热敏灸治疗恶性肿瘤腹水临床观察

Observation on Effect of Heat-sensitive Moxibustion of Malignant Ascites

[目的]观察热敏灸治疗恶性肿瘤腹水的临床疗效。[方法]采用前瞻性设计方法,30例住院患者用热敏灸治疗,选取①水分至中极之间任脉区域;②肾俞、命门区域。按照《热敏灸实用读本》中热敏腧穴探查方法,充分暴露后依次探查,选取两个热敏穴位施以双点温和灸,以热敏现象消失为一次饱和施灸剂量。1次/d,连续15d为1疗程,疗程间隔2d。观测腹水消退情况、治疗前后生存质量(KPS评分)及不良反应。连续治疗3疗程(45d),判定疗效。[结果]完全缓解(CR) 4例,部分缓解(PR) 20例,稳定(NC) 5例,进展(PD) 1例,总有效率80. 0%。生活质量改善17例,稳定8例,降低5例。治疗后(73. 17±8. 15)分,高于治疗前(65. 52±6. 32)分(P <0. 01)。[结论]热敏灸治疗恶性肿瘤腹水疗效确切,且其疗效优于单纯中药,值得临床推广运用。

[Objective]To observe the clinical effect of heat-sensitive moxibustion on malignant ascites.[Methods]Thirty inpatients were treated with heat-sensitive moxibustion with a prospective design method.The areas of Ren meridian between water and central pole,Shenshu( BL23) and Mingmen( DU4) were selected. According to the method of exploring thermally sensitive acupoints in Practical Reading of Thermal Moxibustion,after full exposure,two thermally sensitive acupoints were selected to be treated with two-point mild moxibustion,and the phenomenon of heat sensitivity disappearance was as a saturated dose of moxibustion. The treatment was carried out once a day,15 days for a course of treatment and the treatment interval was 2 days. Ascites subsidence,quality of life( KPS score) and adverse reactions were observed before and after treatment. After continuous treatment for 3 courses( 45 days),we determined the efficacy.[Results]There were 4 cases of complete remission( CR),20 cases of partial remission( PR),5 stablecases( NC) and 1 progressivecase( PD). The total effective rate was 80. 0%. The quality of life improved in17 cases,stabilized in 8 cases and decreased in 5 cases. KPS score( 73. 17 ± 8. 15) after treatment was higher than that( 65. 52 ± 6. 32) before treatment( P < 0. 01).[Conclusion] Heat-sensitive moxibustion is effective in the treatment of malignant ascites,and its curative effect is better than that of traditional Chinese medicine alone,which is worthy of clinical application.