Effects of different moxibustion methods on cancer-related fatigue in patients with gastrointestinal cancer undergoing chemotherapy
-
摘要:
目的 比较不同艾灸方法对胃肠道肿瘤患者化疗中癌因性疲乏的影响,为提高胃肠道肿瘤辅助治疗效果提供依据。 方法 选取2021年1月—2023年4月在浙江中医药大学附属金华中医院行术后化疗的胃肠道恶性肿瘤患者108例,根据随机数字表法分为常规组、传统组和灸温组各36例。比较3组干预前后癌症疲乏程度、生活质量及血常规。 结果 干预后,传统组和温灸组癌因性疲乏量表各维度(情感、躯体、认知)评分及量表总分均明显低于常规组(P<0.05);干预后,传统组QLQ-C30量表各评分(身体、角色、情感、认知、社会、整体生活质量、疲乏感、恶心呕吐、疼痛、呼吸困难、睡眠障碍、食欲减退、便秘、腹泻、经济困难感知)均明显优于常规组,且灸温组均明显优于传统组(P<0.05);干预后,传统组红细胞和血小板计数分别为(4.98±1.63)×1012/L、(141.96±27.85)×109/L,灸温组分别为(5.65±0.74)×1012/L、(149.75±26.89)×109/L,均明显高于常规组的(4.15±1.52)×1012/L、(133.76±25.77)×109/L(F=4.255、8.175,均P<0.05)。 结论 艾灸法能有效缓解胃肠道肿瘤患者化疗期间癌因性疲乏症状,改善血常规水平,提高生活质量,灸温在41~42 ℃更有利于提高艾灸疗效。 Abstract:Objective To compare the effects of different moxibustion methods on cancer-induced fatigue in patients with gastrointestinal tumors during chemotherapy, and provide evidence for improving the efficacy of adjuvant therapy for gastrointestinal tumors. Methods A total of 108 patients with gastrointestinal malignancies who received postoperative chemotherapy in Jinhua Traditional Chinese Medicine Hospital from January 2021 to April 2023 were selected and randomly divided into the conventional group, the traditional group, and the moxibustion warm group with 36 cases in each group according to random number table method. Cancer fatigue degree, quality of life, and blood routine were compared before and after intervention. Results After the intervention, the scores of all dimensions (emotional, physical, and cognitive) and the total score of the cancer fatigue scale in the traditional group and the warm moxibustion group were significantly lower than those in the conventional group (P < 0.05). After the intervention, all QLQ-C30 scales (physical, role, emotional, cognitive, social, overall quality of life, fatigue, nausea and vomiting, pain, dyspnea, sleep disorders, appetite loss, constipation, diarrhea, and perceived economic hardship) in the traditional group were significantly better than those in the conventional group, and the scores in the moxibustion warm group were significantly better than those in the traditional group (P < 0.05). After the intervention, red blood cell count and platelet count were (4.98±1.63) ×1012/L and (141.96±27.85) ×109/L in the traditional group, and (5.65±0.74) ×1012/L and (149.75±26.89) ×109/L in moxibustion warm group, respectively, which were significantly higher than those in the conventional group (4.15±1.52) ×1012/L and (133.76±25.77) ×109/L (F= 4.255, 8.175, both P < 0.05). Conclusion Moxibustion can effectively relieve the symptoms of cancer-related fatigue in patients with gastrointestinal tumors during chemotherapy, and improve the level of blood routine and their quality of life. Moxibustion applied at 41-42 ℃ is more conducive to improving the efficacy of moxibustion. -
Key words:
- Moxibustion /
- Gastrointestinal tumor /
- Moxibustion warming /
- Cancer-related fatigue /
- Quality of life
-
表 1 3组胃肠道恶性肿瘤患者临床资料比较
Table 1. Comparison of clinical data of patients with gastrointestinal malignancy in three groups
组别 例数 性别[例(%)] 年龄
(x±s,岁)肿瘤类型[例(%)] 临床分期[例(%)] 男性 女性 胃癌 结直肠癌 Ⅰ~Ⅱ期 Ⅲ~Ⅳ期 常规组 36 17(47.22) 19(52.78) 65.56±3.79 13(36.11) 23(63.89) 11(30.56) 25(69.44) 传统组 36 20(55.56) 16(44.44) 65.89±3.82 15(41.67) 21(58.33) 13(36.11) 23(63.89) 灸温组 36 19(52.78) 17(47.22) 66.21±3.87 17(47.22) 19(52.78) 14(38.89) 22(61.11) 统计量 0.519a 0.260b 1.472a 0.568a P值 0.771 0.772 0.479 0.573 注:a为χ2值,b为F值。 表 2 3组胃肠道恶性肿瘤患者干预前后癌症疲乏量表评分比较(x±s,分)
Table 2. Comparison of cancer fatigue scale scores of patients with gastrointestinal malignancies in three groups before and after intervention(x±s, points)
组别 例数 情感维度 躯体维度 认知维度 癌症疲乏量表总分 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 常规组 36 7.12±1.25 7.05±1.32 19.57±2.51 18.92±2.79 6.83±0.92 6.76±0.28 31.69±2.58 31.26±2.62 传统组 36 7.18±1.27 6.25±1.13ab 19.75±2.64 17.26±2.62ab 6.77±0.53 5.68±0.81ab 31.57±2.52 27.76±2.63ab 灸温组 36 7.22±1.28 5.19±1.18abc 20.12±2.87 15.68±2.83abc 6.67±0.73 4.69±0.72abc 31.73±2.67 24.79±2.82abc F值 0.057 1.242 0.395 8.144 0.425 11.576 0.037 14.131 P值 0.945 0.006 0.675 0.041 0.655 <0.001 0.964 0.011 注:与同组治疗前比较,aP<0.05;与同期常规组比较,bP<0.05;与同期传统组比较,cP<0.05。 表 3 3组胃肠道恶性肿瘤患者干预前后QLQ-C30量表评分比较(x±s,分)
Table 3. Comparison of QLQ-C30 scale scores in three groups of patients with gastrointestinal malignancies before and after intervention(x±s, points)
组别 例数 身体功能 角色功能 情绪功能 认知功能 社会功能 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 常规组 36 57.67±3.63 58.25±3.43 48.91±3.51 49.17±3.28 61.23±4.52 61.86±4.65 69.22±4.53 70.13±4.63 47.63±3.52 48.18±4.73 传统组 36 57.46±3.31 61.63±4.52ab 49.25±3.21 54.62±4.61ab 61.27±4.62 65.24±4.63ab 68.96±4.36 72.63±4.75ab 47.56±4.62 51.62±4.27ab 灸温组 36 57.22±1.28 63.62±4.72abc 48.82±3.57 56.93±4.41abc 61.58±4.87 68.96±4.88abc 68.91±4.69 75.25±4.82abc 47.62±4.73 54.62±4.72abc F值 0.212 3.758 0.157 12.155 0.061 14.211 0.049 0.784 0.003 1.200 P值 0.809 0.009 0.855 0.033 0.941 0.758 0.953 <0.001 0.997 <0.001 组别 例数 整体生活质量 疲乏感 恶心呕吐 疼痛 呼吸困难 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 常规组 36 51.24±4.52 51.75±4.31 49.26±3.62 48.87±3.67 10.24±1.63 10.29±1.65 29.82±2.16 30.12±2.73 19.24±2.36 19.18±2.63 传统组 36 51.53±4.46 61.53±4.59ab 48.96±3.76 46.52±3.68ab 10.28±1.73 8.91±1.46ab 29.71±2.69 27.63±2.56ab 18.92±2.63 17.25±2.73ab 灸温组 36 51.57±4.74 65.25±4.63abc 49.21±3.62 43.61±3.65abc 10.72±1.46 7.65±1.72abc 29.84±2.68 26.29±1.47abc 19.22±2.68 15.96±2.87abc F值 0.056 5.177 0.069 8.446 0.985 4.155 0.028 0.994 0.176 3.216 P值 0.946 <0.001 0.933 0.027 0.377 <0.001 0.973 0.004 0.868 0.027 组别 例数 睡眠障碍 食欲减退 便秘 腹泻 经济困难感知 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 常规组 36 38.15±2.53 38.61±2.63 27.62±2.15 27.85±2.26 21.19±2.42 21.63±2.58 10.93±1.31 10.87±1.69 55.35±4.63 55.24±4.68 传统组 36 38.29±2.51 36.62±2.47ab 27.83±2.69 25.63±2.52ab 20.96±2.25 19.25±2.61ab 11.25±1.68 9.27±1.78ab 55.62±4.56 53.56±4.78ab 灸温组 36 38.76±2.62 33.68±2.69abc 27.52±2.58 23.68±2.7abc 21.15±2.63 17.73±2.67abc 10.97±1.46 7.85±1.89abc 55.25±4.63 51.69±4.25abc F值 0.564 6.547 0.146 8.342 0.091 15.244 0.492 0.698 0.062 3.691 P值 0.571 <0.001 0.864 <0.001 0.913 <0.001 0.613 0.007 0.940 <0.001 注:与同组治疗前比较,aP<0.05;与同期常规组比较,bP<0.05;与同期传统组比较,cP<0.05。 表 4 3组胃肠道恶性肿瘤患者干预前后血常规比较(x±s)
Table 4. Comparison of blood routine in three groups of patients with gastrointestinal malignancies before and after intervention(x±s)
组别 例数 白细胞计数(×109/L) 红细胞计数(×1012/L) 血小板计数(×109/L) 干预前 干预后 干预前 干预后 干预前 干预后 常规组 36 4.58±1.12 4.63±1.68 4.12±0.42 4.15±1.52 132.52±25.63 133.76±25.77 传统组 36 4.52±1.25 4.65±1.27 4.19±0.28 4.98±1.63ab 133.64±27.67 141.96±27.85ab 灸温组 36 4.78±1.57 4.81±1.68 4.23±0.26 5.65±0.74ab 132.87±25.85 149.75±26.89ab F值 0.379 0.547 1.038 4.255 0.017 8.175 P值 0.686 0.552 0.358 0.033 0.983 < 0.001 注:与同组治疗前比较,aP<0.05;与同期常规组比较,bP<0.05。 -
[1] 邱冬梅. 胃癌患者癌因性疲乏发生现状及影响因素[J]. 中国卫生工程学, 2019, 18(3): 381-383. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWX201903022.htmQIU D M. Occurrence and influencing factors of cancer-induced fatigue in patients with gastric cancer[J]. Chinese Journal of Public Health Engineering, 2019, 18(3): 381-383. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWX201903022.htm [2] 张剑军, 钱建新. 中国癌症相关性疲乏临床实践诊疗指南(2021年版)[J]. 中国癌症杂志, 2021, 31(9): 852-872. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202109015.htmZHAN J J, QIAN J X. Clinical Practice Guidelines for Cancerrelated Fatigue in China (2021 edition)[J]. China Oncology, 2021, 31(9): 852-872. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202109015.htm [3] FABI A, BHARGAVA R, FATIGONI S, et al. Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment[J]. Annals of Oncology, 2020, 31(6): 713-723. doi: 10.1016/j.annonc.2020.02.016 [4] 汪安宁. 针灸学[M]. 北京: 中国中医药出版社, 2018.WANG A N. Science of acupuncture and moxibustion[M]. Beijing: China press of traditional chinese medicine, 2018. [5] 肖斐. 不同灸温对老年膝骨关节炎的疗效影响[J]. 中国疗养医学, 2020, 29(11): 1170-1171. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGLX202011021.htmXIAO P. Effect of different moxibustion temperature on senile knee osteoar- thritis[J]. Chinese Journal of Convalescent Medicine, 2020, 29(11): 1170-1171. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGLX202011021.htm [6] 赵娜. 不同灸温对穴位局部皮肤线粒体呼吸链及SIRT1、SIRT3蛋白的影响[D]. 成都: 成都中医药大学, 2019.ZHAO N. Effects of different moxibustion temperatures on local skin mitochon- drial respiratory chain and SIRT1 and SIRT3 proteins at acupoints[D]. Chengdu: Chengdu University of Traditional Chinese Medicin, 2019. [7] 赵玲, 毛慧娟, 魏建子, 等. 癌性疲劳患者命门温度及与激光灸疗效的相关分析[J]. 长春中医药大学学报, 2020, 36(3): 495-499. https://www.cnki.com.cn/Article/CJFDTOTAL-CZXX202003027.htmZHAO L, MAO H J, WEI J Z, et al. Correlation analysis of vital gate temperature and therapeutic effect of laser moxibustion in patients with cancer fatigue[J]. Journal of Changchun University of Chinese Medicine, 2020, 36(3): 495-499. https://www.cnki.com.cn/Article/CJFDTOTAL-CZXX202003027.htm [8] 张凤玲, 丁玥, 韩丽沙. 癌症疲乏量表中文版的信效度[J]. 中国心理卫生杂志, 2011, 25(11): 810-813. doi: 10.3969/j.issn.1000-6729.2011.11.003ZHANG F L, DING Y, HAN L S. Reliability and validity of the Chinese version of the cancer Fatigue scale[J]. Chinese Mental Health Journal, 2011, 25(11): 810-813. doi: 10.3969/j.issn.1000-6729.2011.11.003 [9] KESSEL K A, VOGEL M M, ALLES A, et al. Mobile App delivery of the EORTC QLQ-C30 questionnaire to assess health-related quality of life in oncological patients: usability study[J]. JMIR Mhealth Uhealth, 2018, 6(2): e45. DOI: 10.2196/mhealth.9486. [10] 宋嘉婷, 黄绮华, 肖文莉, 等. 灸法防治肿瘤患者化疗不良反应的文献计量学分析[J]. 护理学报, 2021, 28(15): 20-24. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202115005.htmSONG J T, HUANG Q H, XIAO E L, et al. Bibliometric analysis of moxibustion for preventing and treating adverse reactions of chemotherapy in cancer patients[J]. Journal of Nursing, 2021, 28(15): 20-24. https://www.cnki.com.cn/Article/CJFDTOTAL-NFHL202115005.htm [11] 杨萍, 陆明. 乳腺癌癌因性疲乏的中西医研究进展[J]. 世界最新医学信息文摘, 2019, 19(31): 115-116. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201931075.htmYANG P, LU M. Research progress of traditional Chinese and Western medicine in breast cancer fatigue[J]. World Latest Medicine Information, 2019, 19(31): 115-116. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201931075.htm [12] 吴贤, 王海波, 娄朝胜, 等. 益胃扶正汤对气虚血瘀型胃癌前病变患者的疗效及其相关机理的研究[J]. 中华全科医学, 2021, 19(6): 1017-1021. doi: 10.16766/j.cnki.issn.1674-4152.001974WU X, WANG H B, LOU C S, et al. Study on the curative effect and related mechanism of Yiwei Fuzheng Decoction on patients with gastric cancer prelesion of Qi deficiency and blood stasis type[J]. Chinese Journal of General Practice, 2021, 19(6): 1017-1021. doi: 10.16766/j.cnki.issn.1674-4152.001974 [13] 唐敏芳, 陆云. 艾灸联合中药足浴对胃肠道肿瘤化疗患者癌因性疲乏的影响[J]. 中西医结合护理(中英文), 2018, 4(7): 63-66. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXHL201807016.htmTANG M F, LU Y. Effect of moxibustion combined with Chinese herbal foot bath on cancer-induced fatigue in patients with gastrointestinal tumors[J]. Nursing of Integrated Traditional Chinese and Western Medicine, 2018, 4(7): 63-66. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXHL201807016.htm [14] 杨恒, 卢幻真, 张妹宁, 等. 雷火灸对气虚证肺癌化疗病人疲乏及睡眠质量的影响[J]. 护理研究, 2021, 35(5): 892-896. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202105024.htmYANG H, LU H Z, ZHANG M N, et al. Effect of lightning moxibustion on fatigue and sleep quality of lung cancer patients with Qi deficiency syndrome undergoing chemotherapy[J]. Chinese Nursing Research, 2021, 35(5): 892-896. https://www.cnki.com.cn/Article/CJFDTOTAL-SXHZ202105024.htm [15] JI Y J, LI S Y, ZHANG X Y, et al. The efficacy of moxibustion for breast cancer patients with chemotherapy-induced myelosuppression during adjuvant chemotherapy: a randomized controlled study[J]. Evid Based Complement Alternat Med, 2021: 1347342. DOI: 10.1155/2021/1347342. [16] 黄彪. 不同温度艾灸对机体不同状态下穴位局部组织微透析液的影响[D]. 成都: 成都中医药大学, 2019.HUANG B. Influence of moxibustion at different temperatures on microdialysate of local tissue at different points in the body[D]. Chengdu: Chengdu University of Traditional Chinese Medicine, 2019. -
![WeChat](/fileZHQKYX/journal/article/zhqkyx/2024/6/WECHAT/wechat_cn_88880976-2345-4479-b431-a78e0cc7ad71.jpg)
计量
- 文章访问数: 28
- HTML全文浏览量: 17
- PDF下载量: 3
- 被引次数: 0