中医综合治疗对肺癌治疗相关癌性疲乏的影响

目的采用简易疲乏量表中国版(BFI-C)、肺癌症状分级量化表评测中医综合治疗对肺癌治疗相关癌性疲乏的影响。方法使用前瞻、随机、对照的成组设计研究,将2015年4月—2018年12月在上海市长宁区天山中医医院肿瘤科住院的125例肺癌经手术、化疗、放疗后出现治疗相关癌性疲乏肺脾气虚证患者随机分为2组,对照组给予复方苦参注射液联合参麦注射液静滴,试验组在对照组治疗基础上联合中医适宜技术(耳穴、敷贴、隔姜灸)治疗,2组干预措施均以10d为1次,每月干预1次,共干预2次。分别于第1次干预前、第2次干预前、第2次干预后20d对2组患者进行BFI-C和肺癌症状分级量化表评测,比较2组肺癌不同治疗方式患者各项评分;观察2组患者干预前及第2次干预后血白细胞计数、中性粒细胞绝对值变化,统计2组干预2次后症状疗效。结果2组中肺癌不同治疗方式患者BFI-C中疲乏程度均分、疲乏影响均分经混合效应模型分析显示组别与时间交互作用均有统计学意义(P均<0.001);试验组手术患者疲乏程度均分、放疗患者疲乏影响均分在第2次干预前与对照组第1次干预前比较差异均无统计学意义(P>0.05),第2次干预后第20天均明显低于对照组第1次干预前(P均<0.05);试验组化疗患者第2次干预前和第2次干预后第20天疲乏程度均分、疲乏影响均分均明显低于对照组第1次干预前(P均<0.05)。2组中手术患者中医症状积分经混合效应模型分析显示组别与时间交互项无统计学意义(P>0.05),化疗、放疗患者组别与时间交互项均有统计学意义(P均<0.05);试验组化疗患者第2次干预前、第2次干预后第20天中医症状积分均较对照组第1次干预前明显降低(P均<0.05);试验组放疗患者第2次干预前中医症状积分与对照组第1次干预前比较差异无统计学意义(P>0.05),第2次干预后第20天较对照组第1次干预前明显降低(P<0.05)。干预后2组白细胞计数、中性粒细胞绝对值比较差异均无统计学意义(P均>0.05)。试验组症状显效率明显高于对照组(P<0.05)。结论中医综合治疗暨中医适宜技术可改善肺癌治疗相关癌性疲乏症状,提高患者生活质量。

Influence of comprehensive treatment of traditional Chinese medicine on cancer-related fatigue related to lung cancer treatment

Objective It is to evaluate the effect of Traditional Chinese Medicine(TCM)comprehensive treatment on lung cancer treatment-related cancer fatigue by the Brief fatigue inventory-Chinese version(BFI-C)and the Lung Cancer Symptom Grading Quantitative Scale.Methods According to a prospective,randomized,controlled grouping method,125 patients with treatment-related cancer fatigue of type of lung and spleen Qi deficiency after surgery,chemotherapy and radiotherapy for lung cancer who were hospitalized in the Department of Oncology,Changning District Tianshan Hospital of Traditional Chinese Medicine from April 2015 to December 2018 were randomly divided into two groups.The control group was given compound Kushen injection combined with Shenmai injection by intravenous drip,and the experimental group was treated with appropriate TCM therapy(auricular acupuncture,application,ginger-partitioned moxibustion)on the basis of the treatment of the control group.10 days as one intervention,one intervention per month,2 interventions in total.Before the first intervention and the second intervention,and 20 days after the second intervention,the patients in the two groups were evaluated by BFI-C and the Quantitative Scale of Lung Cancer Symptom Grading,and the scores of the patients in the two groups treated with different treatment methods were compared.The changes of blood white blood cell count and absolute value of neutrophils before the intervention and after the second intervention were compared,and the symptomatic efficacy of the two groups after the second intervention was evaluated.Results In the two groups,the average score of fatigue degree and the average score of fatigue effect in BFI-C of patients treated with different treatment methods of lung cancer showed that the interaction between group and time was statistically significant according to mixed effects model analysis(P<0.001).There was no significant difference in the average score of fatigue degree and the average score of fatigue impact of radiotherapy patients before the second intervention in the experimental group and that in the control group before the first intervention(all P>0.05),but that on the 20th day after the second intervention were significantly lower than those of the control group before the first intervention(P<0.05);before the second intervention and on the 20th day after the second intervention,the average scores of fatigue degree and the effect of fatigue in the experimental group were significantly lower than those in the control group before the first intervention(all P<0.05).In the two groups,the TCM symptom scores of surgical patients were analyzed by mixed effects model,and the interaction item between group and time was not statistically significant(P>0.05),the interaction items between chemotherapy and radiotherapy patient group and time were statistically significant(all P<0.05);before the second intervention and on the 20th day after the second intervention in the experimental group,the TCM symptom scores were significantly lower than those in the control group before the first intervention(P<0.05);there was no significant difference in TCM symptom scores in the experimental group before the second intervention and the control group before the first intervention(P>0.05),and the 20th day after the second intervention was significantly lower than that in the control group before the first intervention(P<0.05).There was no significant difference in the white blood cell count and absolute value of neutrophils between the two groups after intervention(all P>0.05).The symptom marked rate in the experimental group was significantly higher than that in the control group(P<0.05).Conclusion Comprehensive treatment of TCM and TCM’s suitable technique can improve the symptoms of cancer-related fatigue related to lung cancer treatment and improve the quality of life of patients.