灵龟八法开穴法联合腕踝针对ⅢB、Ⅳ期非小细胞肺癌患者化疗所致恶心呕吐的影响  

Effects of eight methods of sacred tortoise combined with wrist-ankle acupuncture on chemotherapy-induced nausea and vomiting in patients with stageⅢB andⅣnon-small cell lung carcinoma

作　　者：刘玮[1] 段茜 刘亚萍 刘丽娜[1] 龙麟 陈丽娟 肖军 孙炜[2] LIU Wei;DUAN Xi;LIU Yaping;LIU Li'na;LONG Lin;CHEN Lijuan;XIAO Jun;SUN Wei(Cancer Center,Qingdao Hiser Hospital of Qingdao University(Qingdao Hospital of Traditional Chinese Medicine),Qingdao,Shandong 266000,China;Acupuncture&Tuina Rehabilitation Center,Qingdao Hiser Hospital of Qingdao University(Qingdao Hospital of Traditioal Chinese Medicine),Qingdao,Shandong 266000,China)

机构地区：[1]青岛大学附属青岛市海慈医院(青岛市中医医院)肿瘤中心,山东青岛266000 [2]青岛大学附属青岛市海慈医院(青岛市中医医院)针推康复中心,山东青岛266000

出　　处：《湖南中医药大学学报》2024年第11期2078-2084,共7页Journal of Hunan University of Chinese Medicine

基　　金：山东省中医药科技项目(2020Q075);青岛市医药卫生科研计划项目(WJZD047)。

摘　　要：目的探究灵龟八法开穴法联合腕踝针对ⅢB、Ⅳ期非小细胞肺癌(non-small cell lung carcinoma,NSCLC)患者化疗所致恶心呕吐(chemotherapy-induced nausea and vomiting,CINV)的影响。方法选取2021年10月至2022年12月于青岛市中医医院就诊的190例ⅢB、Ⅳ期NSCLC患者为研究对象,按照随机数字表法分为观察组和对照组,每组95例。通过倾向性评分匹配后,两组分别纳入40例。比较两组患者化疗后第1、4天CINV发生情况以及化疗前后生活质量得分情况;对比分析两组患者化疗前及化疗后第1、3、5天的胃动素(motilin,MTL)、胃泌素(gastrin,GAS)、血管活性肽(vasoactive intestinal peptide,VIP)水平变化;采用广义估计方程评价两组患者治疗前后胃肠激素水平变化情况。结果化疗后第1天,两组患者在恶心呕吐发生率、恶心严重程度和呕吐次数方面差异均无统计学意义(P>0.05);化疗后第4天,观察组患者的恶心呕吐发生率、恶心严重程度和呕吐次数均低于对照组(P<0.05)。化疗前,两组患者在各项生活质量评分方面差异无统计学意义(P>0.05);化疗后,观察组患者在生理状态、躯体活动、情感状况、肺癌相关症状以及总分方面均高于对照组(P<0.05)。化疗前和化疗后第1天,两组患者MTL、GAS、VIP水平差异均无统计学意义(P>0.05);化疗后第3、5天,观察组MTL水平高于对照组、VIP水平低于对照组(P<0.05);化疗后第3天,观察组GAS水平低于对照组(P<0.05)。两组患者治疗前后MTL、GAS及VIP水平变化差异均具有统计学意义(P<0.05)。结论灵龟八法开穴法联合腕踝针对ⅢB、Ⅳ期NSCLC患者CINV具有较好的治疗效果,且能够升高MTL水平、降低GAS和VIP水平以调节胃肠激素平衡,在癌症疾病治疗中有重要意义。Objective To investigate the effects of eight methods of sacred tortoise(an acupoint-selecting method according to time)combined with wrist-ankle acupuncture on chemotherapy-induced nausea and vomiting(CINV)in patients with stageⅢB andⅣnon-small cell lung carcinoma(NSCLC).Methods A total of 190 patients with stageⅢB andⅣNSCLC who were admitted to Qingdao Hospital of Traditional Chinese Medicine from October 2021 to December 2022 were selected as the study subjects,and were divided into the observation group and control group according to the random number table method,with 95 cases in each group.After the propensity score matching,40 cases were included in each group.The occurrence of CINV on the 1st and 4th days after chemotherapy,as well as the quality of life scores before and after chemotherapy between the two patient groups were compared;a comparative analysis of changes in motilin(MTL),gastrin(GAS),and vasoactive intestinal peptide(VIP)levels before and on the 1st,3rd,and 5th days after chemotherapy between the two groups were conducted;the generalized estimating equation was used to evaluate the changes of gastrointestinal hormone levels in the two groups before and after treatment.Results On the 1st day after chemotherapy,there were no statistically significant differences in the incidence,severity and frequency of nausea and vomiting between the two groups(P>0.05);on the 4th day after chemotherapy,the incidence,severity and frequency of nausea and vomiting in the observation group were lower than those in the control group(P<0.05).Before chemotherapy,there were no statistically significant differences in quality of life scores between the two groups(P>0.05);after chemotherapy,the observation group scored higher than the control group in physical condition,physical activity,emotional status,lung cancer-related symptoms,and total score(P<0.05).There were no statistically significant differences in the levels of MTL,GAS,and VIP between the two groups before chemotherapy and on the 1st day after chem

关 键 词：灵龟八法开穴法 腕踝针 非小细胞肺癌 恶心呕吐 胃动素 胃泌素 生活质量 

分 类 号：R246[医药卫生—针灸推拿学]