针刺干预癌症相关性疲劳及对患者血清CRP、IL-6、TNF-α及sTNF-R1水平的影响  

Effect of acupuncture on patients with cancer-related fatigue and serum levels of CRP, IL-6, TNF-α and sTNF-R1

作　　者：卿鹏[1] 赵建夫[2] 赵仓焕[1] 胡静[1] 林炎龙[1] 何科杰 QING Peng;ZHAO Jian-fu;ZHAO Cang-huan;HU Jing;LIN Yan-long;HE Ke-jie(Department of Acupuncture and Moxibustion,First Affiliated Hospital of Jinan University,Guangzhou 510630,Guangdong Province,China;Department of Oncology,First Affiliated Hospital of Jinan University,Guangzhou 510630,Guangdong Province,China)

机构地区：[1]暨南大学附属第一医院针灸科,广东广州510630 [2]暨南大学附属第一医院肿瘤科,广东广州510630

出　　处：《中国针灸》2020年第5期505-509,共5页Chinese Acupuncture & Moxibustion

基　　金：广东省中医药局建设中医药强省科研项目:20152110。

摘　　要：目的:探讨针刺干预癌症相关性疲劳的疗效及相关作用机制。方法:将80例癌症相关性疲劳患者随机分为观察组及对照组,实际完成病例67例(观察组36例,对照组31例)。对照组进行常规放化疗以及对症治疗,未采用特殊抗疲劳治疗;观察组在对照组治疗的基础上,配合针刺治疗,穴取百会、关元、气海、风池、足三里、三阴交,每日1次,5次为一疗程,疗程间休息2 d,干预4个疗程。记录两组患者干预前后中文版癌症治疗功能评估疲乏量表(FACT-F)、McGill生存质量问卷(MQOL)评分,以及干预前后血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)及可溶性肿瘤坏死因子受体1(sTNF-R1)水平的变化。结果:(1)干预后,观察组FACT-F评分显著低于干预前(P<0.05),而对照组干预前后差异无统计学意义(P>0.05),观察组干预前后评分差值显著高于对照组(P<0.05)。(2)干预后,观察组MQOL中生理维度、心理维度评分降低(P<0.05),社会支持维度评分提高(P<0.05);观察组生理维度、心理维度及社会支持维度干预前后评分差值均高于对照组(P<0.05)。(3)干预后,观察组血清IL-6、TNF-α及sTNF-R1水平降低(P<0.05),对照组血清CRP、IL-6水平升高(P<0.05),且观察组血清CRP、IL-6、TNF-α水平低于对照组(P<0.05)。结论:(1)针刺可改善癌症相关性疲劳患者的低落情绪、虚弱、头痛等相关症状,并提高患者对获得社会、家庭支持方面的感知,增强患者治病的信心;(2)针刺可有效降低患者血清相关炎性细胞因子水平,这可能是针刺干预CRF的作用机制之一。Objective To observe the therapeutic effect of acupuncture on cancer-related fatigue(CRF) and to explore its possible mechanism. Methods A total of 80 patients with CRF were randomized into an observation group and a control group, and finally 67 patients completed the trial(36 patients in the observation group, 31 patients in the control group). Patients in the control group were treated with conventional chemoradiotherapy and symptomatic treatment, while no particular anti-fatigue intervention was adopted. On the basis of treatment in the control group, acupuncture was applied at Baihui(GV 20), Guanyuan(CV 4), Qihai(CV 6), Fengchi(GB 20), Zusanli(ST 36), Sanyinjiao(SP 6) in the observation group, once a day, 5 times as one course, with 2 days interval between each course, totally 4 courses were required. Before and after treatment, scores of functional assessment of cancer therapy-fatigue(FACT-F) in Chinese and McGill quality of life questionnaire(MQOL), serum levels of C-reactive protein(CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α) and soluble TNF receptor-1(sTNF-R1) were observed in the two groups. Results(1)Compared before treatment, the FACT-F score was decreased after treatment in the observation group(P<0.05), while there was no significant difference in the control group(P<0.05). The change of the FACT-F score in the observation group was larger than that in the control group(P<0.05).(2)In the observation group, scores of physiological and psychological dimension were decreased(P<0.05), score of social support dimension was increased after the treatment(P<0.05). The score changes of physiological, psychological and social support dimension in the observation group were larger than those in the control group(all P<0.05).(3)After treatment, the serum levels of IL-6, TNF-α and sTNF-R1 were decreased in the observation group(P<0.05), while the serum levels of CPR and IL-6 were increased in the control group(P<0.05). The serum levels of CPR, IL-6 and TNF-α in the observation were lower than t

关 键 词：癌症相关性疲劳 针刺 C反应蛋白(CRP) 白细胞介素-6(IL-6) 肿瘤坏死因子α(TNF-α) 可溶性肿瘤坏死因子受体1(sTNF-R1) 

分 类 号：R246.1[医药卫生—针灸推拿学]