培土固本灸治疗消化道恶性肿瘤化疗相关性癌因性疲乏的疗效观察

冷玉玲; 吴勇; 周先阳; 徐珩; 郝皖蓉; 丁艳琦; 曾永蕾; 夏克春

doi:10.16766/j.cnki.issn.1674-4152.002113

培土固本灸治疗消化道恶性肿瘤化疗相关性癌因性疲乏的疗效观察

doi: 10.16766/j.cnki.issn.1674-4152.002113

安徽中医药大学第二附属医院肿瘤科，安徽合肥 230031

基金项目:

安徽省十三五医疗卫生重点专科项目皖卫教研2017[30号]

安徽省自然基金面上资助项目 1608085MH233

详细信息

通讯作者:
曾永蕾, E-mail：547940326@qq.com

中图分类号: R245.81 R735
计量
- 文章访问数: 141
- HTML全文浏览量: 125
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2020-12-23
- 网络出版日期: 2022-02-15

Effect of Pei86tu Guben Moxibustion on chemotherapy-related cancer-related fatigue of gastrointestinal tumour

Oncology Department, the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, Anhui 230031, China

摘要

摘要: 目的观察培土固本灸治疗化疗相关性癌因性疲乏的临床疗效以及对促肾上腺皮质激素(adrenocorticotropic hormone，ACTH)、皮质醇激素(cortisol，Cor)水平的影响。方法选取2018年1月—2020年11月就诊于安徽中医药大学第二附属医院肿瘤科的中晚期消化道恶性肿瘤癌因性疲乏患者50例，按随机数字表法分成治疗组(25例)和对照组(25例)。2组均予以标准化疗方案进行化疗，在此基础上，治疗组给予培土固本灸治疗，1次/d，1周为1个疗程，连续治疗2个疗程。比较2组患者治疗前后癌因性疲乏程度及生活质量(EORTC-QLQ-C30)；比较2组治疗前后ACTH、Cor水平。结果治疗组治疗后轻度疲乏14例，中度疲乏8例，重度疲乏3例；对照组治疗后轻度疲乏2例，中度疲乏14例，重度疲乏9例；2组治疗后疲乏程度比较差异有统计学意义(Z=-3.435，P=0.001)。治疗后2组患者生活质量评分比较，躯体功能、角色功能及情绪功能治疗组改善优于对照组(均P < 0.05)；认知功能领域、社会功能领域无明显变化(均P>0.05)。治疗后治疗组Cor水平较对照组升高(P < 0.05)，ACTH水平较对照组降低(P < 0.05)。结论采用培土固本灸治疗化疗相关性癌因性疲乏可有效改善患者疲乏症状，提高生活质量评分，提高患者Cor水平，降低ACTH水平，Cor与ACTH水平变化可能与肿瘤治疗相关性的癌因性疲乏程度有一定联系。
- 培土固本灸 /
- 癌因性疲乏 /
- 生活质量 /
- 促肾上腺激素 /
- 皮质醇
Abstract: Objective To investigate the clinical effect of the Peitu Guben Moxibustion in the chemotherapy-related cancer-related fatigue and its effect on the levels of adrenocorticotropic hormone (ACTH) and cortisol hormone (COR). Methods Total 50 patients with cancer-related fatigue caused by gastrointestinal cancer who were admitted to the Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2018 to November 2020 were selected and divided into treatment group (25 cases) and control group (25 cases) according to random number table method. The two groups were treated with standard chemotherapy regimen. On this basis, the treatment group was treated with the Peitu Guben Moxibustion therapy regimen, once a day, once a week as a course of treatment, for two courses of continuous treatment. After the treatment, the change of cancer-related fatigue degree and quality of life (EORTC-QLQ-C30) before and after treatment were compared between two groups. The levels of ACTH and COR were compared between the two groups before and after treatment, and investigated the correlation with cancer-related fatigue. Results After treatment, the mild fatigue, medium fatigue and severe fatigue patients in the treatment group were respectively 14 cases, 8 cases and 3 cases; in the control group, the mild fatigue, medium fatigue and severe fatigue patients were respectively 2 cases, 14 cases and 9 cases. The difference between the two groups after treatment was statistically significant (Z=-3.435, P=0.001). After treatment, the improvement of physical function, role function and emotional function in the treatment group was better than that in the control group (all P < 0.05). There were no significant changes in cognitive function and social function (all P>0.05). After treatment, the COR level of treatment group was higher than that of control group (P < 0.05), while the ACTH level of treatment group was lower than that of control group (P < 0.05). Conclusion The Peitu Guben Moxibustion in the treatment of chemotherapy-related cancer-related fatigue can effectively improve the fatigue symptoms and improve the quality of life score of patients, and increase the level of COR and decrease the level of ACTH in patients. The changes of COR and ACTH levels may be related to the degree of cancer-related fatigue.
- Peitu Guben Moxibustion /
- Cancer-related fatigue /
- Quality of life /
- Adrenocorticotropic hormone /
- Cortisol

HTML全文

表 1 2组中晚期消化道恶性肿瘤CRF患者治疗前后疲乏状况比较(例)

组别	例数	轻度疲乏		中度疲乏		重度疲乏
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	25	6	14	14	8	5	3
对照组	25	8	2	13	14	4	9
注：2组治疗后疲乏状况比较，Z=-3.435，P=0.001。

下载: 导出CSV

表 2 2组中晚期消化道恶性肿瘤CRF患者治疗前后生活质量评分比较(x±s, 分)

组别	例数	躯体功能		角色功能		情绪功能		认知功能		社会功能
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	25	50.32±13.93	62.92±9.84^a	51.32±20.89	65.32±16.59^a	53.24±10.71	63.60±12.85^a	43.36±15.23	48.64±15.28	48.72±14.47	51.36±12.91
对照组	25	51.68±13.12	52.18±11.66	49.36±16.38	51.92±13.66	55.72±11.87	52.04±11.34	42.00±15.34	44.48±13.85	44.48±13.85	49.04±12.15
t值		0.355	3.487	0.369	3.119	0.776	3.372	0.315	1.009	0.986	0.362
P值		0.724	< 0.001	0.714	0.003	0.442	< 0.001	0.754	0.318	0.321	0.693
注：与治疗前比较，^aP < 0.05。

下载: 导出CSV

表 3 2组中晚期消化道恶性肿瘤CRF患者治疗前后Cor及ACTH比较(x±s)

组别	例数	Cor(nmol/L)		ACTH(pg/mL)
组别	例数	治疗前	治疗后	治疗前	治疗后
治疗组	25	45.14±6.27	75.68±4.99^a	77.32±5.48	58.20±6.61^a
对照组	25	44.92±5.08	47.32±6.32	75.88±5.26	72.72±7.82
t值		0.137	17.617	0.949	-7.089
P值		0.891	< 0.001	0.347	< 0.001
注：与治疗前比较，^aP < 0.05。

下载: 导出CSV

参考文献(19)

[1]	National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. cancer-relatedfatigue, 2019, version 2[EB/OL]. [2019-10-08]. https://www.nccn.org/professionals/physiciangls/pdf/fatigue.pdf.
[2]	王务萍, 林海燕, 钱媛媛, 等. 淋巴瘤化疗患者癌因性疲乏现状及影响因素分析[J]. 中华全科医学, 2019, 17(6): 1042-1045. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201906042.htm
[3]	钟紫外, 陆华东, 陆晨, 等. 共情式心理干预对自体DC/CIK细胞维持治疗肺腺癌患者癌因性疲乏、希望水平的影响[J]. 中华全科医学, 2018, 16(6): 1025-1028. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY201806048.htm
[4]	TARIMAN J D, DHORAJIWALA S. Genomic variants associated with cancer-related fatigue: A systematic review[J]. Clin J Oncol Nurs, 2016, 20(5): 537-546. doi: 10.1188/16.CJON.537-546
[5]	李晓霞, 王亚军. 针灸治疗癌因性疲乏特点分析[J]. 中医肿瘤学杂志, 2020, 2(2): 58-62. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYZL202002013.htm
[6]	杨丽惠, 胡凯文, 田桢, 等. 灸法治疗癌因性疲乏选穴规律分析[J]. 中医学报, 2019, 34(12): 2708-2712. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZK201912050.htm
[7]	AMIN M B, EDGE S B, GEENE F L, et al. AJCC cancer staging manual[M]. 8th ed. Chicago: Springer, 2017.
[8]	郑筱萸. 中药新药临床研究指导原则(试行)[M]. 北京: 中国医药科技出版社, 2002: 378-383.
[9]	NCCN. NCCN guidelines version 1.2018 cancer-related fatigue[EB/OL]. Fort Washington: NCCN, 2018. https://www.nccn.org/professionals/physician-gls/pdf.
[10]	谢晓冬, 张潇宇. 癌因性疲乏最新进展——NCCN(2018版)癌因性疲乏指南解读[J]. 中国肿瘤临床, 2018, 45(16): 817-820. doi: 10.3969/j.issn.1000-8179.2018.16.676
[11]	BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. doi: 10.3322/caac.21492
[12]	朱云峰, 王乐, 沈永洲, 等. 1977—2018年浙江省海宁市结直肠癌流行趋势分析[J]. 中国肿瘤, 2020, 29(11): 833-837. doi: 10.11735/j.issn.1004-0242.2020.11.A008
[13]	张娜, 于宏杰, 王英鉴, 等. 上海市嘉定区1996—2016年结直肠癌流行规律分析[J]. 复旦学报(医学版), 2020, 47(5): 707-714. doi: 10.3969/j.issn.1672-8467.2020.05.010
[14]	郑桃云, 龙清华, 徐波, 等. 王平从培调元气论治癌因性疲乏经验撷要[J]. 中华中医药杂志, 2018, 33(4): 1428-1431. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201804062.htm
[15]	栗琼洋. 结直肠癌患者癌因性疲乏的证候特征和相关因素分析[D]. 北京: 北京中医药大学, 2019.
[16]	孙春. 艾灸治疗癌因性疲乏的临床研究[D]. 合肥: 安徽中医药大学, 2018.
[17]	王静, 况时祥. 免疫系统与HPA轴相关性的研究进展[J]. 湖北中医药大学学报, 2017, 19(2): 110-114. doi: 10.3969/j.issn.1008-987x.2017.02.31
[18]	吴人杰, 谢长生. 癌因性疲乏发病机制及治疗的研究进展[J]. 肿瘤学杂志, 2020, 26(3): 240-244. https://www.cnki.com.cn/Article/CJFDTOTAL-XHON202003015.htm
[19]	司小敏, 张消, 焦婉, 等. 康复期结肠癌患者癌因性疲乏与血清内分泌激素水平的相关性[J]. 广西医学, 2020, 42(24): 3148-3150, 3155. https://www.cnki.com.cn/Article/CJFDTOTAL-GYYX202024004.htm