针灸气海、关元、足三里治疗结直肠癌化疗患者癌因性疲乏:一项随机对照试验  

Acupuncture and moxibustion(Qihai CV6,Guanyuan CV4 and Zusanli ST36) for chemotherapy-induced cancer-related fatigue in patients with colorectal cancer:A randomized controlled trial

作　　者：杜秀婷 刘鹏 黄玉筠 黄秋华 陈楠[1] 陈雁秋 潘少娜 罗悦嘉 乔冠英[1] DU Xiuting;LIU Peng;HUANG Yujun;HUANG Qiuhua;CHEN Nan;CHEN Yanqiu;PAN Shaona;LUO Yuejia;QIAO Guanying(Department of Medical Oncology,Shunde Hospital Guangzhou University of Chinese Medicine,Guangdong Foshan 528000,China;Department of Medical Oncology,Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine,Guangdong Shenzhen 518172,China)

机构地区：[1]广州中医药大学顺德医院肿瘤科,广东佛山528000 [2]北京中医药大学深圳医院(龙岗)肿瘤科,广东深圳518172

出　　处：《现代肿瘤医学》2024年第17期3296-3305,共10页Journal of Modern Oncology

基　　金：广东省中医药局中医药科研项目(编号:20212226);北京中医药大学深圳医院育龙计划专项科研项目(编号:2022-BUCMSZYLRC21)。

摘　　要：目的:观察针灸气海、关元、双侧足三里治疗结直肠癌患者化疗后所致癌因性疲乏(CRF)的疗效及其对肿瘤坏死因子α(TNF-α)的影响。方法:共51例接受化疗后出现CRF的结直肠癌患者纳入分析,随机分成两组,其中针灸组25例,对照组26例。两组患者均接受常规化疗,其中针灸组化疗期间配合针灸治疗,分别于化疗前1天、化疗第1~3天接受针灸治疗,每天1次,每次30分钟,两个疗程(对应两个化疗周期),共8次针灸治疗。主要疗效指标为Piper疲乏量表,次要疗效指标为中医证候评分、TNF-α含量。分别于随机化入组后的第一程化疗前,第二程化疗结束后及第二程化疗后2周进行评估。结果:Piper疲乏量表评分方面,随着针灸干预次数的增加,针灸组内患者Piper疲乏评分逐渐下降(F=67.425,P<0.001),说明随时间的推移,针灸组癌因性疲乏程度改善。与对照组比较,针灸组Piper疲乏评分明显下降(F=6.706,P=0.013),说明针灸组患者的疲乏程度改善显著优于对照组。中医证候总疗效方面,针灸组和对照组的有效率分别为68%、34.6%,针灸组有效率显著提高(χ^(2)=5.68,P=0.017)。其中,针灸组单项症状中的“体倦乏力”(χ^(2)=14.41,P <0.001)、“神疲”(χ^(2)=7.06,P=0.008)等单项疗效对比对照组亦显著性改善。针灸组治疗后TNF-α含量较治疗前下降(t=1.14,P=0.26),对照组治疗后TNF-α含量较治疗前上升(t=-1.02,P=0.31),呈现出针灸抑制CRF患者TNF-α含量的趋势。结论:针灸气海、关元、双侧足三里4穴减轻结直肠癌患者化疗致CRF的疲乏程度,改善“体倦乏力”“神疲”症状,且存在下调TNF-α水平的趋势,初步提示下调TNF-α促炎细胞因子水平可能是针灸治疗CRF的作用机制之一。Objective:To observe the clinical therapeutic effect on cancer-related fatigue(CRF) after chemotherapy treatment with the reinforcing technique of acupuncture at Qihai(CV6),Guanyuan(CV4) and warm needling on bilateral Zusanli(ST36) in the patients with colorectal cancer as well as its effect on TNF-α.Methods:A total of 51 cases of CRF after chemotherapy for colorectal cancer were included in the final analysis which randomized into an acupuncture group(25 cases) and a control group(26 cases).The patients of the two groups took regular chemotherapy.In the acupuncture group patients were treated with and chemotherapy.The acupuncture treatment was performed at day 1 before chemotherapy and from day 1 to day 3 of chemotherapy separately,once daily,30 min each time,for two courses(eight treatments) in total.The primary outcome was Piper fatigue scale(PFS),and the secondary efficacy index was TCM syndrome score and TNF-α content.Assessments were performed before the first course of chemotherapy after randomization,after the end of the second course of chemotherapy,and 2 weeks after the second course of chemotherapy.Results:Regarding the Piper fatigue score,as the number of acupuncture and moxibustion interventions increased,the Piper fatigue scores of the patients in the acupuncture group gradually decreased(F=67.425,P<0.001),suggesting that the degree of cancer-related fatigue in the acupuncture group improved over time.Compared with the control group,the Piper fatigue score in the acupuncture group decreased significantly(F=6.706,P=0.013),indicating that the fatigue level of patients in the acupuncture group had significantly improved better than patients in the control group.Regarding the TCM syndrome score,the effective rates of the acupuncture group and the control group were 68% and 34.6%,respectively,and the effective rates of the acupuncture group were significantly increased(χ^(2)=5.68,P=0.017).Among them,the single symptoms of "fatigue"(χ^(2)=14.41,P<0.001),"mental fatigue"(χ^(2)=7.06,P<0.008) in the acu

关 键 词：气海 关元 足三里 针灸 癌因性疲乏 对照研究 

分 类 号：R735.35[医药卫生—肿瘤]