艾灸联合穴位敷贴法改善晚期大肠癌患者生活质量的临床观察

A clinical study of moxibustion combined with acupoint application for improving quality of life in patients with advanced colorectal cancer

目的:观察艾灸联合穴位敷贴法改善晚期大肠癌的患者生活质量的疗效及安全性,为晚期大肠癌患者提供安全、简便且有效的联合治疗方案。方法:将60例病理学诊断为晚期大肠癌的患者随机分为治疗组(最佳支持治疗+艾灸联合穴位敷贴法)和对照组(最佳支持治疗)各30例,均以7d为1个疗程,共治疗2个疗程。评估并比较两组患者治疗前后卡氏评分、生命质量核心量表评分、中医证候积分及不良反应发生情况。结果:两组卡式评分与中医证候积分治疗前后组间及组内比较,差异均有统计学意义(P<0.05,P<0.01)。两组治疗后生命质量核心量表评分比较,差异均有统计学意义(P<0.05);但治疗组治疗前后在改善认知功能、呼吸困难方面比较,差异均无统计学意义(P>0.05),其余方面比较,差异均有统计学意义(P<0.05,P<0.01)。各组患者均未出现较明显不能耐受的损害性改变,安全性较好。结论:艾灸联合穴位敷贴能有效改善晚期大肠癌患者生活质量,是一种值得进一步推广及研究的中医综合治疗晚期大肠癌的方案。

Objective: To observe the efficacy and safety of moxibustion combined with acupoint application for improving the quality of life in patients with advanced colorectal cancer and to provide a safe,simple,and effective combination therapy for these patients. Methods: Sixty patients with a pathological diagnosis of advanced colorectal cancer were randomly divided into treatment group( n = 30) and control group( n = 30). The treatment group received the optimal supportive treatment as well as moxibustion combined with acupoint application,while the control group received the optimal supportive treatment. Both groups received two courses of treatment( 7 d for each course). The treatment outcomes of the two groups were compared in terms of Karnofsky Performance Scale( KPS) score,European Organization for Research and Treatment of Cancer Quality of Life Questionnaire( EORTC QLQ-C30) score,traditional Chinese medicine( TCM) syndrome score,and the incidence of adverse events. Results: After treatment,both groups showed significant improvements in KPS score and TCM syndrome score,and there were significant differences between the two groups( P < 0. 05 or P < 0. 01). There was significant difference in EORTC QLQ- C30 score between the two groups after treatment( P < 0. 05); the treatment group showed no significant improvements in cognitive function and dyspnea( P > 0. 05),but showed significant improvements in other aspects( P <0. 05 or P <0. 01). No significant intolerable impairments were found in either group,suggesting a good safety of moxibustion combined with acupoint application. Conclusion: Moxibustion combined with acupoint application can effectively improve the quality of life in patients with advanced colorectal cancer,and it is a combined TCM therapy for advanced colorectal cancer that holds promise for further application.