雷火灸对非小细胞肺癌患者血液高凝状态的影响

Effect of Thunder-fire Wonder Moxibustion on the Hypercoagulable State in Patients with Non-small Cell Lung Cancer

目的观察雷火灸对非小细胞肺癌患者血液高凝状态的影响。方法将80例非小细胞肺癌血液高凝状态患者随机分为对照组、观察组,每组40例。对照组予化疗联合低分子肝素钙,观察组在此基础上予雷火灸。比较凝血相关指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板(PLT)计数]、血液流变学指标、Karnofsky行为状态(KPS)评分、血清血管内皮生长因子(VEGF)和核因子(NF)-κB水平。随访6个月,比较两组血栓相关事件发生情况。结果治疗后,两组PT、APTT、FIB、D-D、PLT均改善(P<0.05),观察组优于对照组(P<0.05);两组高切全血黏度、低切全血黏度、血浆黏度、红细胞压积均降低(P<0.05),观察组低于对照组(P<0.05)。治疗后,对照组KPS评分无明显改善(P>0.05);观察组KPS评分明显升高(P<0.05),且高于对照组(P<0.05)。治疗后,对照组血清VEGF水平明显降低(P<0.05),血清NF-κB水平无明显变化(P>0.05);观察组血清VEGF、NF-κB水平均降低(P<0.05),且低于对照组(P<0.05)。随访期间,观察组血栓相关事件发生率低于对照组(P<0.05);观察组胃肠道反应发生率低于对照组(P<0.05),两组骨髓抑制、肝功能损伤的发生率比较差异无统计学意义(P>0.05)。结论在化疗联合低分子肝素钙基础上,雷火灸可改善非小细胞肺癌患者的血液高凝状态,提高其生存质量,降低血栓相关事件发生几率,减轻化疗引起的胃肠道反应,调节血清VEGF、NF-κB水平。

Objective To observe the effect of thunder-fire wonder moxibustion on the hypercoagulable state in patients with non-small cell lung cancer.Method Eighty patients suffering from non-small cell lung cancer with the hypercoagulable state were randomized to control and observation groups,with 40 cases in each group.The control group received chemotherapy plus low molecular weight heparin calcium and the observation group,thunder-fire wonder moxibustion in addition.Blood coagulation-related indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D)and platelet(PLT)],hemorheological indicators,the Karnofsky performance status(KPS)scores,and serum vascular endothelial growth factor(VEGF)and nuclear factor(NF)-κB levels were compared.The incidences of thrombosis-related events were also compared between the two groups at the 6-month follow-up.Result After treatment,PT,APTT,FIB,D-D and PLT improved in both groups(P<0.05)and were better in the observation group than in the control group(P<0.05);whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity and hematocrit decreased in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,the KPS score didn’t change significantly in the control group(P>0.05)and it increased significantly in the observation group(P<0.05)and was higher than in the control group(P<0.05).After treatment,serum VEGF levels increased significantly(P<0.05)and NF-κB levels didn’t change significantly(P>0.05)in the control group;serum VEGF and NF-κB levels decreased in the observation group(P<0.05)were lower than in the control group(P<0.05).At the follow-up,the incidences of thrombosis-related events were lower in the observation group than in the control group(P<0.05);the incidences of gastrointestinal reactions were significantly lower in the observation group than in the control group(P<0.05).The incidences of bone marrow suppression and liver function injuries had no statistically significant differences between the two groups(P>0.05).Conclusion Thunder-fire wonder moxibustion based on chemotherapy plus low molecular weight heparin calcium can ameliorate the hypercoagulable state,improve the quality of life,decrease the incidences of thrombosis-related events,reduce gastrointestinal reactions to chemotherapy and regulate serum VEGF and NF-κB levels in patients with non-small cell lung cancer.