Zhang, X., Jin, H.F., Fan, Y.H., Lu, B., Meng, L.N., & Chen, J.D. (2014). Effects and mechanisms of transcutaneous electroacupuncture on chemotherapy-induced nausea and vomiting. Evidence-Based Complementary and Alternative Medicine, 2014, 860631. 

DOI Link

Study Purpose

To evaluate transcutaneous electroacupuncture (TEA) on chemotherapy-induced nausea and vomiting (CINV) as well as serotonin and dopamine levels among patients with cancer

Intervention Characteristics/Basic Study Process

The intervention consisted of transcutaneous electroacupuncture at acupoints PC6 and PC5. The control consisted of sham electroacupuncture with the same electrical stimulation but at two sham points. Treatment lasted one hour and occurred twice daily for three days. Both groups received 3 mg of granisetron during the three days of the intervention and rescue medication at the patient’s request. Data were recorded for three days following the administration of chemotherapy. Blood samples were collected at 6 am on days 1 and 3 after overnight fasting.

Sample Characteristics

  • N = 72
  • AGE = Not stated
  • MALES: 60% (43), FEMALES: 40% (29)
  • KEY DISEASE CHARACTERISTICS: Not stated
  • OTHER KEY SAMPLE CHARACTERISTICS: All were naïve to chemotherapy or received only moderate to highly emetogenic chemotherapy; scheduled to receive moderate or highly emetogenic chemotherapy (cisplatin > 50 mg/m2, cyclophosphamide > 1,500 mg/m2, or carmustine > 250 mg/m2)

Setting

  • SITE: Single site
  • SETTING TYPE: Inpatient
  • LOCATION: Zhejiang Provincial Hospital of Traditional Chinese Medicine

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, controlled trial

Measurement Instruments/Methods

  • Nausea and vomiting: Patients recorded the date and time of emesis or retching, the degree of nausea (none, mild, moderate, or severe), and the use of rescue medications (name, dose, and time) in a diary.
  • Serotonin and dopamine
  • Safety measures: Vital signs, 12-lead electrocardiogram (EKG), blood tests (white blood cell count, aspartate transaminase, alanine transaminase, and creatinine clearance), and urinalysis

Results

Vomiting was significantly improved in the treatment group compared to the control group at 48 hours only (p = 0.046). No difference was noted at 24 hours (p = 0.9) or 72 hours (p = 0.68). Nausea was significantly better for the treatment group than the control group at 48 hours (p = 0.001) and 72 hours (p = 0.025) but not at 24 hours. Serotonin and dopamine were not different at baseline but were significantly reduced in the treatment group when compared to the control group at 48 hours (p = 0.03) and 72 hours (p = 0.02). No safety issues were noted in any patients. Laboratory results and EKG tests were normal.

Conclusions

Transcutaneous electroacupuncture was effective at improving delayed nausea and vomiting and had no significant safety issues.

Limitations

  • Small sample (< 100)
  • Other limitations/explanation: Sample characteristics were not adequately reported, and no differences between the groups were noted. The authors did not report if any subjects withdrew from the study.

Nursing Implications

The needleless system of transcutaneous electroacupuncture made administration easy and compliance rates high.