火针对非小细胞肺癌化疗患者生存质量的影响

Effects of fire needle on quality of life in patients with chemotherapy of non-small cell lung cancer

目的:观察火针配合化疗与单纯化疗对非小细胞肺癌化疗患者生存质量的影响。方法:采用随机、对照方法将60例非小细胞肺癌化疗患者分为观察组(火针配合化疗组)和对照组(化疗组),每组30例。观察组采用火针四花穴(膈俞、胆俞)配合化疗[TP(紫衫醇+顺铂)/GP(吉西他滨+顺铂)/DP(多西他赛+顺铂)/NP(长春瑞滨+顺铂]进行治疗,具体化疗方案由肿瘤医师根据患者病情制定,每日火针四花穴1次,治疗7 d,治疗1个疗程(1周),同时配合化疗1个周期(21 d)。对照组采用单纯化疗,化疗一个周期(21 d)。在治疗前及治疗第21天采用肿瘤客观指标评定标准(response evaluation criteria in solid tumors,RECIST)进行评价,同时采用行为状态量表(Karnofsky performance status,KPS)及肺癌治疗功能评价表(functional assessment of cancer therapy-lung,FACT-L)对非小细胞肺癌化疗患者进行生存质量评价。结果:观察组有效率为20.0%(6/30),稳定率为73.3%(22/30),对照组有效率为16.7%(5/30),稳定率为63.3%(19/30),观察组有效率、稳定率有高于对照组的趋势,但差异无统计学意义(均P>0.05)。对照组治疗后KPS评分低于治疗前(P<0.05),观察组治疗前后KPS评分比较差异无统计学意义(P>0.05);观察组治疗后KPS评分高于对照组(P<0.05)。观察组治疗后FACT-L生存质量评分总分及各分项评分均高于治疗前(均P<0.05),对照组治疗后FACT-L生存质量评分中日常生活领域、情感状态领域评分高于治疗前(均P<0.05);观察组治疗后FACT-L生存质量评分总分、日常生活领域、活动能力领域、其他因素领域高于对照组,差异有统计学意义(均P<0.05),社会/家庭状况领域、情感状况领域评分虽高于对照组,但差异无统计学意义(均P>0.05)。两组治疗前后KPS评分总分差值与FACT-L生存质量评分总分差值呈中度正相关(P<0.01)。结论:火针可改善非小细胞肺癌化疗患者生存质量。

Objective To observe the effect difference between fire needle combined with chemotherapy and fire needle on quality of life in patients with chemotherapy of non-small cell lung cancer（NSCLC）. Methods With randomized controlled method, a total of 60 patients with chemotherapy of NSCLC were divided into an observation group（fire-needle plus chemotherapy group） and a control group（chemotherapy group）, 30 cases in each one. The observation group was treated with fire needle at Sihua points which consisted of Geshu（BL 17） and Danshu（BL 19）, combined with chemotherapy selected from TP（paclitaxel＋cisplatin）/GP（gemcitabine＋cisplatin）/DP（docetaxel＋cisplatin）/NP（vinorelbine＋cisplatin） by the oncologist according to patients＇ condition. The fire needle was given once a day for 7 days, and chemotherapy was given for 21 days. The control group was treated with chemotherapy alone for 21 days. Before and after treatment,response evaluation criteria in solid tumors（RECIST） was applied for evaluation, and Karnofsky performance status（KPS） and functional assessment of cancer therapy-lung（FACT-L） were applied for evaluation of quality of life in patients with chemotherapy of NSCLC. Results The effective rate was 20.0%（6/30） and the stability rate was 73.3%（22/30） in the observation group, which were insignificantly higher than 16.7%（5/30） and 63.3%（19/30） in the control group,respectively（both P0.05）. The KPS after treatment was lower than that before treatment in the control group（P0.05）;the KPS after treatment was similar to that before treatment in the observation group（P0.05）; the KPS in theobservation group after treatment was higher than that in the control group（P0.05）. The total score and each item score of FACT-L after treatment were higher than those before treatment in the observation group（all P0.05）; the physical score and emotional score of FACT-L after treatment were higher than those before treatment in the control group（both P0.05）; the total score, physical score, functional score and subscale score in the observation group were significantly higher than those in the control group after treatment（all P0.05）, while the social/family score and emotional score in the observation group were insignificantly higher than those in the control group（both P0.05）. The differences of KPS total score before and after treatment in the two groups had moderate positive correlation with differences of FACT-L total score（P0.01）. Conclusion Fire needle can improve quality of life in patients of NSCLC chemotherapy.