督脉灸对中晚期恶性肿瘤患者化疗期间生活质量及药物不良反应的影响

Effect of Dumai Moxibustion on life quality and adverse reactions on patients with advanced malignant tumor during chemotherapy

目的观察督脉灸对中晚期恶性肿瘤患者化疗期间生活质量及药物不良反应的影响。方法将240例中晚期恶性肿瘤化疗患者采用随机数字表法按2∶1的比例分为2组,对照组80例(实际完成研究73例)根据原发肿瘤情况予常规化疗治疗,治疗组160例(实际完成研究148例)在对照组基础上联合督脉灸治疗。2组均治疗4个化疗周期后统计疗效,比较2组治疗前及治疗2、4个周期后中文版癌症治疗功能评定量表(FACT-G)评分(包括生理状况、社会家庭状况、情感状况及功能状况)变化情况,比较2组治疗期间的药物不良反应恶心呕吐、中性粒细胞绝对值下降、血小板计数下降、贫血、乏力、神经毒性、腹泻、肝功能异常及肾功能异常发生情况,并根据世界卫生组织(WHO)化疗药物毒性反应分度标准进行分度。结果治疗组治疗2、4个周期后FACT-G各项评分及总分均无明显变化(P>0.05),对照组治疗2个周期后情感状况评分及总分即出现明显下降(P<0.05),治疗4个周期后FACT-G各项评分及总分则均出现明显下降(P<0.05),且治疗组治疗4个周期后FACT-G生理状况、情感状况、功能状况评分及总分均明显高于对照组治疗4个周期后水平(P<0.05)。2组化疗期间Ⅰ~Ⅱ度不良反应发生情况比较差异均无统计学意义(P>0.05),但治疗组Ⅲ~Ⅳ度不良反应中中性粒细胞绝对值下降、血小板计数下降及乏力的发生率均明显低于对照组(P<0.05)。结论督脉灸对中晚期恶性肿瘤患者化疗期间生活质量具有明显改善作用,可预防和减少化疗药物的不良反应,减轻化疗对患者生活质量的影响,提高患者治疗的依从性,进而保证化疗的顺利进行。

Objective To observe the effect of Dumai Moxibustion on life quality and adverse reactions in patients with advanced malignant tumor during chemotherapy.Methods A total of 240 patients with advanced malignant tumor(AMT)undergoing chemotherapy were randomly divided into two groups according to the ratio of 2∶1.According to primary tumor status,the control group with 80 cases(73 cases actually completed the study)was treated with routine chemotherapy,and the treatment group with 160 cases(148 cases actually completed the study)was additionally treated with Dumai Moxibustion on the basis of control group.The curative effect in both groups was counted after 4 cycles of chemotherapy.The Chinese version of"Cancer Treatment Function Evaluation Scale"was used to compare FACT-G score changes,including physiological status,social and family status,emotional status and functional status,between the two groups before treatment and after 2,4 cycles of treatment;OTOH,adverse reactions in two groups during treatment(nausea and vomiting,absolute value of neutrophils decreased,platelet count decreased,anemia,fatigue,neurotoxicity,diarrhea,abnormal liver function,renal dysfunction)were also compared,and those data was graded according to chemotherapy drug toxicity(WHO standard).Results Compared with before treatment,FACT-G score and total score in the treatment group had no significant change after 2,4 cycles of treatment(P>0.05),emotional status score and total score in the control group had significantly decreased after 2 cycles of treatment(P<0.05),FACT-G scores and total score had significantly decreased after 4 cycles of treatment(P<0.05),and all status in treatment group significantly higher than those in the control grou after 4 cycles of treatment.(P<0.05).There was no significant difference between the two groups in occurrence ofⅠ~Ⅱdegree adverse reactions during chemotherapy(P>0.05);the adverse reactions inⅢ~Ⅳdegree(absolute value of neutrophi decrease,platelet count decrease and fatigue)in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion Dumai Moxibustion has a definite effect on their life quality for AMT patients during chemotherapy,it can prevent and reduce the toxicity of chemotherapy drugs,reduce the impact of chemotherapy on the life quality of patients,improving compliance to ensure chemotherapy smoothly.