Electroacupuncture at Zu San Li (St 36) for the Toxic Reactions to Chemotherapy
Bob Flaws, Lic. Ac., FNAAOM (USA), FRCHM (UK)
Keywords: Chinese medicine, acupuncture, electroacupuncture, oncology, cancer, chemotherapy, St 36
In issue #3, 2004 of Xin Zhong Yi (New Chinese Medicine), Chen Chuang et al. of Nanning in Guangxi published an article titled, “A Clinical Survey of the Treatment of Toxic Reactions to Chemotherapy with Electroacupuncture at Zu San Li (St 36).” This article appeared on pages 46-47 of that journal, and a summary is presented below.
All the patients in this study had confirmed diagnoses of cancer, had been referred for chemotherapy, and had a life expectancy of more than three months. The total of 56 patients enrolled in this study were randomly divided into two groups of 28 each, a treatment group and a comparison group. In the treatment group. there were 18 males and 10 females with an average age of 46.2 years. Eleven of these cases had nasopharyngeal cancer and 17 had non-small cell lung cancer. In the comparison group, there were 20 males and eight females with an average age of 49 years. In this group, there were 13 cases of nasopharyngeal cancer and 15 cases of non-small cell lung cancer. Therefore, these two groups were considered statistically comparable (P , 0.05).
All the patients with nasopharyngeal cancer received 60mg/m2d1 of cisplatin (DDP), 500mg/ m2d1-d5 of 5-flououracil (5-Fu), and 600mg/ m2d1-d2 of cytoxan (CTX) for one week each 21 days. All the patients with non-small cell lung cancer received 60mg/m2d1 of DDP and 90-100mg/m2d1-d3 of etoposide (VP-16) for one week each 21 days. The electroacupuncture group (i.e., the treatment group) additionally received electroacupuncture bilaterally at Zu San Li (St 36). Electric stimulation was accomplished using the G6805 electroacupuncture machine manufactured in Shanghai. A 26 gauge fine needle was inserted three inches deep perpendicularly. After obtaining the qi, a high frequency, continuous wave pulse (3 beats per second) was used at as strong a degree of stimulation as the patient could bear. Each treatment lasted 20 minutes and was done once per day. These treatments were initiated three days before starting the chemotherapy and were continued until seven days after the end of each course of chemo. Outcomes were analyzed after two courses of treatment.
Fifteen days after chemo, blood was analyzed for T cell counts. Digestive reactions to chemo included nausea, vomiting, diarrhea, and abdominal distention. Criteria for assessing toxic reactions to chemo were based on WHO guidelines. Based on these criteria, mean WBC counts in the electroacupuncture group before chemo were 6.4 ” 1.83 x 109/L and were 6.0 ” 2.47 x 109/L after chemo. Mean WBC counts in the comparison group were 7.0 ” 1.68 x 109/L before chemo and 4.1 ” 2.18 x 109/L after chemo. Therefore, electroacupuncture appears to have made a significant difference in preventing suppression of WBC production. While percentages of CD3 and CD4 cells did not change significantly in either of the two groups, the percentage of CD8 cells increased significantly in the comparison group while it did not in the treatment group. Therefore, there was a significant drop in CD4/CD8 ratio in the comparison group but no significant drop in that ratio in the treatment group. Similarly, there was a significant drop in mean NK cells in the comparison group but no significant drop in NK cells in the treatment group. In the treatment group, 15 patients (53.6%) experienced nausea and vomiting, six patients (21.4%) experienced diarrhea, and nine patients (32.1%) experienced abdominal distention. In the comparison group, 21 patients (75%) experienced nausea and vomiting, 15 (53.6%) experienced diarrhea, and 18 (64.3%) experienced abdominal distention. Therefore, there were significant differences in the occurrence of nausea and vomiting, diarrhea, and abdominal distention in these two groups, with the treatment group experiencing less. In addition, there was a significant lesser degree of difference in severity of both nausea and vomiting and diarrhea in the treatment group. The severity of diarrhea in those who experienced it was not significantly different between the two groups.
Electroacupuncture at Zu San Li (St 36) in coordination with chemotherapy can prevent bone marrow suppression, maintain healthy CD4/CD8 ratios, and maintain healthy NK cell levels and decrease both the incidence and severity of gastrointestinal toxic reactions. Therefore, this protocol was deemed to have gotten a relatively good clinical effect.
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