지압이 항암요법환자의 오심과 구토에 미치는 효과 관련 연구 분석
The Meta-Analysis of the Effect of Acupressure for Nausea and Vomiting in Cancer Patients Receiving Chemotherapy
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초록
본 연구는 지압이 항암요법을 받는 환자의 오심과 구토에 미치는 효과를 검증하기 위해 한국교육학술정보원, 국회도서관, Kiss, Korea Med, 과학기술마을(NDSL), PubMed, EBSCO, Cochrane library, OVID 등에서 검색된 2009년 12월까지의 국내외 실험연구 13편을 대상으로 실시한 메타분석연구이다. 연구 결과로는 주로 간호학 분야에서 항암요법환자의 오심과 구토 해결에 지압중재를 적용한 연구를 수행하였으며, 3편만이 무작위통제연구를 시행하였고, 나머지는 10편이 통제연구를 하였으며, 연구의 질을 나타내는 Jadad score의 경우 3점 이상인 연구가 3편에 불과했다. 사용한 지압중재 유형은 손으로 직접 지압한 경우 6편으로 가장 많았고 그 밖에 지압밴드, 스티커 침, 지압봉 등을 이용하였다. 그리고 지압 부위로는 내관 지압이 가장 많고, 내관과 함께 족삼리, 합곡, 태충 등을 지압하였다. 종속변수인 오심과 구토를 측정하는 도구로는 주관적 호소에 의한 설문지인 INVR (Rhodes Index of Nausea,Vomiting and Retching)를 주로 사용했고, 평정 척도(Likert scale), 도표평정척도(GRS) 외에 항구토제 복용횟수나 혈청 세로토닌과 같은 객관적인 측정변수를 사용하였다.
Abstract
Purpose: This study was to analyze the characteristics and effect size of intervention studies that used acupressure for the control of chemotherapy-induced nausea and vomiting (CINV). Methods: Nine electronic databases including Korea Education Research and Information, the National Assembly Library, KISS, Korea Med, NDSL, PubMed, EBSCO, Cochrane library, and OVID (to December,2009) were searched. Thirteen studies of randomized controlled trials (RCTs) or controlled clinical trials (CCTs) were selected. Data were analyzed by SPSS/WIN 18.0. Results: Overall effect size of acupressure was moderate (0.684). Nausea had a moderate effect size (0.770) and nausea and vomiting had a high effect size (0.899). Acupressure using sticker needles had a high effect size (1.368) among finger acupressure, si-acupuncture, and wrist band treatment. Conclusion: This study suggests that acupressure using sticker needles on the spots of nei-guan, chok-samni and hap-kok can reduce the levels of nausea and vomiting in cancer patients receiving chemotherapy. For improving the reliability of the meta-analysis results, further randomized controlled trials with better study methodology are needed.
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