四缝穴点刺联合背俞穴挑治治疗三阴性乳腺癌化疗后消化不良临床观察

Clinical Observation of Puncturing Sifeng Points(EX-UE10) plus Pricking Back-Shu Points for Dyspepsia Due to Chemotherapy for Triple-negative Breast Cancer

目的评价四缝穴点刺联合背俞穴挑治治疗三阴性乳腺癌化疗后消化不良的有效性。方法将60例患者随机分为观察组(30例)和对照组(30例)。观察组采用四缝穴点刺联合背俞穴挑治治疗,背俞穴取双侧脾俞、胃俞、膈俞穴,配合挑治四缝穴,每周1次。对照组采用促胃肠动力治疗(伊托必利50 mg)及补充消化酶(复方阿嗪米特肠溶片)等对症治疗。观察两组患者治疗前后中医症状积分、营养状态评分、KPS等变化,并评定两组疗效。结果观察组总有效率为93.3%(28/30),对照组为70.0%(21/30),组间比较差异有统计学意义(P<0.05)。治疗后两组中医症状积分均明显改善(P<0.01),且观察组改善优于对照组(P<0.01)。两组治疗后PG-SGA评分明显下降(P<0.01),两组治疗后PG-SGA评分比较差异无统计学意义(P>0.05)。治疗后两组KPS评分均明显提高,差异均有统计学意义(P<0.01),治疗后两组比较差异有统计学意义(P<0.05),观察组KPS评分的改善优于对照组。结论四缝穴点刺联合背俞穴挑治治疗三阴性乳腺癌化疗后消化不良疗效肯定,可改善患者食欲,提高患者生活质量。

Objective To assess the effectiveness of puncturing Sifeng points(EX-UE10)and pricking Back-Shu points in treating dyspepsia due to chemotherapy for triple-negative breast cancer(TNBC).Method Sixty patients were randomized into an observation group(30 cases)and a control group(30 cases).The observation group was intervened by puncturing Sifeng points and pricking Back-Shu points,once a week.The selected Back-Shu points included bilateral Pishu(BL20),Weishu(BL21)and Geshu(BL17).The control group was treated by promoting gastrointestinal motility(itopride hydrochloride 50 mg)and supplementing digestive enzymes(compound azintamide tablets).The two groups were observed before and after treatment in terms of traditional Chinese medicine(TCM)symptom score,nutritional status score and Karnofsky Performance Score(KPS).The therapeutic efficacies were also assessed.Result The total effective rate was 93.3%(28/30)in the observation group versus 70.0%(21/30)in the control group,and the between-group difference was statistically significant(P<0.05).The TCM symptom score showed significant improvement in both groups after treatment(P<0.01),and the improvement in the observation group was more significant than that in the control group(P<0.01).After treatment,the score of Patient Generated-Subjective Global Assessment(PG-SGA)decreased significantly in both groups(P<0.01),while there was no significant difference in the score between the two groups(P >0.05).The KPS score increased significantly in both groups after treatment(P<0.01),and there was a significant difference between the two groups(P<0.05),indicating a more significant improvement of KPS score in the observation group.Conclusion Puncturing Sifeng plus pricking Back-Shu points is effective in treating dyspepsia due to chemotherapy for TNBC.It can improve patient’s appetite and quality of life.