足三里穴位注射地塞米松在提高乳腺癌化疗耐受性中的应用效果

Application effect of the acupoint injection of dexamethasone at Zusanli on improving the tolerance of ;chemotherapy in the patients with breast cancer

目的：探讨预防性使用地塞米松足三里穴位注射对乳腺癌化疗后骨髓抑制程度及一系列不适症状的影响。方法将80例符合纳入标准的乳腺癌化疗患者按随机数字表法分为对照组与研究组各40例。对照组口服盐酸小檗胺片、利血生等药物，研究组在此基础上于化疗后第5天预防性使用地塞米松足三里穴位注射，5 mg/d，连续3 d。比较两组患者化疗后骨髓抑制程度，采用简明疲乏量表（ BFI）、食欲视觉类比量表（ VAS）比较两组疲乏及食欲情况。结果化疗后7 d研究组血常规WBC、NE、HB指标分别为（4．73±2．11）×10^9/L，（2．13±0．61）×10^9/L，（112．20±5．76）g/L，均优于对照组的（3．21±0．85）×10^9/L，（1．66±0．42）×10^9/L，（107．90±5．72）g/L，差异有统计学意义（t分别为4．212，4．026，3．349；P＜0．01）；研究组WBC计数在化疗后7 d呈上升趋势，后缓慢下降，下降程度小于对照组，两组发展趋势存在差异（F＝53．19，P＜0．05）；研究组在化疗后7 d疲乏程度和骨髓抑制程度均优于对照组，差异有统计学意义（ Z分别为-2．795，-3．307；P＜0．01）；两组患者化疗后食欲逐渐恢复正常，化疗后疲乏与骨髓抑制程度变化存在正相关（ r分别为0．656，0．682；P＜0．05）；患者骨髓抑制程度≥Ⅲ度时，研究组有6例、对照组有15例给予重组人体粒细胞集落刺激因子治疗，两组比较差异有统计学意义（χ2＝5．230，P＜0．05）。结论预防性使用地塞米松足三里穴位注射能减轻乳腺癌化疗后骨髓抑制程度及因此而造成的疲乏症状，从而提高乳腺癌化疗耐受性。

Objective To explore the effect of the preventive acupoint injection of dexamethasone at Zusanli on the degree of bone marrow suppression and a series of unwell symptoms in the patients with breast cancer after chemotherapy .Methods Eighty patients who met the inclusion criteria of the breast cancerafter chemotherapy were randomly divided into the control group and the observation group according to the random number table, each with 40 cases.The control group was taken oral medicine as Berbamine Hydrochloride Tablets and Leucogenum , and the observation group received the preventive acupoint injection of dexamethasone at Zusanli on the fifth days after chemotherapy , 5mg/d for 3d, on the basis of the control group .The degree of bone marrow suppression was compared , and the fatigue and appetite of patients were also evaluated by the brief fatigue scale（BFI） and visual analogue scale（VAS） in two groups.Results The levels of WBC, NE and HB in the observation group were respectively （4.73 ±2.11）×10^9/L, （2.13 ±0.61） ×10^9/L, （112.20 ±5.76）g/L on the seventh day after chemotherapy , and better than （3.21 ±0.85） ×10^9/L, （1.66 ±0.42） ×10^9/L, （107.90 ±5.72）g/L in the control group, and the differences were statistically significant （t=4.212, 4.026, 3.349, respectively;P＆lt;0.01）.The count of WBC was on the increase in the observation group on the seventh day after chemotherapy , and then decreased slowly , and the degree of decrease in the observation group was lower than that of control group , and the difference was found in the development trend between two groups （ F=53.19, P〈0.05）.The degree of fatigue and bone marrow suppression in the observation group on the seventh day after chemotherapy were better than those in the control group , and the differences were statistically significant （Z=-2.795, -3.307, respectively;P＆lt;0.01）.The appetite of patients in two groups gradually＆amp;nbsp;returned to normal , and there was a positive correlation the degree of fatigue and bone marrow suppression after chemotherapy （r =0.656, 0.682, respectively; P＆lt;0.05）.The cases of the more than Ⅲdegree of bone marrow suppression was 6 cases in the observation group , and 15 cases in the control groups , and these patients received the Recombinant human granulocyte colony-stimulating factor （rhG-CSF） treatment, and the difference was statistically significant （χ2 =5.230, P 〈0.05 ）.Conclusions The preventive acupoint injection of dexamethasone at Zusanli can reduce the degree of bone marrow suppression and the fatigue symptoms caused by bone marrow suppression after chemotherapy in the patients with breast cancer so as to improve their tolerance of chemotherapy .