针刺改善胃癌术后辅助化疗期间患者症状负荷疗效观察  

Clinical observation on acupuncture for symptom burden in gastric cancer patients undergoing adjuvant chemotherapy after gastrectomy

作　　者：常雪松 朱燕娟[1,4,5] 彭建军 吴晓宇[3] 王伟[1] 刘译鸿[1] 詹丹丹[7] 陈亚栋 张海波 CHANG Xue-song;ZHU Yan-juan;PENG Jian-jun;WU Xiao-yu;WANG Wei;LIU Yi-hong;ZHAN Dan-dan;CHEN Ya-dong;ZHANG Hai-bo(Guangdong Provincial Hospital of TCM,Second Affiliated Hospital of Guangzhou University of CM,Guangzhou 510120,China;First Affiliated Hospital,Sun Yat-sen University;Jiangsu Province Hospital of CM/Affiliated Hospital of Nanjing University of Chinese Medicine;Guangdong Provincial Key Laboratory of Clinical Research on TCM Syndrome;Guangdong-Hong Kong-Macao Joint Lab on Chinese Medicine and Immune Disease Research;State Key Laboratory of Dampness Syndrome of Chinese Medicine;Second Clinical Medical College of Guangzhou University of CM)

机构地区：[1]广东省中医院/广州中医药大学第二附属医院,广州510120 [2]中山大学附属第一医院 [3]江苏省中医院/南京中医药大学附属医院 [4]广东省中医证候临床研究重点实验室 [5]粤港澳中医药与免疫疾病研究联合实验室 [6]省部共建中医湿证国家重点实验室 [7]广州中医药大学第二临床医学院

出　　处：《中国针灸》2022年第11期1226-1232,共7页Chinese Acupuncture & Moxibustion

基　　金：国家科技部重点研发计划项目:2017YFC1700603;广东省科技计划项目:2017A020213021。

摘　　要：目的:观察针刺对胃癌患者术后辅助化疗期间症状负荷的影响。方法:将58例胃癌术后辅助化疗患者随机分为高频组(19例,脱落5例)、低频组(20例,脱落6例)和对照组(19例,脱落2例)。对照组予常规化疗及止呕处理。在对照组治疗基础上,高频组每个化疗周期针刺7次,共21次;低频组每个化疗周期针刺3次,共9次,均穴取百会、足三里、内关等穴,并根据经络热度感测法选取背俞穴,同侧足三里和内关连接电针,予连续波,频率2 Hz,留针20 min。分别于每个化疗周期第1~7天、第14天和第21天观察各组患者埃德蒙顿症状评估系统(ESAS)评分。结果:3组患者均以每个化疗7 d内的症状负荷最重。第3个化疗周期后,低频组患者ESAS总分低于对照组(P<0.05),针刺组(高频组合并低频组)患者ESAS总分及健康感觉不佳、疼痛、气急症状评分均低于对照组(P<0.05)。结论:针刺可有效控制胃癌患者术后辅助化疗期间症状负荷。Objective To observe the efficacy of acupuncture on symptom burden in patients with gastric cancer during adjuvant chemotherapy after gastrectomy.Methods A total of 58 patients were randomized into a high-dose acupuncture group(19 cases,5 cases dropped off),a low-dose acupuncture group(20 cases,6 cases dropped off)and a control group(19 cases,2 cases dropped off).Conventional chemotherapy and antiemetic treatment were adopted in the control group.On the basis of the treatment in the control group,acupuncture was applied 7 times each chemotherapy cycle for totally 21 times in the high-dose acupuncture group,and 3 times each chemotherapy cycle for totally 9 times in the low-dose acupuncture group.Baihui(GV 20),Zusanli(ST 36),Neiguan(PC 6),etc.were selected in the two acupuncture groups,as well as back-shu points selected by the meridian heat sensing technique.Electroacupuncture was connected to ipsilateral Zusanli(ST 36)and Neiguan(PC 6),with continuous wave,2 Hz in frequency for 20 min.The Edmonton symptom assessment system(ESAS)score was observed on day 1-7,14,and 21 of each cycle of chemotherapy respectively in the 3 groups.Results The symptom burden was worst within 7 days of each cycle of chemotherapy in the 3 groups.After the 3rd chemotherapy cycle,the total score of ESAS in the low-dose acupuncture group was lower than the control group(P<0.05),the total score and the scores of feeling of non-well being,pain and shortness of breath of ESAS in the acupuncture group(the high-dose acupuncture group combined with the low-dose acupuncture group)were lower than the control group(P<0.05).Conclusion Acupuncture shows promising effect in controlling symptom burden during adjuvant chemotherapy in gastric cancer patients after gastrectomy.

关 键 词：胃癌 辅助化疗 针刺 治疗频次 症状负荷 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]