针刺联合改良督灸治疗肺癌化疗后癌因性疲乏的临床研究  

Clinical Research of Acupuncture Combined with the Modified Governor Vessel Moxibustion for Cancer-related Fatigue After Chemotherapy for Lung Cancer

作　　者：白平[1] 张国铎[1] 苏立[1] 郭婷婷[1] 何苗[1] 刘楠[1] 胡陵静[1] BAI Ping;ZHANG Guoduo;SU Li;GUO Tingting;HE Miao;LIU Nan;HU Lingjing(Chongqing Traditional Chinese Medicine Hospital,Chongqing 400011,China)

机构地区：[1]重庆市中医院,重庆400011

出　　处：《上海针灸杂志》2022年第4期353-358,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：重庆市卫生计生委中医药科技项目(ZY201802015,ZY201802067);重庆市科研院所绩效激励引导专项项目(cstc2018jxjl130005);重庆市中医院院级名中医学术经验继承项目。

摘　　要：目的观察针刺联合改良督灸治疗肺癌化疗后肺脾气虚型癌因性疲乏(CRF)的临床疗效。方法以Ⅲ和Ⅳ期非小细胞肺癌患者为研究对象,将80例肺脾气虚型CRF患者分为针刺组和联合组,每组40例。两组均予基础支持治疗,针刺组予针刺治疗,联合组予针刺联合改良督灸治疗。比较两组治疗前、治疗后及治疗后2周Piper疲乏修订量表(revised Piper fatigue scale,PFS-R)评分、生活质量评分、中医证候评分及患者外周血免疫指标的变化。结果治疗后及治疗后2周,两组PFS-R各单项评分均较同组治疗前降低,但仅行为、躯体及总分的组间效应、时间效应及交互效应具有统计学意义(P<0.05)。治疗后及治疗后2周,两组生活质量总分及躯体、角色及情感单项功能评分均较同组治疗前升高,疲劳单项评分较同组治疗前降低,但仅生活质量总分、躯体单项功能评分及疲劳单项评分的组间效应、时间效应及交互效应具有统计学意义(P<0.05)。治疗后及治疗后2周,两组中医证候评分较同组治疗前降低,CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均较同组治疗前升高,各项组间效应、时间效应及交互效应均具有统计学意义(P<0.05)。结论针刺联合改良督灸治疗肺癌化疗后肺脾气虚型癌因性疲乏可减轻患者疲乏和中医证候,提高患者生活质量和免疫功能,疗效优于单纯针刺治疗。Objective To observe the clinical efficacy of acupuncture plus modified Governor Vessel moxibustion in treating cancer-related fatigue(CRF)after chemotherapy for lung cancer due to lung-spleen Qi deficiency.Method The patients with non-small-cell lung cancer(NSCLC)at stagesⅢ-Ⅳwere recruited as the subjects.Eighty CRF patients due to lung-spleen Qi deficiency were divided into an acupuncture group and an integration group.Both groups received basic support treatment.In addition,the acupuncture group received acupuncture intervention,and the integration group was given acupuncture plus modified Governor Vessel moxibustion.Before and after treatment and 2weeks later,the revised Piper fatigue scale(PFS-R)score,quality of life score,symptom score of traditional Chinese medicine(TCM),and peripheral blood immune indexes in the two groups were observed.Result After treatment and 2 weeks later,the PFS-R scores all declined compared with the baseline in both groups,but only the behavior and physical body scores and the global scores showed statistical significance comparing the between-group effect,time effect,and interactive effect(P<0.05).The total score and the physical body,role,and emotional function component scores of the quality of life increased,and the fatigue component score dropped after the treatment and 2 weeks later in both groups,but only the total score and component scores of physical body and fatigue showed statistical significance comparing the between-group effect,time effect,and interactive effect(P<0.05).After the treatment and 2 weeks later,the TCM symptom score declined,and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)increased in both groups,and all showed statistical significance comparing the between-group effect,time effect,and interactive effect(P<0.05).Conclusion Acupuncture plus modified Governor Vessel moxibustion can reduce fatigue and TCM symptoms and enhance the quality of life and immune function in treating CRF after chemotherapy for lung cancer due to lung-spleen Qi deficiency

关 键 词：针刺疗法 灸法 督脉 肺癌 化疗 辅助 疲劳 肺脾气虚 

分 类 号：R246.5[医药卫生—针灸推拿学]