调和气血、补心益智针刺法治疗乳腺癌化疗相关认知障碍气血失调证患者53例临床观察

Clinical Observation on Acupuncture of Reconciling Qi and Blood,Tonifying Heart and Mind Method in the Treatment of 53 Patients of Breast Cancer Chemotherapy-related Cognitive Impairment with Disorder of Qi and Blood Syndrome

目的观察调和气血、补心益智针刺法治疗乳腺癌化疗相关认知障碍气血失调证患者的临床疗效。方法将104例患者随机分为治疗组53例和对照组51例,治疗组选用调和气血、补心益智针刺组穴,对照组选用非经非穴浅刺法,两组患者均每周治疗2次,治疗8周。分别于治疗前后及治疗结束16周后(随访期)进行蒙特利尔评估量表(MoCA)、简易智力状况量表(MMSE)、欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)评分,并于治疗后及随访时评价MoCA量表疗效及MMSE量表疗效。结果治疗后及随访时,治疗组和对照组的MoCA、MMSE评分均较治疗前升高(P <0. 01),且治疗组的改善程度优于对照组(P <0. 05或P <0. 01)。治疗组治疗后、随访时MoCA量表总有效率分别为64. 15%、66. 04%,MMSE量表总有效率分别为77. 36%、83. 02%;对照组分别为13. 72%、17. 65%,47. 06%、47. 06%,治疗组治疗后及随访时MoCA、MMSE量表的总有效率均高于同时间对照组(P <0. 01)。治疗后及随访时,治疗组和对照组患者在视空间与执行功能、注意力与计算力、语言、抽象和延迟回忆5个方面较治疗前评分明显提高(P <0. 05或P <0. 01),且治疗组明显优于同时间对照组(P <0. 05)。结论调和气血、补心益智针刺法对改善乳腺癌化疗相关认知障碍气血失调证患者认知功能损伤以及情绪、失眠、疲乏等生活质量情况具有肯定的疗效,且有明显的远期疗效。

Objective To observe the clinical efficacy of acupuncture using reconciling qi and blood,tonifying heart and mind method in the treatment of 53 patients of breast cancer chemotherapy-related cognitive impairment with disorder of qi and blood syndrome.Methods A total of 104 patients were randomly divided into treatment group(53 cases)and control group(51 cases).The treatment group was treated with acupuncture for reconciling qi and blood,tonifying heart and mind acupuncture at paired acupoints,and the control group was treated with shallow acupuncture in non-acupoints and non-meridians.Both groups were treated twice per week for 8 weeks.The Montreal Assessment Scale(MoCA),the mini-mental state examination(MMSE),and the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire(EORTC QLQ-C30)were scored before,after treatment and16 weeks after finish of the treatment(follow-up period).The efficacy of the MoCA scale and the efficacy of the MMSE scale were evaluated after treatment and at follow-up.Results After treatment and at follow-up,the MoCA and MMSE scores of the treatment group and the control group were higher than those before treatment(P<0.01),and the improvement of the treatment group was better than that of the control group(P<0.05 or P<0.01).In the treatment group,the total effective rate of the MoCA scale after treatment and at follow-up was 64.15%and 66.04%,and the total effective rate of the MMSE scale was 77.36%and 83.02%,respectively.The coresponding data of the control group was 13.72%,17.65%,47.06%,and 47.06%,respectively.The total effective rate of MoCA and MMSE scales in the treatment group after treatment and at follow-up was higher than that in the control group(P<0.01).After treatment and at follow-up,the treatment group and the control group showed a significant increase in visual space and executive function,attention and computational ability,language,abstraction and delayed recall compared with the pre-treatment score(P<0.05 or P<0.01).The treatment group was significantly better than the control group at the same time(P<0.05).Conclusion Acupuncture for reconciling qi and blood,tonifying heart and mind has a positive effect on the cognitive function damage and emotional quality,insomnia,fatigue and quality of life in patients with qi and blood disorder syndrome of breast cancer chemotherapy-related cognitive impairment,and it has obvious long-term effectiveness.