中药穴位贴敷治疗癌因性疲乏临床研究
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R730.9

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浙江省中医药科技计划项目(2019ZB105)


Clinical Study on Point Application with Chinese Herbal Medicine for Cancer Related Fatigue
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    摘要:

    目的:观察中药穴位贴敷治疗癌因性疲乏(CRF) 的临床疗效。方法:将120 例CRF 患者按随机数字表法分为对照组和观察组各60 例,对照组给予常规护理和对症治疗,观察组在对照组治疗基础上给予中药穴位贴敷治疗。治疗2 周和4 周后,评价临床疗效和不良反应,比较Piper 疲乏修订量表(PFS-R) 评分和生活质量评分,采用酶联免疫吸附实验(ELISA) 检测血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1) 及干扰素-γ(IFN-γ) 水平,采用化学发光免疫法检测促肾上腺皮质激素(ACTH) 和皮质醇(C) 水平,电化学发光法检测肾上腺素(AD) 水平。结果:治疗2 周,观察组总有效率为81.67%,高于对照组63.33%(P<0.05)。治疗4 周,观察组总有效率为95.00%,高于对照组71.67%(P<0.05)。且观察组治疗4 周后总有效率高于治疗2 周(P<0.05)。治疗2 周和4 周后,2 组行为、情感、感觉、认知及情绪评分逐渐降低(P<0.05),组内比较,差异均有统计学意义(P<0.05);且观察组各项评分均低于同时间点对照组(P<0.05)。治疗2 周和4 周后,2 组躯体、角色、认知、情绪及社会功能评分逐渐升高(P<0.05),组内比较,差异均有统计学意义(P<0.05);且观察组躯体、角色、认知、情绪及社会功能评分显著高于同时间点对照组(P<0.05)。治疗2 周和4 周后,2 组血清IL-6、TNF-α、IL-1 及IFN-γ 水平逐渐降低(P<0.05),组内比较,差异均有统计学意义(P<0.05);且观察组血清IL-6、TNF-α、IL-1 及IFN-γ 水平均低于同期对照组(P<0.05)。治疗2 周和4 周后,2 组ACTH 和AD 逐渐降低,C 水平逐渐升高(P<0.05),组内比较,差异均有统计学意义(P<0.05);且观察组ACTH 和AD 水平低于同时间点对照组,而C 水平高于同时间点对照组(P<0.05)。观察组不良反应发生率为26.67%,对照组为28.33%,2 组比较,差异无统计学意义(χ2=164,P=0.685)。结论:中医穴位贴敷对CRF 具有较好的临床疗效,可显著改善细胞因子和神经内分泌激素水平,且安全性较高。

    Abstract:

    Abstract:Objective:To observe the clinical effect of point application with Chinese herbal medicine for cancer related fatigue(CRF). Methods:A total of 120 cases of CRF patients were divided into the control group and the observation group according to the random number table method, 60 cases in each group. The control group was given routine nursing and symptomatic treatment, and the observation group was additionally given point application with Chinese herbal medicine based on the treatment of the control group. After two weeks and four weeks of treatment,the clinical effect and adverse reactions were evaluated; the scores of Revised Piper Fatigue Scale(PFS- R) and Quality of Life were compared; the enzyme-linked immunosorbent assay(ELISA) method was applied to detect the levels of interleukin-6(IL-6),tumor necrosis factor- α(TNF- α), interleukin- 1(IL- 1) and interferon- γ(IFN- γ) in serum; chemiluminescence immunoassay was used to detect the levels of adrenocorticotropic hormone(ACTH) and cortisol(C);electrochemiluminescence immunoassay was used for detection of the level of adrenaline(AD). Results:After two-week treatment,the total effective rate was 81.67% in the observation group,higher than that of 63.33% in the control group(P<0.05). After four-week treatment,the total effective rate was 95.00% in the observation group, higher than that of 71.67% in the control group(P<0.05). In the observation group,the total effective rate after four-week treatment was higher than that after two-week treatment(P<0.05). After two weeks and four weeks of treatment,the scores of behavior,affection,sensory,cognition,and mood in both groups were gradually decreased(P<0.05), the differences within the group were statistically significant(P<0.05); each score in the observation group was lower than that in the control group at the same time point(P<0.05). After two weeks and four weeks of treatment,the scores of body,role,cognition,mood and social skills in the two groups were gradually increased(P< 0.05),the differences within the group were statistically significant(P<0.05);the above five scores in the observation group were significantly higher than those in the control group at the same time point(P<0.05). After two weeks and four weeks of treatment,the levels of IL-6,TNF-α,IL-1 and IFN-γ in serum in the two groups were gradually decreased(P<0.05),the differences within the group were statistically significant(P<0.05);the above four levels in serum in the observation group were all lower than those in the control group in the same period(P<0.05). After two weeks and four weeks of treatment,the levels of ACTH and AD in the two groups were gradually decreased,and the levels of C were gradually increased(P<0.05); the differences within the group were statistically significant(P<0.05);the levels of ACTH and AD in the observation group were lower than those in the control group at the same time point, and the level of C was higher, differences being significant(P<0.05). The incidence of adverse reactions was 26.67% in the observation group, and 28.33% in the control group, there was no significance in the difference(χ2=164, P=0.685). Conclusion: Point application with Chinese herbal medicine has good clinical effect on CRF,which can significantly improve the levels of cytokine and endocrine hormone in nerve,with high safety.

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郑香琴,王苗,袁亚芬,杨洁青,郑晓真.中药穴位贴敷治疗癌因性疲乏临床研究[J].新中医,2020,52(13):113-118

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  • 在线发布日期: 2020-07-10
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