隔姜灸联合经肝动脉化疗栓塞术治疗肝郁脾虚型原发性肝癌的效果观察  

Clinical effect of ginger- partitioned moxibustion combined with transarterial chemoembolization in treatment of primary liver cancer with stagnation of liver qi and spleen deficiency

作　　者：诸佳瑜[1] 徐望[2] 陈闯[3] 欧杰[3] 毛素菲 莫晓丽[1] 陆冬玲[3] ZHU Jiayu XU Wang CHEN Chuang et al(Guangxi University of Chinese Medicine, Nanning 530000, Chin)

机构地区：[1]广西中医药大学,南宁530000 [2]湖南省岳阳市中医院,湖南岳阳414000 [3]广西医科大学附属肿瘤医院,南宁530000

出　　处：《临床肝胆病杂志》2017年第1期87-90,共4页Journal of Clinical Hepatology

基　　金：2015年广西科学研究与技术开发计划项目(桂科攻1598012-54)

摘　　要：目的观察隔姜灸足三里、涌泉穴配合经肝动脉化疗栓塞术(TACE)治疗原发性肝癌的临床疗效。方法收集2013年12月-2014年12月于广西医科大学附属肿瘤医院住院的中医证候属肝郁脾虚证的原发性肝癌初诊患者60例,随机分为艾灸组和对照组,每组各30例。两组患者均行TACE治疗,术后均给予常规护肝、护胃、止痛、止吐等对症支持治疗。艾灸组在此基础上,自TACE术前1 d开始进行艾灸治疗。施灸穴位取双侧涌泉穴、双侧足三里,1次/d,30 min/次,连续施灸8 d。于术前1 d和术后7 d记录肝癌患者的生活质量,对比两组患者术后不良反应、中医证候评分和生命质量测定量表EORTC QLQ-C3问卷结果变化。计量资料组间比较采用t检验;计数资料组间比较采用χ~2检验,等级资料组间比较采用Mann-Whitney U检验。结果艾灸组患者术后出现恶心、呕吐症状等不良反应较对照组少,差异有统计学意义(Z=9.692,P=0.046)。艾灸组中医证候显著改善7例,部分改善16例,总有效率为77%;对照组中医证候显著改善5例,部分改善9例,总有效率为47%,两组比较差异有统计学意义(χ~2=7.198,P=0.027)。生活质量方面,艾灸组患者疲倦、食欲减退、恶心呕吐以及总体健康状况的改善情况均明显优于对照组(t值分别为2.722、2.530、2.538、3.144,P值分别为0.011、0.017、0.017、0.004)。结论双侧足三里、涌泉穴隔姜灸配合TACE治疗原发性肝癌,可减轻TACE术后不良反应,改善患者中医证候及生活质量,体现了"局部+全身"的综合治疗模式治疗原发性肝癌的特点和优势。Objective To investigate the clinical effect of ginger -partitioned moxibustion at Zusanli and Yongquan points combined with transarterial chemoembolization （TACE）in the treatment of primary liver cancer.Methods A total of 60 patients initially diagnosed with primary liver cancer with stagnation of liver qi and spleen deficiency who were hospitalized in The Affiliated Tumor Hospital of Guangxi Medi-cal University from December 2013 to December 2014 were enrolled and randomly divided into moxibustion group and control group,with 30 patients in each group.The patients in both groups were given TACE and symptomatic /supportive treatment after TACE,including conven-tional liver -protecting,stomach -protecting,pain -relieving,and antiemetic treatment.The patients in the moxibustion group were given moxibustion since day 1 before TACE.Moxibustion was performed at bilateral Yongquan and Zusanli points once a day （30 minutes each time）for 8 consecutive days.The patients′quality of life was recorded at 1 day before and 7 days after surgery,and the postoperative ad-verse events,traditional Chinese medicine （TCM）syndrome score,and EORTC QLQ -C30 results were compared between the two groups. The t -test was used for comparison of continuous data between groups,the chi -square test was used for comparison of categorical data be-tween groups,and the Mann -Whitney U test was used for comparison of ranked data between groups.Results The moxibustion group had a significantly lower proportion of patients who experienced nausea and vomiting after surgery than the control group （Z =9.692,P =0.046）.Among the patients in the moxibustion group,7 achieved significant improvements in TCM syndrome and 16 achieved partial im-provements in TCMsyndrome,resulting in an overall response rate of 77%;among the patients in the control group,5 achieved significant improvements and 9 achieved partial improvements,resulting in an overall response rate of 47%;there was a significant difference in overall response rate between the tw

关 键 词：肝肿瘤 隔姜灸 肝气郁结 脾虚 治疗 

分 类 号：R735.7[医药卫生—肿瘤] S853.618[医药卫生—临床医学]