不同灸法对胃肠道肿瘤化疗患者癌因性疲乏的影响

朱小燕; 胡颖颖

doi:10.16766/j.cnki.issn.1674-4152.003564

不同灸法对胃肠道肿瘤化疗患者癌因性疲乏的影响

doi: 10.16766/j.cnki.issn.1674-4152.003564

朱小燕^,,
胡颖颖

浙江中医药大学附属金华中医院肿瘤科，浙江金华 310017

基金项目:

浙江省中医药科技计划项目 2020ZB283

详细信息

通讯作者:
朱小燕，E-mail：crb740925@163.com

中图分类号: R735 R245.8
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出版历程
- 收稿日期: 2023-09-01
- 网络出版日期: 2024-07-22

Effects of different moxibustion methods on cancer-related fatigue in patients with gastrointestinal cancer undergoing chemotherapy

ZHU Xiaoyan^,,
HU Yingying

Department of Oncology, Jinhua Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine, Jinhua, Zhejiang 310017, China

摘要

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。
- 艾灸 /
- 胃肠道肿瘤 /
- 灸温 /
- 癌因性疲乏 /
- 生活质量
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.
- Moxibustion /
- Gastrointestinal tumor /
- Moxibustion warming /
- Cancer-related fatigue /
- Quality of life

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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(%)]
组别	例数	男性	女性	年龄 (x±s，岁)	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		0.519^a		0.260^b	1.472^a		0.568^a
P值		0.771		0.772	0.479		0.573
注：^a为χ²值，^b为F值。

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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
组别	例数	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±1.13^ab	19.75±2.64	17.26±2.62^ab	6.77±0.53	5.68±0.81^ab	31.57±2.52	27.76±2.63^ab
灸温组	36	7.22±1.28	5.19±1.18^abc	20.12±2.87	15.68±2.83^abc	6.67±0.73	4.69±0.72^abc	31.73±2.67	24.79±2.82^abc
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。

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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
组别	例数	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±4.52^ab	49.25±3.21	54.62±4.61^ab	61.27±4.62	65.24±4.63^ab	68.96±4.36	72.63±4.75^ab	47.56±4.62	51.62±4.27^ab
灸温组	36	57.22±1.28	63.62±4.72^abc	48.82±3.57	56.93±4.41^abc	61.58±4.87	68.96±4.88^abc	68.91±4.69	75.25±4.82^abc	47.62±4.73	54.62±4.72^abc
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
组别	例数	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±4.59^ab	48.96±3.76	46.52±3.68^ab	10.28±1.73	8.91±1.46^ab	29.71±2.69	27.63±2.56^ab	18.92±2.63	17.25±2.73^ab
灸温组	36	51.57±4.74	65.25±4.63^abc	49.21±3.62	43.61±3.65^abc	10.72±1.46	7.65±1.72^abc	29.84±2.68	26.29±1.47^abc	19.22±2.68	15.96±2.87^abc
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
组别	例数	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±2.47^ab	27.83±2.69	25.63±2.52^ab	20.96±2.25	19.25±2.61^ab	11.25±1.68	9.27±1.78^ab	55.62±4.56	53.56±4.78^ab
灸温组	36	38.76±2.62	33.68±2.69^abc	27.52±2.58	23.68±2.7^abc	21.15±2.63	17.73±2.67^abc	10.97±1.46	7.85±1.89^abc	55.25±4.63	51.69±4.25^abc
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。

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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)
组别	例数	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±1.63^ab	133.64±27.67	141.96±27.85^ab
灸温组	36	4.78±1.57	4.81±1.68	4.23±0.26	5.65±0.74^ab	132.87±25.85	149.75±26.89^ab
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。

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