穴位注射联合可待因片治疗中央型肺癌咳嗽的疗效评估

Efficacy evaluation of acupoint injection combined with codeine tablets in the treatment of cough with central lung cancer

目的通过比较穴位注射、可待因片以及穴位注射联合可待因片三种不同治疗方式对中央型肺癌引起咳嗽的治疗效果及安全性。方法收集2018年1月至2021年1月宜春市人民医院呼吸与危重医学科60例诊断为中央型肺癌患者,随机分为可待因组、穴位注射组、可待因+穴位注射组,每组各20例。经过三种治疗方式后,通过比较治疗前、治疗5 d后、治疗10 d后行咳嗽问卷评分,包括莱斯特咳嗽问卷、咳嗽特异性生活质量问卷、咳嗽视觉模拟量表、咳嗽症状评分;血清SP-D水平及PARC/CCL-18趋化因子。结果治疗5、10 d后,三组患者咳嗽问卷评分、咳嗽特异性生活质量问卷评分较治疗前有所升高,三组患者咳嗽视觉模拟量表评分及咳嗽症状评分较治疗前有所降低,差异有统计学意义(P<0.05);治疗5、10 d后,穴位注射组咳嗽问卷评分、咳嗽特异性生活质量问卷评分及咳嗽视觉模拟量表评分明显低于可待因组,可待因+穴位注射组咳嗽问卷评分、咳嗽特异性生活质量问卷评分及咳嗽视觉模拟量表评分明显高于穴位注射组和可待因组,差异有统计学意义(P<0.05)。治疗5、10 d后,穴位注射组咳嗽症状评分明显高于可待因组,可待因+穴位注射组咳嗽症状评分明显低于穴位注射组和可待因组,差异有统计学意义(P<0.05)。治疗5、10 d后,三组血清肺表面活性蛋白D(SP-D)较治疗前明显下降,差异有统计学意义(P<0.05);治疗5、10 d后,穴位注射组血清肺表面活性蛋白D(SP-D)明显高于可待因组,可待因+穴位注射组血清肺表面活性蛋白D(SP-D)明显低于穴位注射组和可待因组,差异有统计学意义(P<0.05)。治疗5、10 d后,三组肺部活化调节趋化因子(CCL18)较治疗前明显下降,差异有统计学意义(P<0.05);治疗5、10 d后,穴位注射组肺部活化调节趋化因子(CCL18)明显低于可待因组,差异有统计学意义(P<0.05);治疗5 d后,可待因+穴位注射组肺部活化调节趋化因子(CCL18)明显低于穴位注射组和可待因组,差异有统计学意义(P<0.05);治疗10 d后,可待因+穴位注射组肺部活化调节趋化因子(CCL18)明显低于穴位注射组和可待因组,差异有统计学意义(P<0.05)。结论中央型肺癌咳嗽与PARC/CCL-18趋化因子、血清SP-D有关,穴位注射联合可待因组治疗效果优于可待因组和穴位注射组。

Objective To compare and evaluate the therapeutic effect and safety of three different treatment methods of acupoint injection,codeine tablets,and acupoint injection combined with codeine tablets on cough caused by central type lung cancer. Methods A total of 60 patients with central lung cancer diagnosed in the Department of Respiratory and Critical Care Medicine of Yichun People’s Hospital from January 2018 to January 2021 were collected and randomly divided into the codeine group,the acupoint injection group,and codeine combined with acupoint injection group,with 20 cases in each group. After three treatments,the scores of the cough questionnaire before treatment,5 days after treatment,and 10 days after treatment,including Leicester Cough Questionnaire,Cough Specific Quality of Life Questionnaire,Cough Visual Analog Scale,Cough Symptom Score,serum SP-D level and PARC/CCL-18 chemokine were compared. Results 5 d,10 d after treatment,the scores of Leicester Cough Questionnaire and Cough-Specific Quality of Life Questionnaire among the three groups were higher than those before the treatment,the scores of Cough Visual Analog Scale and Cough Symptom Score among the three groups were lower than those before the treatment,with significant differences(P<0.05). 5 d,10 d after treatment,the scores of Leicester Cough Questionnaire,Cough-Specific Quality of Life Questionnaire and Cough Visual Analog Scale in the acupoint injection group were lower than those in the codeine group,and the above scores in the acupoint injection combined with codeine group were higher than those in the acupoint injection group and the codeine group, with significant differences(P<0.05). 5 d,10 d after treatment,the scores of Cough Symptom Score in the acupoint injection group were higher than those in the codeine group,and the scores of Cough Symptom Score in the acupoint injection combined with codeine group were lower than those in the acupoint injection group and the codeine group, with significant differences(P<0.05). 5 d,10 d after treatment,the level of serum SP-D among the three groups were lower than those before the treatment, with significant differences(P<0.05).5 d,10 d after treatment,the level of serum SP-D in the acupoint injection group were higher than those in the codeine group,and the level of serum SP-D in the acupoint injection combined with codeine group were lower than those in the acupoint injection group and the codeine group, with significant differences(P<0.05). 5 d,10 d after treatment,the level of serum PARC/CCL-18 chemokines among the three groups were lower than those before the treatment, with significant differences(P<0.05). 5 d,10 d after treatment,the level of serum PARC/CCL-18 chemokines in the acupoint injection group were lower than those in the codeine group,with significant differences(P<0.05). 5 d after treatment,the level of serum PARC/CCL-18 chemokines in the acupoint injection combined with codeine group were lower than those in the acupoint injection group and the codeine group, with significant differences(P<0.05). 10 d after treatment,the level of serum PARC/CCL-18 chemokines in the acupoint injection combined with codeine group were lower than those in the acupoint injection group and the codeine group, with significant differences(P<0.05). Conclusion Central lung cancer cough is related to PARC/CCL-18 chemokine and serum SP-D. The therapeutic effect of acupoint injection combined with codeine group is better than that of codeine group.