薑對癌症病人因化學藥物治療引起噁心與嘔吐之控制成效－系統性回顧暨統合分析

Ginger and Chemotherapy Induced Nausea and Vomiting: A Systematic Review and Meta-Analysis

張文蓓(Wen-Pei Chang) ； 陳淑芬(Shu-Fen Chen)

《腫瘤護理雜誌》 17卷1期 (2017/06) Pp. 11-20

https://doi.org/10.3966/168395442017061701002

摘要

背景：噁心與嘔吐是癌症病人接受化學藥物治療之主要副作用，嚴重之噁心或嘔吐症狀可能導致治療療程中斷或延誤，甚至影響病人後續的存活情形。動物實驗已證實薑的萃取物可治療因化學藥物引起之噁心與嘔吐，然而以人類為對象之研究結果仍是有爭議的。目的：本統合分析目的在了解薑對於化學治療改善其噁心嘔吐的不適效果。方法：採用系統性文獻回顧方法，搜尋2000至2017年發表於Cochrane Library、CINAHL（Cumulative Index to Nursing and Allied Health Literature）、PubMed、MEDLINE、ProQuest等資料庫，選取符合篩選標準之相關文獻，並使用Comprehensive Meta-Analysis 2（CMA2）統計軟體進行統合分析。共6篇符合評選標準，其中5篇有完整數值可進行統合分析。結果：針對統合分析之綜合效果量而言，薑對於控制化學藥物導致之急性噁心嘔吐與控制組相比較，森林圖顯示標準平均差（Standard mean difference）為-0.48（95% CI: -0.99~-0.03, p = 0.064）。而薑對於控制化學藥物導致之延遲性噁心嘔吐與控制組相比較，森林圖結果顯示標準平均差（Standard mean difference）則為-1.43（95% CI: -2.53~-0.33, p = 0.011）。結論：本統合分析得到的實證研究結果，代表薑治療組與控制組對於化學藥物導致急性噁心嘔吐之療效雖然無統計上的差異，而薑治療組對於延遲性噁心嘔吐之療效則較控制組為佳。驥望此結果可提供管理階層制定化學藥物導致急性噁心嘔吐預防方法之參考，也建議日後能有更多的臨床試驗研究結果支持，以便能加入相關照護指引。

關鍵字

薑 ； 化學藥物治療 ； 噁心嘔吐 ； 癌症 ； 統合分析

並列摘要

Background: Nausea and vomiting are the most common chemotherapy related side effects and the severe nausea or vomiting may cause treatment interruptions, which could influence the overall patient survival. Earlier animal studies suggest that ginger extracts may help relieve the nausea or vomiting of chemotherapy. Nevertheless, there is still controversy surrounding the effectiveness of ginger in relieving chemotherapy induced nausea and vomiting in cancer patients. Objective: The objective of this study was to determine whether ginger is effective in relieving chemotherapy induced nausea and vomiting in cancer patients. Methods: Using a systematic approach, we searched for literature published between 2000 and 2017 in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest, and Cochrane Library databases. We used Comprehensive Meta-Analysis version 2 (CMA2) to perform our meta-analysis. After the screening and review processes, we identified 6 studies that met our selection criteria. Among these studies, 5 contained complete data for meta-analysis. Results: The overall mean effect size for relieving acute nausea and vomiting was -1.85 (p = 0.064), indicating the ginger group did not show statistically significant differences in relieving acute nausea and vomiting compared with the placebo group. The overall mean effect size for relieving delayed nausea and vomiting was -2.54 (p = 0.011), and the finding showed statistically significant decrease in delayed nausea and vomiting in the ginger group. Discussion: The empirical results of this meta-analysis can serve as a reference for hospital in developing methods for the prevention of chemotherapy induced nausea and vomiting in cancer patients.

並列關鍵字

ginger ； chemotherapy ； nausea and vomiting ； cancer ； meta-analysis

參考文獻

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