Effect of ginger and P6 acupressure on chemotherapy-induced nausea and vomiting: a randomized controlled study

Chenbing, Xiao; Huiling, Xia; Qianqian, Xing; Dan, Wang; Guilan, Xie; Ling, Yang; Lingling, Xie; Weiwei, Qian

doi:10.1590/1980-220X-REEUSP-2023-0104en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 57 • 2023 • https://doi.org/10.1590/1980-220X-REEUSP-2023-0104en copy

Effect of ginger and P6 acupressure on chemotherapy-induced nausea and vomiting: a randomized controlled study

Efeitos das compressões de acuponto de gengibre e Neiguan sobre náuseas e vômitos induzidos por quimioterapia: um estudo randomizado e controlado

Efecto del jengibre y la acupresión de P6 en las náuseas y vómitos inducidos por la quimioterapia: estudio controlado aleatorizado

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the effect of ginger with P6 acupressure in preventing and treating chemotherapy-induced nausea and vomiting (CINV) in cancer patients.

Method:

A total of 172 participants were randomly divided into the control, ginger, acupressure, and joint groups, who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from February and September 2022. The baseline characteristics, nausea, vomiting, and retching, benefit finding, functional living index-emesis, treatment satisfaction, and adverse reaction, were used in data collection.

Results:

No significant difference was found in benefit finding and adverse reactions among the four groups (P > 0.05). Ginger significantly improved delayed CINV and function living index-nausea (P < 0.05) but had no significant effect on acute CINV, retching, and delayed vomiting, functional living index-emesis, and treatment satisfaction (P>0.05). Acute nausea and retching, delayed nausea, vomiting, and retching, functional living index-emesis, and treatment satisfaction were effectively improved in the acupressure and joint groups (P < 0.05).

Conclusion:

Ginger with P6 acupressure may contribute to improving CINV in patients undergoing chemotherapy.

DESCRIPTORS
Acupressure; Drug Therapy; Nausea; Ginger; Vomiting

Items		Control group	Ginger group	Acupressure group	Joint group	F/X² (p)	P(p)
Age ( $\bar{x}$ ± s)		59.03 ± 1.59	57.35 ± 2.09	56.43 ± 1.60	59.55 ± 1.64	0.698^a Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.555
Height ( $\bar{x}$ ± s)		163.28 ± 1.10	163.73 ± 1.28	164.25 ± 1.27	163.03 ± 1.17	0.199^a Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.897
Weight ( $\bar{x}$ ± s)		59.50 ± 1.68	63.45 ± 1.73	61.50 ± 1.66	59.70 ± 1.54	1.238^a Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.298
Body surface area ( $\bar{x}$ ± s)		1.64 ± 0.027	1.69 ± 0.027	1.67 ± 0.03	1.64 ± 0.02	0.873^a Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.457
KPS ( $\bar{x}$ ± s)		89.75 ± 0.25	90.00 ± 0.00	89.63 ± 0.25	89.75 ± 0.25	0.491^a Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.689
Chemotherapy cycle ( $\bar{x}$ ± s)		4.22 ± 0.36	5.08 ± 0.56	5.38 ± 0.73	5.45 ± 0.69	0.866^a Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.460
Sex (n, %)	Male	17 (42.5%)	20 (50%)	20 (50%)	21 (52.5%)	0.901^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.825
Sex (n, %)	Female	23 (57.5%)	20 (50%)	20 (50%)	19 (47.5%)		0.825
Religion (n, %)	Yes	6 (15%)	9 (22.5%)	7 (17.5%)	4 (10%)	2.388^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.496
Religion (n, %)	No	34 (85%)	31 (77.5%)	33 (82.5%)	36 (90%)		0.496
Smoking history (n, %)	Yes	12 (30%)	13 (32.5%)	10 (25%)	14 (35%)	1.030^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.794
Smoking history (n, %)	No	28 (70%)	27 (67.5%)	30 (75%)	26 (65%)		0.794
Drinking history (n, %)	Yes	14 (35%)	20 (50%)	15 (37.5%)	22 (55%)	4.532^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.209
Drinking history (n, %)	No	26 (65%)	20 (50%)	25 (62.5%)	18 (45%)		0.209
Motion history (n, %)	Yes	18 (45%)	12 (30%)	9 (22.5%)	12 (30%)	4.922^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.178
Motion history (n, %)	No	22 (55%)	28 (70%)	31 (77.5%)	28 (70%)		0.178
Sleep quality (n, %)	Well	12 (30%)	8 (20%)	12 (30%)	9 (22.5%)	2.391^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.880
	General	17 (42.5%)	21 (52.5%)	19 (47.5%)	22 (55%)
	Bad	11 (27.5%)	11 (27.5%)	9 (22.5%)	9 (22.5%)
Difficulty concentrating (n, %)	Yes	11 (27.5%)	11 (27.5%)	10 (25%)	9 (22.5%)	0.361^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.948
Difficulty concentrating (n, %)	No	29 (72.5%)	29 (72.5%)	30 (75%)	31 (77.5%)		0.948
Underlying diseases (n, %)	Yes	7 (17.5%)	12 (30%)	6 (15%)	9 (22.5%)	3.137^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.371
Underlying diseases (n, %)	No	33 (82.5%)	28 (70%)	34 (85%)	31 (77.5%)		0.371
Anxiety before chemotherapy (n, %)	No	39 (97.5%)	34 (85%)	36 (90%)	35 (87.5%)	3.889^c Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.274
Anxiety before chemotherapy (n, %)	Yes	1 (2.5%)	6 (15%)	4 (10%)	5 (12.5%)		0.274
Depression before chemotherapy (n, %)	No	33 (82.5%)	34 (85%)	34 (85%)	38 (95%)	3.234^c Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.357
Depression before chemotherapy (n, %)	Yes	7 (17.5%)	6 (15%)	6 (15%)	2 (5%)		0.357
Education (n, %)	Primary school	16 (40%)	15 (37.5%)	10 (25%)	13 (32.5%)	3.162^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.788
	Junior middle school	14 (35%)	17 (42.5%)	20 (50%)	16 (40%)
	High school	10 (25%)	8 (20%)	10 (25%)	11 (27.5%)
Occupation (n, %)	Peasant	19 (47.5%)	21 (52.5%)	20 (50%)	23 (57.5%)	3.539^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.739
	Serving officer	12 (30%)	13 (32.5%)	16 (40%)	11 (27.5%)
	Retiree	9 (22.5%)	6 (15%)	4 (10%)	6 (15%)
Pregnancy-vomiting history (n, %)	Yes	14 (35%)	12 (30%)	9 (22.5%)	10 (25%)	1.372^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.712
Pregnancy-vomiting history (n, %)	No	9 (22.5%)	8 (20%)	11 (27.5%)	9 (22.5%)		0.712
Pathological staging of tumor (n, %)	1/2 phase	15 (37.5%)	13 (32.5%)	17 (42.5%)	14 (35%)	4.497^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.610
	3 phase	8 (20%)	15 (37.5%)	7 (17.5%)	9 (22.5%)
	4 phase	14 (35%)	12 (30%)	15 (37.5%)	13 (32.5%)
Oxaliplatin dose (n, %)	150mg	11 (27.5%)	12 (30%)	11 (27.5%)	16 (40%)	1.978^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.577
Oxaliplatin dose (n, %)	200mg	29 (72.5%)	28 (70%)	29 (72.5%)	24 (60%)		0.577
Cancer types (n, %)	Gastric	14 (35%)	14 (35%)	10 (25%)	10 (25%)	9.037^b Annotation: a: variance analysis, b: chi-square test, c: Fisher exact method.	0.434
	Rectal	6 (15%)	14 (35%)	8 (20%)	11 (27.5%)
	Colon	13 (32.5%)	7 (17.5%)	14 (35%)	10 (25%)
	Other	7 (17.5%)	5 (12.5%)	8 (20%)	9 (22.5%)

	Acute nausea	Delayed nausea	Acute vomiting	Delayed vomiting	Acute retching	Delayed retching
Control group	3.85 ± 3.47	4.83 ± 3.01	0.89 ± 2.01	0.70 ± 1.35	1.59 ± 1.87	2.58 ± 2.08
Ginger group	2.81 ± 2.94	2.69 ± 2.09	1.01 ± 1.81	0.44 ± 0.84	1.71 ± 1.89	1.54 ± 1.43
Acupressure group	2.45 ± 2.84	1.93 ± 2.39	0.64 ± 1.64	0.16 ± 0.47	0.83 ± 1.38	0.64 ± 1.14
Joint group	1.46 ± 2.08	0.93 ± 1.47	0.41 ± 1.13	0.13 ± 0.49	0.43 ± 1.04	0.25 ± 0.61
F	4.700	20.542	1.009	3.787	6.026	21.373
P	0.004	0.000	0.390	0.012	0.001	0.000
Control/ginger	0.109	0.000	0.740	0.187	0.725	0.001
Control/acupressure	0.031	0.000	0.507	0.006	0.033	0.000
Control/joint	0.000	0.000	0.208	0.004	0.001	0.000
Ginger/acupressure	0.574	0.142	0.320	0.153	0.013	0.005
Ginger/joint	0.037	0.001	0.112	0.108	0.000	0.000
Acupressure/joint	0.127	0.056	0.550	0.895	0.261	0.220

Items (x ± SD)	Control group	Ginger group	Acupressure group	Joint group	F(p)	P(p)
Acceptance	12.43 ± 2.79	11.68 ± 2.68	11.60 ± 3.42	11.63 ± 3.51	0.647^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.586
Family relationships	8.73 ± 1.58	8.63 ± 1.53	9.07 ± 1.37	8.98 ± 1.59	0.704^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.551
World outlook	12.10 ± 2.91	11.03 ± 3.37	11.53 ± 3.57	11.93 ± 2.74	0.912^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.437
Personal growth	25.30 ± 6.65	24.10 ± 5.90	26.10 ± 5.48	24.25 ± 6.63	0.926^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.430
Social relationships	13.18 ± 2.83	12.00 ± 2.76	12.63 ± 3.20	13.00 ± 2.61	1.323^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.269
Health behaviors	12.20 ± 2.14	11.60 ± 2.52	12.38 ± 2.06	12.55 ± 2.38	1.312^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.273
Total	83.98 ± 12.24	79.03 ± 14.52	83.30 ± 12.58	82.33 ± 12.45	1.144^a Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.333
Dizziness	1 (2.5%)	3 (7.5%)	3 (7.5%)	5 (12.5%)	2.883^b Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.410
Headache	8 (20%)	5 (12.5%)	7 (17.5%)	5 (12.5%)	1.280^c Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.734
Fever	0 (0%)	1 (2.5%)	2 (5%)	2 (5%)	2.271^b Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.518
Abdominal pain	6 (15%)	4 (10%)	5 (12.5%)	4 (10%)	0.657^b Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.883
Diarrhea	3 (7.5%)	3 (7.5%)	0( 0%)	5 (12.5%)	4.979^b Annotation: a: variance analysis, b: Fisher exact method, c: chi-square test.	0.676

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[1] Corresponding author: Qian Weiwei 99 Huaihai West Road, Quanshan District 221002– Xuzhou, China 373225219@qq.com