化脓灸调节中晚期胃癌患者免疫水平的临床研究

Efficacy of festering moxibustion on the level of immunocompetence in patients with advanced gastric cancer

目的:探讨足三里穴化脓灸对胃癌患者免疫功能的调节作用。方法:将80例中晚期胃癌患者随机分成治疗组和对照组,分别有39例、41例。对照组采用Fol Fox-6方案对所有患者进行基础治疗,治疗组在Fol Fox-6的基础上增加化脓灸足三里穴(双侧)治疗。观察周期为2个疗程,共80d。检测患者的免疫学指标,根据SF-36量表评价并比较两组患者的生活质量,进一步评价化疗的毒副反应水平。结果:(1)治疗组与对照组均因要求转院治疗而脱失2例和3例。对照组和治疗组患者在性别、年龄、化疗周期等资料上没有明显差异,具有可比性(P>0.05)。(2)对照组患者在治疗后CD4+、CD8+T指标明显低于治疗前(P<0.05),治疗组患者CD8+T细胞水平也明显低于治疗前(P <0.05)。治疗组患者的肿瘤坏死因子-α(TNF-α)水平显著降低(P <0.05),且明显低于对照组(P <0.05)。(3)治疗后,治疗组患者的生理机能、躯体疼痛、总体健康和精力等4个维度的评分显著上升(P <0.01);对照组患者的生理职能、躯体疼痛和精力等3个维度评分显著升高(P <0.05);治疗组在疼痛、总体健康和精力维度方面也明显高于对照组(P <0.05)。(4)治疗后,对照组PLT显著升高(P <0.05);治疗组WBC、PLT水平显著升高(P <0.05),但Hb水平出现降低(P <0.05)。治疗后组间比较,治疗组WBC和PLT显著高于对照组(P <0.05)。结论:化脓灸足三里穴结合Fol Fox-6方案化疗治疗中晚期胃癌,能够调节患者的免疫功能,提高患者的生活质量。

Objective:To investigate the festering moxibustion at Zusanli(足三里)on advanced gastric cancer.Methods:80 cases were randomly divided into the treatment group and the control group,respectively 39 and 41 cases.All patients were given basic chemotherapy with the FolFox-6 protocol.The treatment group was treated with suppurative moxibustion at Zusanli(bilateral).The observation period is 2 courses,a total of 80 days.The immunological parameters were measured and the quality of life in two groups were evaluated and compared according to the SF-36 scale to further evaluate the toxicity of chemotherapy.Results:The treatment group and the control group lost 2 cases and 3 cases due to the request for transfer.The gender,age,and chemotherapy cycles in two groups of patients were statistically compared.The difference was not statistically significant(P>0.05).After treatment,the levels of CD4+and CD8+T cells in the control group were significantly lower(P<0.05).The levels of CD8+T cells in the treatment group were significantly lower(P<0.05).The level of tumor necrosis factor-α(TNF-α)in the treatment group was significantly lower(P<0.05),and was significantly lower than that in the control group(P<0.05).Physical function,somatic pain,general health and the scores of energy and other four dimensions were increased significantly(P<0.01);the physical function,physical pain and energy in the control group were significantly higher(P<0.05);the somatic pain in the treatment group was overall.The scores of health and energy dimensions were significantly improved than control group(P<0.05).After treatment,PLT in the control group was increased significantly(P<0.05);WBC and PLT levels in the treatment group were increased significantly(P<0.05),but hemoglobin level was decreased(P<0.05).WBC and PLT were significantly higher than the control group(P<0.05).Conclusion:The purulent Zusanli point combined with FolFox-6 chemotherapy for the treatment of advanced gastric cancer can regulate the patient's immune function and improve the patient's quality of life.