title: Effect of transcutaneous electrical acupoint stimulation combined with palonosetron on chemotherapy-induced nausea and vomiting: a single-blind, randomized, controlled trial.
abstract: BACKGROUND
  Chemotherapy-induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization (TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation (TEAS) on nausea and vomiting after TACE.
  
  
  METHODS
  A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active-acupuncture (n = 72) or placebo-acupuncture (n = 70) groups using a covariate-adaptive randomization at a ratio of 1:1. The acupoints Hegu (LI4), Neiguan (P6), and Zusanli (ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory (MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.
  
  
  RESULTS
  Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant (all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active-acupuncture group than in the placebo-acupuncture group and continued to decrease over time with treatment (all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active-acupuncture group were slightly lower than those for the placebo-acupuncture group, but the differences were not statistically significant (all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event (P > 0.05).
  
  
  CONCLUSIONS
  TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy. Trial registration NCT01895010. Registered 21 June 2013.
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.
authors.forename: Lei-Hua
authors.initials: LH
authors.lastname: Chen
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.
authors.forename: Zhou-Yu
authors.initials: ZY
authors.lastname: Ning
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.
authors.forename: Chen-Yue
authors.initials: CY
authors.lastname: Zhang
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China. mengzhq@gmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China. mengzhq@gmail.com.
authors.forename: Zhi-Qiang
authors.initials: ZQ
authors.lastname: Meng
authors.affiliation: Department of Integrative Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, P. R. China. zhuxiaoyanx@126.com.|Department of Oncology, Shanghai Medical College, Fudan University, 270 Dong'An Road, Shanghai, 200032, P. R. China. zhuxiaoyanx@126.com.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Zhu
mesh_terms: D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007546:Isoquinolines / Q000008:administration & dosage*; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000628:therapy*; D000077924:Palonosetron; D011812:Quinuclidines / Q000008:administration & dosage*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced / Q000628:therapy*
chemical_list: D007546:Isoquinolines; D011812:Quinuclidines; D000077924:Palonosetron; D002945:Cisplatin
keywords: Acupuncture; Anorexia; Electro-acupuncture; Nausea; Transcutaneous electrical acupoint stimulation; Vomiting