±50.38)ng/ml,(115.45±22.62)pg/ml,(384.48±22.18)pg/ml], and the differences were statistically significant(t=2.723, 3.030, 3.243, all P<0.05).After intervention, the levels of gastrin(GAS) [(129.14±11.28)μg/L] and mottin(MTL) [(172.26±12.31)ng/L] in dual combination group were higher than those in basic group [(121.49±10.52)μg/L,(156.23±12.15)ng/L], the differences were statistically significant(t=3.507, 6.553, both P<0.05).After intervention, the scores of Pittsburgh Sleep Quality Index Scale in dual combination group were lower than those in basic group(all P<0.05). Conclusion Wrist-ankle acupuncture combined with auricular point embedding can inhibit secretion of neurotransmitters in young and middle-aged breast cancer patients, promote recovery of gastric function, and improve symptoms and sleep quality.