热敏灸对中晚期非小细胞肺癌化疗后T淋巴细胞亚群及无进展生存期的影响  

Effects of Heat-sensitive Moxibustion on T-lymphocyte Subsets and Progression-free Survival in Advanced Non-small-cell Lung Cancer After Chemotherapy

作　　者：韩琳[1] 苏秀贞[1,2] 张俊萍 祝敬燕[2] 刘洪星[2] HAN Lin;SU Xiuzhen;ZHANG Junping;ZHU Jingyan;LIU Hongxing(Shandong University of Traditional Chinese Medicine,Jinan 250000,China;Weifang Hospital of Traditional Chinese Medicine,Weifang 261000,China)

机构地区：[1]山东中医药大学,济南250000 [2]潍坊市中医院,潍坊261000

出　　处：《上海针灸杂志》2022年第2期122-127,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：山东省中医药科技发展计划项目(2019-2020年度)(2019-0710)。

摘　　要：目的观察热敏灸对中晚期非小细胞肺癌(NSCLC)患者化疗后T淋巴细胞亚群及无进展生存期(PFS)的影响。方法将70例中晚期非小细胞肺癌患者随机分为对照组和观察组,每组35例。对照组中鳞癌采用吉西他滨与顺铂两药联合(GP)化疗方案,腺癌采用培美曲塞二钠与顺铂两药联合(PP)化疗方案;观察组在对照组基础上加用热敏灸。比较两组治疗前后T淋巴细胞亚群及NK细胞的变化,比较两组PFS、Kamofsky功能状态(KPS)评分、临床疗效和不良反应发生情况。结果治疗前,两组T淋巴细胞亚群各项指标及NK细胞比较,差异均无统计学意义(P>0.05),具可比性。观察组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞高于对照组(P<0.05),CD8^(+)低于对照组(P<0.05);观察组较对照组中位PFS延长了1.6个月(P<0.05);观察组KPS评分提高率优于对照组(P<0.05),降低率低于对照组(P<0.05)。观察组临床控制率为78.1%,优于对照组的50.0%(P<0.05)。结论热敏灸有助于恢复中晚期NSCLC患者化疗后受损的免疫功能,提高化疗耐受性,能有效改善患者生活质量,延长无进展生存期。Objective To observe the effects of heat-sensitive moxibustion on T-lymphocyte subsets and progression-free survival(PFS)in patients with advanced non-small-cell lung cancer(NSCLC)after chemotherapy.Method Seventy patients with advanced NSCLC were randomized into a control group and an observation group,with 35 cases in each group.In the control group,GP chemotherapy(Gemcitabine plus Cisplatin)was used for squamous-cell carcinoma,and PP chemotherapy(Pemetrexed disodium plus Cisplatin)was used for adenocarcinoma.The observation group was given additional heat-sensitive moxibustion.Before and after the treatment,the T-lymphocyte subsets and natural killer(NK)cells in the two groups were compared.The PFS,Karnofsky performance status(KPS)score,clinical efficacy,and adverse reactions were also compared.Result Before the treatment,there were no significant differences in the parameters of T-lymphocyte subsets or the NK cells between the two groups(P>0.05),suggesting the comparability.After the treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and NK cells were higher in the observation group than in the control group(P<0.05),and the level of CD8^(+)was lower(P<0.05).The median PFS in the observation group was 1.6 months longer than that in the control group(P<0.05).The increased rate of KPS score in the observation group won out over in the control group(P<0.05),and the decreased rate was lower in the observation group(P<0.05).The effective rate was 78.1%in the observation group,higher than 50.0%in the control group(P<0.05).Conclusion Heat-sensitive moxibustion can help heal the impaired immune function due to chemotherapy in patients with advanced NSCLC.It can effectively enhance the patients’quality of life and prolong the PFS.

关 键 词：灸法 热敏灸 艾条灸 肺癌 非小细胞 药物疗法 化疗 无进展生存期 T淋巴细胞 

分 类 号：R246.5[医药卫生—针灸推拿学]