三焦针灸法对中晚期胃腺癌癌因性疲乏的疗效及对免疫功能的影响  

Effect of Sanjiao acupuncture on cancer-related fatigue and immune function in advanced gastric adeno-carcinoma

作　　者：李文涛[1,2] 刘阿庆 张冠 刘云鹤 崔倩[3] 杨艳杰 王栋 于建春 Li Wentao;Liu Aqing;Zhang Guan;Liu Yunhe;Cui Qian;Yang Yanjie;Wang Dong;Yu Jianchun(Oncology Department,the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Graduate College,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第一附属医院肿瘤科,天津300381 [2]国家中医针灸临床医学研究中心,天津300381 [3]天津中医药大学研究生院,天津301617

出　　处：《实用肿瘤杂志》2023年第3期270-275,共6页Journal of Practical Oncology

摘　　要：目的观察三焦针灸法治疗中晚期胃腺癌癌因性疲乏的疗效及对免疫功能的影响。方法收集2019年1月至2020年12月天津中医药大学第一附属医院收治的中晚期胃腺癌癌因性疲乏患者200例。应用随机数字表法将患者分为对照组和治疗组各100例;剔除脱落患者后,对照组85例,治疗组77例。对照组接受常规中西医对症治疗,治疗组在此基础上联合三焦针灸法治疗。观察两组治疗前后的卡氏功能状态(Karnofsky performance status,KPS)评分、Piper量表评分、红细胞计数、血红蛋白浓度以及淋巴细胞亚群(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、NK细胞和B细胞)百分比和绝对计数的变化。结果对照组治疗后KPS评分升高且Piper量表中行为维度评分、红细胞计数、血红蛋白浓度和淋巴细胞亚群CD4^(+)T细胞绝对计数均下降,差异均具有统计学意义(均P<0.05)。对照组治疗前后Piper量表中情绪维度、感觉维度、认知维度和总分评分以及淋巴细胞亚群百分比、CD3^(+)T细胞绝对计数、CD8^(+)T细胞绝对计数、NK细胞绝对计数和B细胞绝对计数比较,差异均无统计学意义(均P>0.05)。治疗组治疗后KPS评分升高,Piper量表中行为维度、情绪维度、感觉维度和总分评分均降低,CD3^(+)和CD4^(+)T细胞绝对计数升高,差异均具有统计学意义(均P<0.05)。治疗组治疗前后Piper量表中认知维度评分、红细胞计数、血红蛋白浓度、淋巴细胞亚群百分比及CD8^(+)T、NK和B细胞绝对计数比较,差异均无统计学意义(均P>0.05)。结论三焦针灸法后可缓解中晚期胃腺癌患者的疲乏状态、提高生活质量和降低贫血的发生,其作用机制可能通过提高淋巴细胞数量、改善免疫功能和改善贫血状态来实现的,是临床上治疗胃腺癌癌因性疲乏的一种简便易行且确实有效的方法。Objective To observe the effect of Sanjiao acupuncture and moxibustion on cancer-related fatigue in advanced gastric adenocarcinoma and its influence on immune function.Methods Two-hundred advanced gastric adenocarcinoma patients with cancer-related fatigue admitted to the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from January 2019 to December 2020 were collected.The patients were randomly assigned to the control group and treatment group,100 patients in each group.After removal of abscission patients,there were 85 patients in the control group and 77 patients in the treatment group.The control group received routine treatment and the treatment group used conventional treatment with Sanjiao acupuncture and moxibustion therapy.The changes of the Karnofsky performance status(KPS)scale,Piper fatigue scale,red blood cell count,hemoglobin concentration,and lympho-cyte subgroup percentage and absolute count,including CD3^(+)T cells,CD4^(+)T cells,CD8^(+)T cells,NK cells and B cells,before and after the treatment in both groups were analyzed.Results After treatment,KPS score increased,and Piper behavior dimension score,red blood cell count,hemoglobin concentration,and CD4^(+)T cell absolute count decreased in the control group(all P<0.05).In the control group before and after treatment,there were no statistically significant differences in the emotional,sensory,cognitive,and total Piper scale scores,all lymphocyte subgroup percentages and absolute counts of CD3^(+)T,CD8^(+)T,NK and B cells(all P>0.05).After treatment,the KPS score of the treatment group increased,the behavioral,emotional,sensory and total scores of Piper scale decreased,and the absolute counts of CD3^(+)and CD4^(+)T cells increased in the treatment group(all P<0.05).There were no significant differences in the Piper scale score of cognitive di-mension,red blood cell count,hemoglobin concentration,percentages of lymphocyte subsets and absolute counts of CD8^(+)T,NK and B cells(all P>0.05).Conclusions Sanjiao acupunct

关 键 词：胃腺癌 三焦针灸法 癌因性疲乏 淋巴细胞亚群 

分 类 号：R246.5[医药卫生—针灸推拿学]