艾灸联合运动疗法对鼻咽癌放化疗患者癌因性疲乏的影响观察  

Effects of exercise therapy combined with moxibustion on cancer-related fatigue in nasopharyngeal carcinoma patients underwent chemoradiotherapy

作　　者：杨秀芳[1] 洪福莉 杨玲玲[1] 班海燕 李欢 陈小华[1] YANG Xiufang;HONG Fuli;YANG Lingling;BAN Haiyan;LI Huan;CHEN Xiaohua(Department of Otolaryngology,the First People's Hospital of Qinzhou,Qinzhou,Guangxi 535099)

机构地区：[1]广西壮族自治区钦州市第一人民医院耳鼻咽喉科,广西钦州535099

出　　处：《河北中医》2023年第10期1698-1702,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z20200330)。

摘　　要：目的观察艾灸联合运动疗法防治鼻咽癌放化疗患者癌因性疲乏的临床效果。方法选择2020年1月至2022年6月收治的鼻咽癌放化疗患者90例,按照随机数字表法分为2组,对照组45例予常规运动疗法进行辅助治疗,治疗组45例在对照组的基础上联合艾灸治疗。2组均治疗6个月,比较2组治疗前及治疗3、6个月简短疲乏量表(BFI)评分、焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分变化情况,比较2组治疗前及治疗6个月生活质量调查问卷-35(QOL-35)(包括躯体、心理、社会及总体感觉4个维度)评分变化情况,比较2组治疗前及治疗6个月血清促肾上腺皮质激素(ACTH)及皮质醇(Cor)水平变化情况。结果与本组治疗前比较,2组治疗3、6个月BFI评分均降低(P<0.05),且治疗组治疗3、6个月BFI评分均低于对照组同期(P<0.05)。与本组治疗前比较,2组治疗3、6个月SAS及SDS评分均降低(P<0.05),且治疗组治疗3、6个月SAS及SDS评分均低于对照组同期(P<0.05)。与本组治疗前比较,2组治疗6个月QOL-35躯体、心理、社会、总体感觉评分及总分均升高(P<0.05),且治疗组治疗6个月QOL-35躯体、心理、社会、总体感觉评分及总分均高于对照组(P<0.05)。与本组治疗前比较,2组治疗6个月血清ACTH水平均降低(P<0.05),Cor水平均升高(P<0.05),且治疗组治疗6个月ACTH水平低于对照组(P<0.05),Cor水平高于对照组(P<0.05)。结论艾灸联合运动疗法防治鼻咽癌放化疗患者癌因性疲乏疗效确切,可有效改善患者疲乏症状,缓解焦虑、抑郁情绪,提高生活质量,其作用机制可能与调节ACTH及Cor水平,纠正下丘及脑-垂体-肾上腺皮质(HPA)轴功能紊乱有关。Objective To investigate the effects of exercise therapy combined with moxibustion on cancer-related fatigue in nasopharyngeal carcinoma(NPC)patients underwent chemoradiotherapy.Methods From January 2020 to June 2022,ninety NPC patients underwent chemoradiotherapy were randomly assigned to receive either routine exercise therapy(the control group,n=45)or routine exercise therapy+moxibustion(the treatment group,n=45).Treated for 6 months,aiming to compare inter-group differences in the scores of Brief Fatigue Inventory(BFI),Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)on day 0,month 3,and month 6.The 35-item quality-of-life questionnaire(QOL-35)(physical,psychological,social and general feelings),and the changes in serum adrenocorticotropic hormone(ACTH),cortisol(Cor)were assessed on day 0 and month 6.Results On months 3 and 6,BFI score in groups was significantly decreased(P<0.05),which was significantly lower in the treatment group than in the concurrent control group(P<0.05).SAS and SDS scores on months 3 and 6 were significantly decreased(P<0.05),the reduction in the treatment group was more prevalent compared with the concurrent control group(P<0.05).QOL-35 scores(physical,psychological,social and general feelings)on month 6 were significantly increased(P<0.05),which in the treatment group were more common than the control group(P<0.05).On month 6,decreased ACTH levels,and increased Cor levels were detected in the two groups(all P<0.05),and the treatment group was superior to the control group for ACTH and Cor levels(all P<0.05).Conclusion Exercise therapy combined with moxibustion has a definite effect on cancer-related fatigue in NPC patients underwent chemoradiotherapy.It can effectively improve fatigue symptoms,relieve anxiety and depression,and improve the quality of life by regulating ACTH and Cor levels and correcting hypothalamic pituitary adrenal axis dysfunction.

关 键 词：鼻咽癌 癌因性疲乏 放化疗 运动疗法 艾灸 

分 类 号：R739.6[医药卫生—肿瘤]