Effect of Ginger Tea on Chemotherapy-Induced Nausea and Vomiting among Patients Attending the Oncology Teaching Hospital, Baghdad 2020

Abstract

Background: Ginger has been widely used to relieve nausea and vomiting in several settings, one ofthem, patients receiving chemotherapy. This study was done to assess the effect of ginger in controlling thechemotherapy induced nausea and vomiting (CINV) among patients. Methods: An interventional (pre-post)study design was conducted in oncology teaching hospital in Baghdad for three months. Sixty participantswere randomly assigned into intervention group (30 participants received ginger tea (1.5 g/d) with routineantiemetic regimen for the first 5 days of the chemotherapy cycle) and control group (30 participants receivedonly routine antiemetic regimen). MASCC Antiemesis Tool (MAT) was used for assessment of CINV incancer patients before and after the use of ginger tea.Results: No significant difference was observed between the intervention and control groups in the acuteand delayed phases of CINV after intervention with ginger tea(p >0.05), but difference between the studygroups was found statistically significant (p <0.05)regarding the severity of nausea postchemotherapy.Conclusions: The addition of ginger tea to routine antiemetic regimen in patients receiving chemotherapyeffectively reduced the severity of nausea. However, there is no additional role for ginger in reducing theacute and delayed phases of CINV.

Full text

Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 1463
Effect of Ginger Tea on Chemotherapy-Induced Nausea and
Vomiting among Patients Attending the Oncology Teaching
Hospital, Baghdad 2020
Remal Adel Kadhim1, Besmah Mohammed Ali2, Maysaa Adel Kadhim3, Samer Jassim Mohammed4
1 Family Medicine Specialist, Clinical Nutrition Fellowship/ Arab Board, Ministry of Health/Environment, Iraq,
2Consultant Community Medicine, Head of Scientic Council of Nutrition Fellowship/Arab Board, Ghazy
Al- Hariri Hospital For Surgical Specialties/Medical City Directorate, Baghdad, 3Family Medicine Specialist,
Baghdad Al-Rusafa Health Directorate, 4Community Medicine Specialist, Al- Baladiat Health Sector/Baghdad Al-
Rusafa Health Directorate
Abstract
Background: Ginger has been widely used to relieve nausea and vomiting in several settings, one of
them, patients receiving chemotherapy. This study was done to assess the effect of ginger in controlling the
chemotherapy induced nausea and vomiting (CINV) among patients. Methods: An interventional (pre-post)
study design was conducted in oncology teaching hospital in Baghdad for three months. Sixty participants
were randomly assigned into intervention group (30 participants received ginger tea (1.5 g/d) with routine
antiemetic regimen for the rst 5 days of the chemotherapy cycle) and control group (30 participants received
only routine antiemetic regimen). MASCC Antiemesis Tool (MAT) was used for assessment of CINV in
cancer patients before and after the use of ginger tea.
Results: No signicant difference was observed between the intervention and control groups in the acute
and delayed phases of CINV after intervention with ginger tea(p >0.05), but difference between the study
groups was found statistically signicant (p <0.05)regarding the severity of nausea postchemotherapy.
Conclusions: The addition of ginger tea to routine antiemetic regimen in patients receiving chemotherapy
effectively reduced the severity of nausea. However, there is no additional role for ginger in reducing the
acute and delayed phases of CINV.
Key words: Chemotherapy -nausea -vomiting -ginger-cancer.
Corresponding author:
Remal Adel Kadhim
E-mail: dr_remal_81@yahoo.com
Introduction
Nausea and vomiting are the most frequent health
concern with cancer patients receiving chemotherapy(1,2).
The primary mechanism of chemotherapy induced
nausea and vomiting (CINV) is related to the
production of free radicals within the gastrointestinal
tract postchemotherapy. This leads to release of
neurotransmitters from enterochromafn cells, which
stimulates emesis(3).
Three types of CINV: acute (during rst 24
hours postchemotherapy); delayed (after 24 hours
postchemotherapy and may last for up to 6 or 7 days)
and anticipatory (affects people who have experienced
severe nausea and vomiting in their previous use of
chemotherapeutic agents). The prevalence of untreated
CINV is about 70-80%(4), some chemotherapeutic
agents including (cyclophosphamide and cisplatin)
can increase the incidence of CINV up to 90%(5).The
prevention of CINV is a priority in the oncology setting,
despite that development of anti-emetic medications
and the reduction of the prevalence of CINV, vomiting
and nausea are still reported by up to 25% and 61%,
respectively(6,7).

1464 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3
Ginger (Zingiber ofcinale Roscoe) is a perennial
herb belonging to the family Zingiberaceae , primarily
grown in Asia and tropical regions and it is one of
the most widely consumed herbs globally(5). Ginger
contains: zingerone, shogaols, gingerols and volatile
oil. Gingerol is mainly help in facilitate the movement
of digested food contents and toxins through the
gastrointestinal system and reducing incidence of nausea
and vomiting(2,8).
Ginger is used in different forms such as fresh, dried,
pickled, preserved, candied and powdered. Presentations
can include capsules, tablets, tea, and liquid extracts(5,9),
it is considered a safe herb for human consumption(5).
Clinical trials were encouraged to scientically assess
the effectiveness of ginger as a complementary and
alternative medicine(5,10).
Aims of the Study
1- To study the effect of ginger tea on the two
phases of vomiting and nausea between intervention and
control groups
2- To assess the severity of acute and delayed nausea
between both study groups after intervention with ginger
tea.
Materials and Methods
This is an interventional (pre-post) study design was
conducted in Oncology Teaching Hospital in Baghdad
from the rst of April to end of June 2020. The sample
was chosen from those patients with cancer who attended
the chemotherapy day unit.
Sixty participants were qualied to enter the trial,
they were randomly assigned into two groups: 30
in intervention group used ginger tea (1.5 g/d) plus
routine antiemetic regimen for the rst 5 days of the
chemotherapy cycle and 30 in control group used routine
antiemetic regimen alone. Randomization was done by
random sampling technique depending on the days of
the week; groups were created on alternative days.
The exclusion criteria were applied equally to both
study groups, include(age less than 18 years, history
of hematological malignancies, ginger in the diet or
history of allergy to ginger, history of chronic disease
on medications, concurrent illnesses that induced nausea
independent of chemotherapy, history of bleeding
disorders and clinically signicant thrombocytopenia
and nally patients who were lost to follow up). The
consent was taken from participants prior to direct
interview.
The main items covered in the questionnaire form
were age, sex, duration of cancer (calculated since the
date of rst diagnosis), type of cancer (including in
the screening), stage of the cancer classied according
to TNM staging system (tumour, node, metastases),
management of cancer, cycle’s number of chemotherapy
course.
For assessment of CINV in cancer patients, we
were used MASCC Antiemesis Tool (MAT) which
is developed by the Multinational Association of
Supportive Care in Cancer (MASCC), it was designed
to be a short self-administered tool for measuring both
acute and delayed nausea and vomiting(11).
In order to measure the phases of CINV before and
after intervention with ginger tea, participants were
asked to ll MAT for 5 days postchemotherapy. Patients
were advised to eat easily digestible foods and avoid
emetogenic ones.
Results
Data were analyzed by descriptive and inferential
statistics using SPSS version 25, P value ≤ 0.05 was
considered signicant.
The nding of this study showed that 46.7%
of participants in intervention group and 33.3% in
control group were in the age group(51-60) years .
Most of the participants were females. The rest of
baseline demographic and clinical characteristics were
summarized in[Table 1].

Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 1465
Table1: Baseline demographic and clinical characteristics
Characteristics Intervention group
N= 30 (%)
Control group
N= 30 (%)
Age (years)
21-30
31-40
41-50
51-60
> 60
2 (6.7)
0
8 (26.7)
14 (46.7)
6 (20.0)
4 (13.3)
5 (16.7)
7 (23.3)
10 (33.3)
4 (13.3)
Gender
Male
Female
7 (23.3)
23 (76.7)
9 (30.0)
21 (70.0)
Duration of cancer history(years)
<1
1
2
3
4
≥ 5
20 (66.7)
3 (10.0)
3 (10.0)
1 (3.3)
2 (6.7)
1 (3.3)
16 (53.3)
3 (10.0)
4 (13.3)
2 (6.7)
2 (6.7)
3 (10.0)
Type of cancer
Breast
Colorectal
Gynecological
Lung
Others
15 (50.0)
6 (20.0)
1 (3.3)
1 (3.3)
7 (23.3)
14 (46.7)
4 (13.3)
4 (13.3)
3 (10.0)
5 (16.7)
Stage of cancer*
Early
Intermediate
Advanced
5 (16.7)
14 (46.7)
11(36.7)
9 (30.0)
10 (33.3)
11 (36.7)
Management of cancer
Chemotherapy
Mixed therapy**
4 (13.3)
26 (86.7)
8 (26.7)
22 (73.3)
Chemotherapy cycle
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
0
6 (20.0)
7 (23.3)
6 (20.0)
1 (3.3)
3 (10.0)
5 (16.7)
2 (6.7)
0
7 (23.3)
6 (20.0)
3 (10.0)
4 (13.3)
1 (3.3)
3 (10.0)
6 (20.0)
* Early stage (localized primary tumour), intermediate stage (regional lymph nodes involvement), advanced

1466 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3
stage (presence of metastases)
**Mixed therapy (chemotherapy, surgery,
radiotherapy)
The data in[Table 2] shows that 50% of intervention
group and 43.3% of control group had acute vomiting
pretest while posttest it was 40% and 43.3%.
In the other hand, 43.3% of intervention group and
36.7% of control group had delayed vomiting pretest
but after posttest, it was 26.7% and 30%. Despite that
there was no signicant statistical association tested
by McNemar test between the pre-posttest level of
chemotherapy-induced acute and delayed vomiting
among both groups[Table 2].
Ninety percent of intervention group and 76.7%
of control group had acute nausea pretest and this
was decreased posttest by 33.3% and 3.4%. The high
percentage of intervention group (76.6%) and (73.3%)
of control group reported delayed nausea pretest while
posttest, it decreased only in intervention group. The
differences before and after ginger tea use in acute and
delayed nausea in intervention group was provided by
McNemar test and it was statistically signicant while in
control group it was not[Table 2].
Overall, after intervention, no signicant
difference was detected by ANOVA test between
the study groups in acute and delayed phases of
vomiting(p=0.798,p=0.779) and in acute and delayed
phases of nausea(p=0.182,p=0.112).
Table2: Differences in nausea and vomiting before and after Ginger tea use among the intervention and
control groups
Phases of vomiting and nausea
before and after Ginger tea use
Intervention
group
Control
group P- Value
N (%) N (%) Intervention Control
Acute
vomiting
pretest yes 15 (50.0) 13 (43.3)
0.250 1.000
no 15 (50.0) 17 (56.7)
posttest
yes 12 (40.0) 13 (43.3)
no 18 (60.0) 17 (56.7)
Acute nausea
pretest yes 27 (90.0) 23 (76.7)
0.002 1.000
no 3 (10.0) 7 (23.3)
posttest
yes 17 (56.7) 22 (73.3)
no 13 (43.3) 8 (26.7)
Delayed
vomiting
pretest yes 13 (43.3) 11(36.7)
0.063 0.625
no 17 (56.7) 19 (63.3)
posttest
yes 8 (26.7) 9 (30.0)
no 22 (73.3) 21 (70.0)
Delayed
nausea
pretest yes 23 (76.7) 22 (73.3)
0.016 1.000
no 7 (23.3) 8 (26.7)
posttest yes 16 (53.3) 22 (73.3)
no 14 (46.7) 8 (26.7)

Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 1467
Concerning the severity of acute nausea, it was
found that in pretest the high percentage of intervention
group had moderate degree and in control group the
percentage was equally distributed between mild and
moderate nausea. After intervention, reporting of no
nausea was increased by 33% and no one reported
severe degree while in control group there was increase
in number of the participants reported severe nausea.
The difference in the severity of acute nausea before and
after ginger tea use in intervention group was statistically
signicant(p=0.0001)[Table 3].
Regarding the severity of delayed nausea in
intervention group, 36.7% had mild degree and it’s the
same in control group. After asking the participants in
intervention group about the relief that was provided
by ginger tea ,they reported no nausea and mild nausea
in equal percentages while nearly no change in control
group. The difference pre-posttest in intervention group
was statistically signicant[Table 3].
Focusing on the differences between both study
groups regarding the severity of nausea posttest, it
was found statistically signicant by using ANOVA
test[Table 4].
Table3: Differences in the severity of nausea before and after Ginger tea administration among intervention
and Control groups
Severity of nausea before and
after ginger tea use
Intervention
group
N (%)
Wilcoxon
Signed
Ranks Test
(Z)
Asymp. Sig.
(2-tailed)
Control
group
N (%)
Wilcoxon
Signed
Ranks Test
(Z)
Asymp.
Sig.
(2-tailed)
Acute
nausea
Pre
test
no 3 (10.0)
- 4.772 0.0001
7 (23.3)
0.0001 1.000
mild 10 (33.3) 11 (36.7)
moderate 13 (43.3) 11 (36.7)
severe 4 (13.3) 1 (3.3)
Post
test
no 13 (43.3) 8 (26.7)
mild 15 (50.0) 10 (33.3)
moderate 2 (6.7) 10 (33.3)
severe 0 2 (6.7)
Delayed
nausea
Pre
test
no 7 (23.3)
- 4.359 0.0001
8 (26.7)
- 0.378 0.705
mild 11 (36.7) 11(36.7)
moderate 10 (33.3) 11(36.7)
severe 2 (6.7) 0
Post
test
no 14 (46.7) 8 (26.7)
mild 14 (46.7) 12 (40.0)
moderate 2 (6.7) 10 (33.3)
severe 0 0

1468 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3
Table 4: The effect of Ginger tea on the severity of nausea posttest between the intervention and control
groups
Phases (Posttest) Severity F Sig.
Acute nausea
No
7.811 0.007
Mild
Moderate
Severe
Delayed nausea
No
6.518 0.013
Mild
Moderate
Severe
Discussion
Nausea and vomiting remains as one of the most
important problems postchemotherapy(12). In this study
, the percentage of acute and delayed vomiting in
intervention group decreased after ginger tea use, despite
that there was no signicant differences between the
study groups in both phases of chemotherapy induced
vomiting. Five studies showed this result too by nding
that ginger intake had no signicant effect in controlling
acute and delayed vomiting (Li et al.2018; Thamlikitkul
et al.2017; Ansari et al.2016; Lua et al.2015; Panahi
et al.2012)(1,13,14,15,4), but all the previous studies
including this study disagreed with what had been
concluded by(Arslan et al.2015; Yekta et al.2012) that
ginger had signicant effect on chemotherapy induced
vomiting(16,17).This might be due to that in our study the
intervention with ginger was after chemotherapy. Ryan
et al. speculated that using ginger before chemotherapy
may prepare the intestine for emetic response by binding
to 5‐HT3 receptors which may give better results(18,19).
The present study showed that the differences
between pre-posttest level of chemotherapy induced
acute and delayed nausea in intervention group was
statistically signicant. Surprisingly, no signicant
difference was detected between the two study groups,
this was close to a study of Li et al.2018, they noted that
no signicant difference of acute and delayed nausea
between the two study groups(1)but disagreed with
Sanaati et al.2016 who stated that ginger signicantly
affect the frequency of nausea(19/20). These differences
in results might be due to different types of ginger could
give different effects on nausea)21(.
The data of Panahi et al. study in 2012, showed
no signicant difference between the intervention and
control groups in each of the four subclasses of severity
of acute and delayed nausea(4). Another three studies did
not support the effect of ginger in reducing the severity
of nausea (Ansari et al.2016; Thamlikitkul et al.2017; Li
et al.2018)(14,13,1,19),on the contrary to these studies, our
study showed that the differences in severity of acute
and delayed nausea between both study groups were
statistically signicant.
Two studies also approved these results; the rst
was carried out in Turkey, 2015 by Arslan et al(16) and
the second one in USA, 2012 by Ryan et al(18) in which
they found that ginger administration will be safely able
to reduce nausea severity postchemotherapy.

Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3 1469
In 2020, a study carried by Neethu et al showed that
the difference in severity of CINV after giving ginger tea
was signicant between study groups(22).
All the previous studies including our study
demonstrated the effect of ginger on CINV among
cancer patients. Some studies supported this effect
, while others did not. As mentioned earlier in the
discussion, the ndings of the present study may not
be directly comparable to some of the previous studies
because of differences in the type of the study design,
presence or absence of control group, chemotherapeutic
regimens, ginger used (dose, type, concentration of
active compounds, duration) and the assessment tools
which was used to assess CINV.
Several ethical issues concerning cancer patients,
beside uncontrolled chemotherapy regimens (high
versus low emetogenic regimens) could be the reasons
for the negative ndings. This study overcame some
limitations of other studies as 1)using validated
assessment tool (MAT) to assess CINV because of the
subjective nature of nausea 2)including different types
of cancers which had specic therapeutic protocol and
show different degrees of nausea, this was approved
by Lee et al 2013(23) 3)involvement of control group to
determine the intervention’s true effect 4)CINV before
the intervention was evaluated and 5) the dose of ginger
was specied.
In conclusion, this study showed the use of ginger as
a complementary therapy to routine antiemetic therapy
had no signicant effect in controlling the CINV but
it had additional benet in reducing the severity of
chemotherapy induced nausea in cancer patients. Ginger
is a safe herbal medication but its effects on CINV need
further investigation.
Ethical Clearance: The Research Ethical
Committee at scientic research by ethical approval of
Council of Arab Board of health Specializations, the
Oncology Teaching Hospital/medical city directorate/
Baghdad and the Ministry of Health/Environment in Iraq
Source of Funding: Self- funding
Conict of Interest: None to declare
References
1- Li X, Qin Y, Liu W, Zhou XY, Li YN, Wang LY.
Efcacy of ginger in ameliorating acute and delayed
chemotherapy-induced nausea and vomiting among
patients with lung cancer receiving cisplatin-based
regimens: a randomized controlled trial. Integrative
cancer therapies.2018 Sep;17(3):747-54.
2- Das S, Banra MP, Joseph NM. Effect of ginger tea
on chemotherapy-induced nausea and vomiting
among cancer patients in selected hospitals,
Bhubaneswar, Odisha. International Journal of
Research in Pharmaceutical Sciences.2020 Feb
8;11(1):1165-71.
3- Danwilai K, Konmun J, Sripanidkulchai BO,
Subongkot S. Antioxidant activity of ginger extract
as a daily supplement in cancer patients receiving
adjuvant chemotherapy: a pilot study. Cancer
management and research.2017;9:11.
4- Panahi Y, Saadat A, Sahebkar A, Hashemian F,
Taghikhani M, Abolhasani E. Effect of ginger on
acute and delayed chemotherapy-induced nausea
and vomiting: a pilot, randomized, open-label
clinical trial. Integrative cancer therapies.2012
Sep;11(3):204-11.
5- Lete I, Alluέ J. The effectiveness of ginger in
the prevention of nausea and vomiting during
pregnancy and chemotherapy. Integrative medicine
insights.2016 Jan;11:IMI-S36273.
6- Marx W, McCarthy AL, Ried K, McKavanagh D,
Vitetta L, Sali A, Lohning A, Isenring E. The effect
of a standardized ginger extract on chemotherapy-
induced nausea-related quality of life in patients
undergoing moderately or highly emetogenic
chemotherapy: a double blind, randomized, placebo
controlled trial. Nutrients.2017 Aug;9(8):867.
7- Hsieh RK, Chan A, Kim HK, Yu S, Kim JG, Lee
MA, Dalén J, Jung H, Liu YP, Burke TA, Keefe
DM. Baseline patient characteristics, incidence of
CINV, and physician perception of CINV incidence
following moderately and highly emetogenic
chemotherapy in Asia Pacic countries. Supportive
Care in Cancer.2015 Jan 1;23(1):263-72.
8- Moghaddasi MS, Kashani HH. Ginger (Zingiber
ofcinale): a review. Journal of Medicinal Plants
Research.2012 Jul 31;6(26):4255-8.
9- Baliga MS, Haniadka R, Pereira MM, D’Souza
JJ, Pallaty PL, Bhat HP, Popuri S. Update on
the chemopreventive effects of ginger and its

1470 Indian Journal of Forensic Medicine & Toxicology, July-September 2021, Vol. 15, No. 3
phytochemicals. Critical reviews in food science
and nutrition.2011 Jul 1;51(6):499-523.
10- Palatty PL, Haniadka R, Valder B, Arora R,
Baliga MS. Ginger in the prevention of nausea and
vomiting: a review. Critical reviews in food science
and nutrition.2013 Jan 1;53(7):659-69.
11- Alafafsheh A, Ahmad M. Tool development to
assess nausea and vomiting among patients receiving
chemotherapy. Int J Cancer Oncol.2016;3(1):1-5.
12- Lavdaniti M, Tsitsis N. Investigation of nausea
and vomiting in cancer patients undergoing
chemotherapy. Health Psychology Research.2014
Nov 6;2(3).
13- Thamlikitkul L, Srimuninnimit V, Akewanlop
C, Ithimakin S, Techawathanawanna S,
Korphaisarn K, Chantharasamee J, Danchaivijitr
P, Soparattanapaisarn N. Efcacy of ginger for
prophylaxis of chemotherapy-induced nausea
and vomiting in breast cancer patients receiving
adriamycin–cyclophosphamide regimen: a
randomized, double-blind, placebo-controlled,
crossover study. Supportive Care in Cancer.2017
Feb 1;25(2):459-64.
14- Ansari M, Porouhan P, Mohammadianpanah M,
Omidvari S, Mosalaei A, Ahmadloo N, Nasrollahi
H, Hamedi SH. Ef cacy of Ginger in Control of
Chemotherapy Induced Nausea and Vomiting in
Breast Cancer Patients Receiving Doxorubicin-
Based Chemotherapy. Asian Pacic Journal of
Cancer Prevention.2016 Aug 1;17(8):3877-80.
15- Lua PL, Salihah N, Mazlan N. Effects of inhaled
ginger aromatherapy on chemotherapy-induced
nausea and vomiting and health-related quality of
life in women with breast cancer. Complementary
therapies in medicine.2015 Jun 1;23(3):396-404.
16- Arslan M, Ozdemir L. Oral intake of ginger for
chemotherapy-induced nausea and vomiting
among women with breast cancer. Clinical journal
of oncology nursing.2015 Oct 1;19(5).
17- Yekta ZP, Ebrahimi SM, Hosseini M, Nasrabadi
AN, Sedighi S, Surmaghi MH, Madani H. Ginger
as a miracle against chemotherapy-induced
vomiting. Iranian Journal of Nursing and Midwifery
Research.2012 Jul;17(5):325.
18- Ryan JL, Heckler CE, Roscoe JA, Dakhil SR,
Kirshner J, Flynn PJ, Hickok JT, Morrow GR.
Ginger (Zingiber ofcinale) reduces acute
chemotherapy-induced nausea: a URCC CCOP
study of 576 patients. Supportive care in
cancer.2012 Jul 1;20(7):1479-89.
19- Saneei Totmaj A, Emamat H, Jarrahi F, Zarrati
M. The effect of ginger (Zingiber ofcinale) on
chemotherapy‐induced nausea and vomiting in
breast cancer patients: A systematic literature review
of randomized controlled trials. Phytotherapy
Research.2019 Aug;33(8):1957-65.
20- Sanaati F, Naja S, Kashaninia Z, Sadeghi M.
Effect of ginger and chamomile on nausea and
vomiting caused by chemotherapy in Iranian
women with breast cancer. Asian Pacic Journal of
Cancer Prevention.2016 Aug 1;17(8):4125-9.
21- Marx WM, Teleni L, McCarthy AL, Vitetta L,
McKavanagh D, Thomson D, Isenring E. Ginger
(Zingiber ofcinale) and chemotherapy-induced
nausea and vomiting: a systematic literature review.
Nutrition reviews.2013 Apr 1;71(4):245-54.
22- Das S, Banra MP, Joseph NM. Effect of ginger tea
on chemotherapy-induced nausea and vomiting
among cancer patients in selected hospitals,
Bhubaneswar, Odisha. International Journal of
Research in Pharmaceutical Sciences.2020 Feb
8;11(1):1165-71
23- Jiyeon Lee RN, Heeyoung Oh RN. Ginger as an
antiemetic modality for chemotherapy-induced
nausea and vomiting: a systematic review and
meta-analysis. In Oncology nursing forum 2013
Mar 1 (Vol. 40, No. 2, p. 163). Oncology Nursing
Society.