Yekta, Z.P., Ebrahimi, S.M., Hosseini, M., Nasrabadi, A.N., Sedighi, S., Surmaghi, M.H., & Madani, H. (2012). Ginger as a miracle against chemotherapy-induced vomiting. Iranian Journal of Nursing and Midwifery Research, 17(5), 325–329.

Study Purpose

To evaluate the effect of the ginger plant on chemotherapy-induced vomiting

Intervention Characteristics/Basic Study Process

The intervention persisted for six days starting three days before the chemotherapy session. During this period, all participants took four 250 mg capsules (Zintoma) at six-hour intervals (1 g per day) complemented by the routine antiemetic regimen, including Kytril, or granisetron hydrochloride tablets, (1 mg per day) and dexamethasone ampoules (8 mg per day). A self-made, two-part, self-reporting instrument was used to measure the number of vomiting cases in both the groups. Vomiting times were recorded in the instruments each night just before sleep. 

Sample Characteristics

  • N = 80
  • AVERAGE AGE = (placebo group) 45.1 +/– 10 years; (intervention group) 41.8 +/– 8.4 years        
  • FEMALES: 100%
  • KEY DISEASE CHARACTERISTICS: Breast cancer

Setting

  • SITE: Single site  
  • SETTING TYPE: Inpatient  
  • LOCATION: Tehran, Iran

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment
  • APPLICATIONS: Palliative care

Study Design

Randomized, double-blind, placebo-controlled clinical trial

Measurement Instruments/Methods

A self-made, two-part, self-reporting instrument was used to measure the number of vomiting cases in both the groups. This instrument was a reliable standard table that has been used in various studies.

Results

Vomiting cases were meaningfully lower in the ginger group in the anticipatory (p = 0.04), acute (p = 0.04), and delayed (p = 0.003) phases, and after a total sum of six days (p = 0.002). The only stated side effect during the study was heartburn. However, there were no significant differences between the two groups at the anticipatory (p = 0.2), acute (p = 0.06), and delayed (p = 0.5) phases.

Conclusions

The results of this randomized, controlled trial showed that ginger alleviated nausea and vomiting in patients in the ginger arm compared to the placebo group. Ginger could be a promising antiemetic herbal remedy; however, its positive effects could be dose-related or specific agent-related. Therefore, we need further evidence, including multiagent chemotherapy with different types of cancers.

Limitations

  • The paper stated that participants received single-day chemotherapy. Although the prescribed antiemetics (e.g., Kytril,  Zofran, and dexamethasone) were clearly identified, this paper lacked information regarding the names of the chemotherapy agents. According to Table 1, the researchers considered chemotherapy agents to be low to moderately emetogenic, and refer the reader to check the American Society of Clinical Oncology's guidelines.
  • Small sample (< 100)
  • Key sample group differences that could influence results
  • Other limitations/explanation: This study was only done on women with breast cancer undergoing single-day courses of chemotherapy. Results were only connected with and applicable for patients with breast cancer and, consequently, cannot be generalized to other types of cancers.

Nursing Implications

The nursing implication was confined to teaching patients and their families about the ginger capsules.