热敏灸辅助姑息治疗提高老年恶性肿瘤患者生存质量:随机对照试验  

Heat-sensitive moxibustion assisted in palliative treatment to improve the quality of life in elderly patients with malignant tumor: a randomized controlled trial

作　　者：余婷[1] 柳华伟 刘祖琴 陈日新[4] 谢丁一[5] YU Ting;LIU Huawei;LIU Zuqin;CHEN Rixin;XIE Dingyi(Department of TCM,Second Affiliated Hospital of Nanchang University,Nanchang 330006,Jiangxi Province,China;First Department of Internal Medicine,Bo'xing County Hospital of TCM;Department of Moxibustion,Bo'xing County Hospital of TCM;College of Acupuncture-Moxibustion and Tuina,Jiangxi University of CM;Administration Office of Heat-Sensitive Moxibustion,Affiliated Hospital of Jiangxi University of CM,Nanchang330025)

机构地区：[1]南昌大学第二附属医院中医科,江西南昌330006 [2]博兴县中医医院内一科 [3]博兴县中医医院灸疗科 [4]江西中医药大学针灸推拿学院 [5]江西中医药大学附属医院热敏灸项目管理办公室,南昌330025

出　　处：《中国针灸》2025年第2期167-172,共6页Chinese Acupuncture & Moxibustion

基　　金：国家重点基础研究发展计划(973)项目:2015CB554503;江西省重大科技研发专项:20232ACG01006;江西省临床医学研究中心;江西省热敏灸临床医学研究中心;江西中医药大学校级科技创新团队发展计划项目:CXTD22010;江西省2022年度研究生创新专项项目:YC2022-B190;山东省中医药科技项目:Q-2022044。

摘　　要：目的:在姑息治疗基础上,观察热敏灸对老年恶性肿瘤患者生存质量的影响。方法:将100例老年恶性肿瘤患者随机分为观察组(50例,脱落3例)与对照组(50例,脱落4例)。对照组进行常规姑息治疗;观察组在常规姑息治疗的基础上加用热敏灸治疗,穴取神阙、中脘,每天1次,每周5次,2周为一疗程,连续治疗2个疗程。观察组中15例患者自愿继续坚持热敏灸治疗,作为观察组1,每周3次,共6个月。采用倾向性评分匹配法,从观察组中选取15例只完成2个疗程的患者作为观察组2。比较观察组和对照组患者治疗前后欧洲癌症研究和治疗组织核心生活质量问卷(EORTCQLQ-C30)评分、卡氏功能状态量表(KPS)评分、厌食/恶液质量表-12(A/CS-12)评分、免疫指标[血清免疫球蛋白(Ig)G、IgA、IgM及补体C3、C4含量];统计观察组1和观察组2治疗后6个月每月存活人数;分析观察组患者治疗前热敏灸灸感得气量表评分与EORTCQLQ-C30评分变化值的相关性。结果:治疗后,观察组除经济困难评分外EORTC QLQ-C30各项评分较治疗前升高(P<0.05),对照组总体健康情况、恶心呕吐、疼痛、气促、便秘、腹泻评分较治疗前升高(P<0.05);除经济困难评分外,观察组各项评分均高于对照组(P<0.05)。治疗后,观察组KPS评分较治疗前升高(P<0.05),且高于对照组(P<0.05)。治疗后,两组患者A/CS-12评分均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,观察组血清IgG、IgA、IgM及补体C3、C4含量较治疗前升高(P<0.05),对照组血清IgG、C3、C4含量较治疗前降低(P<0.05);观察组血清IgG、IgA、IgM及补体C3、C4含量均高于对照组(P<0.05)。观察组1治疗后6个月存活率高于观察组2(P<0.05)。观察组热敏灸灸感得气量表评分与EORTC QLQ-C30评分变化值呈正相关关系(r>0,P<0.001)。结论:在姑息治疗基础上,热敏灸可提高老年恶性肿瘤患者生存质量,改善食欲,增强免疫力,长期�Objective To observe the effect of heat-sensitive moxibustion on the quality of life in the elderly patients with malignant tumor based on palliative treatment.Methods A total of 100 elderly patients with malignant tumor were randomly divided into an observation group(50 cases,3 cases dropped out)and a control group(50 cases,4 cases dropped out).The conventional palliative treatment was performed in the control group.On the basis of conventional palliative treatment,heat-sensitive moxibustion was added at Shenque(CV8)and Zhongwan(CV12)in the observation group,once a day,5 times a week,one course of treatment was composed of 2 weeks,and 2 consecutive courses of treatment were given.In the observation group,15 patients voluntarily continued heat-sensitive moxibustion treatment,which was collected in the sub-observation group No.1,these patients were treated 3 times a week and for 6 months consecutively.Using the propensity score matching method,15 patients who only completed 2 courses of treatment were assigned into the sub-observation group No.2.Before and after treatment,the scores of European Organization for Research and Treatment of Cancer quality of life questionnaire(EORTC QLQ-C30),the Karnofsky performance status(KPS),and the anorexia/cachexia subscale-12(A/CS-12),as well as the immune indexes(the contents of serum immune globulin[Ig]G,IgA,IgM and complements C3 and C4)were observed in the patients of the observation group and the control group.The monthly survivals were recorded in the two sub-observation groups after 6 months of treatment completion.The coordination was analyzed on the score of deqi scale of heat-sensitive moxibustion at the probing stage before treatment and the change in the score of EORTC QLQ-C30 before and after treatment in the patients of the observation group.Results After treatment,except the score related to the financial difficulties,the score of every items in EORTC QLQ-C30 was greater than that before treatment in the observation group(P<0.05);the scores for overall health,nau

关 键 词：恶性肿瘤 老年 热敏灸 姑息治疗 生存质量 免疫功能 

分 类 号：R246.5[医药卫生—针灸推拿学]