麝香灸联合替吉奥与食物疗法治疗晚期胰腺癌患者的临床效果

Clinical effect of musk moxibustion combined with diet therapy and S-1 on advanced pancreatic cancer

目的观察麝香灸联合替吉奥与食物疗法治疗晚期胰腺癌的临床效果。方法采用单盲法、随机数字表法将66例晚期胰腺癌患者随机分为常规组22例、艾灸组22例及麝香灸组22例。常规组患者给予食物疗法联合替吉奥治疗,艾灸组患者在常规组基础上给予艾灸治疗,麝香灸组患者在常规组基础上给予麝香灸治疗。治疗前后检测3组患者血浆P物质(SP)、血清β内啡肽(β-EP)、前列腺素E_(2)(PGE_(2))、自然杀伤T细胞(NKT)、γ干扰素(IFN-γ)、胰腺再生蛋白4(REG4)、巨噬细胞抑制因子-1(MIC-1)、T淋巴细胞亚群水平,评价两组患者疼痛数字评分法(NRS)、中医证候、卡氏功能状态(KPS)、癌症患者生命质量测定量表(QLQ-C30)评分,记录3组患者3个月及6个月生存率。结果治疗后,3组患者NKT、IFN-γ、β-EP水平均高于治疗前,REG4、MIC-1、PGE_(2)、SP水平均低于治疗前,且艾灸组、麝香灸组患者NKT、IFN-γ、β-EP水平均高于常规组,REG4、MIC-1、PGE_(2)、SP水平均低于常规组,麝香灸组患者NKT、IFN-γ、β-EP水平均高于艾灸组,REG4、MIC-1、PGE_(2)、SP水平均低于艾灸组,差异均有统计学意义(P﹤0.05)。治疗后,3组患者CD4^(+)、CD3^(+)、CD8^(+)水平均低于治疗前,且艾灸组、麝香灸组患者CD4^(+)、CD3^(+)、CD8^(+)水平均高于常规组,麝香灸组患者CD4^(+)、CD3^(+)、CD8^(+)水平均高于艾灸组,差异均有统计学意义(P﹤0.05)。治疗后,3组患者NRS、中医证候评分均低于治疗前,KPS、QLQ-C30评分均高于治疗前,且艾灸组、麝香灸组患者NRS、中医证候评分均低于常规组,KPS、QLQ-C30评分均高于常规组,麝香灸组患者NRS、中医证候评分均低于艾灸组,KPS、QLQ-C30评分均高于艾灸组,差异均有统计学意义(P﹤0.05)。艾灸组、麝香灸组患者3个月、6个月生存率均高于常规组,麝香灸组患者3个月、6个月生存率均高于艾灸组,差异均有统计学意义(P﹤0.05)。结论麝香灸联合替吉奥与食物疗法治疗晚期胰腺癌患者,可降低患者REG4、MIC-1水平,保护机体免疫功能,减少机体疼痛介质,改善患者临床症状,提升患者生活质量。

Objective To observe the clinical effect of musk moxibustion combined with diet therapy and S-1 in the treatment of advanced pancreatic cancer.Method A total of 66 patients with advanced pancreatic cancer were selected and randomly divided into 3 groups according to the single blind method and the random number table method,22 patients in the routine group were given diet therapy combined with S-1 treatment,22 patients in the moxibustion group were treated with moxibustion on the basis of the routine group,and 22 patients in the musk moxibustion group were treated with musk moxibustion on the basis of the routine group.The blood indexes of the three groups were detected before and after treatment:plasma substance P(SP),β-endorphin(β-EP),prostaglandin E_(2)(PGE_(2)),natural killer T cell(NKT),interferon-γ(IFN-γ),regenerating family member 4(REG4),macrophage inhibitory factor-1(MIC-1)and T lymphocyte subsets.Numeric rating scale(NRS),traditional Chinese medicine(TCM)syndrome,Karnofsky performance status(KPS)and quality of life questionnaire core 30(QLQ-C30)were compared between three groups.The 3-month and 6-month survival rates of the three groups were recorded.Result After treatment,the levels of NKT,β-EP and IFN-γin the three groups were higher than those before treatment,the levels of REG4,MIC-1,PGE_(2) and SP were lower than those before treatment,the levels of NKT,IFN-γ and β-EP in moxibustion group and musk moxibustion group were higher than those in the routine group,the levels of REG4,MIC-1,PGE_(2) and SP were lower than those in the routine group,and the levels of NKT,IFN-γ and β-EP in the musk moxibustion group were higher than those in the moxibustion group,and the levels of REG4,MIC-1,PGE_(2) and SP were lower than those in moxibustion group(P<0.05).After treatment,the levels of CD4^(+),CD3^(+) and CD8^(+) in the three groups were lower than those before treatment,and the levels of CD4^(+),CD3^(+) and CD8^(+) in the moxibustion group and musk moxibustion group were higher than those in the routine group,the levels of CD4^(+),CD3^(+)and CD8^(+) in the musk moxibustion group were higher than those in the moxibustion group(P<0.05).After treatment,the scores of NRS and TCM syndrome of the three groups were lower than those before treatment,and the scores of KPS and QLQ-C30 were higher than those before treatment,the scores of NRS and TCM syndrome of the moxibustion group and musk moxibustion group were lower than those of the routine group,and the scores of KPS and QLQ-C30 of the moxibustion group and musk moxibustion group were higher than those of the routine group,the scores of NRS and TCM syndrome of the musk moxibustion group were lower than those of the moxibustion group,and the scores of KPS and QLQ-C30 of the musk moxibustion group were higher than those of the moxibustion group(P<0.05).The 3-month and 6-month survival rates of patients in moxibustion group and musk moxibustion group were higher than those in routine group,and the 3-month and 6-month survival rates of patients in musk moxibustion group were higher than those in moxibustion group(P<0.05).Conclusion Musk moxibustion combined with diet therapy and S-1 in the treatment of patients with advanced pancreatic cancer can reduce the level of REG4 and MIC-1,protect the immune function,reduce pain mediators,improve the clinical symptoms,and improve the quality of life.