热敏灸加中药对多发性骨髓瘤患者化疗后血清炎症指标及微小核糖核酸表达的影响

Effects of heat-sensitive moxibustion plus Chinese medication on the expression of serum inflammatory indicators and microRNAs in patients with multiple myeloma after chemotherapy

目的观察热敏灸联合中药治疗对多发性骨髓瘤患者化疗后血清炎症指标、T淋巴细胞亚群及血清微小核糖核酸表达的影响。方法选取多发性骨髓瘤终止化疗后患者82例,以随机数字表法分为观察组和对照组,每组41例。对照组给予西医对症治疗和中药益肾强骨汤口服,观察组在对照组治疗基础上加用热敏灸治疗。观察两组治疗后的临床疗效,中医证候评分,肿瘤病人生存质量评分[包括体力状态卡式(KPS)评分、体力状况分析标准(PS)评分及肿瘤病人生活质量(QOL)评分],血清炎症指标[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及白细胞介素-6(IL-6)],T淋巴细胞亚群(CD3^(+)、CD4^(+)及CD8^(+)),血清微小核糖核酸-302(miR-302)、微小核糖核酸-140-5p(miR-140-5p)及微小核糖核酸-125a(miR-125a)的相对表达量。结果观察组治疗后总有效率为85.4%,高于对照组的68.3%(P<0.05);观察组在改善血清炎症因子水平、中医证候评分、肿瘤病人生存质量评分、T淋巴细胞亚群及血清miR-302、miR-140-5p、miR-125a相对表达量方面均优于对照组,组间差异均有统计学意义(P<0.05)。结论热敏灸联合中药治疗可降低多发性骨髓瘤患者化疗后血清炎症因子水平,提高免疫功能,改善中医证候,提高生活质量,增加血清miR-125a、miR-140-5p及miR-302表达水平。

Objective To observe the effects of heat-sensitive moxibustion plus Chinese medication on serum inflammatory indicators,T-lymphocyte subsets,and serum microRNAs in patients with multiple myeloma after chemotherapy.Methods Eighty-two patients with multiple myeloma who had terminated chemotherapy were divided into an observation group and a control group using the random number table method,with 41 cases in each group.The control group received symptomatic treatment of Western medicine plus oral Chinese medication Yi Shen Qiang Gu Tang(decoction for benefiting the kidney to strengthen bones),and the observation group received additional heat-sensitive moxibustion treatment.After the intervention,the following measures were observed,including clinical efficacy,symptom scores of traditional Chinese medicine(TCM),and tumor patient’s quality of life(QOL)scores[including Karnofsky performance status(KPS)score,performance scale(PS)score,and tumor-specific QOL questionnaire score]alongside the serum inflammatory indicators[tumor necrosis factor-a(TNF-α),C-reactive protein(CRP),and interleukin-6(IL-6)],and the relative expression levels of T-lymphocyte subsets(CD3^(+),CD4^(+),and CD8^(+))and serum microRNA-302(miR-302),microRNA-140-5p(miR-140-5p),and microRNA-125a(miR-125a).Results After treatment,the total effective rate was 85.4%in the observation group,higher than 68.3%in the control group(P<0.05).The observation group was superior to the control group in improving the serum inflammatory factor levels,TCM symptom scores,tumor patient’s QOL scores,and the relative expression levels of T-lymphocyte subsets and serum miR-302,miR-140-5p,and miR-125a,and the between-group differences were statistically significant(P<0.05).Conclusion Heat-sensitive moxibustion plus Chinese medication can lower the serum inflammatory factor levels,strengthen immune function,mitigate TCM symptoms,enhance QOL,and raise the expression levels of serum miR-125a,miR-140-5p,and miR-302 in multiple myeloma patients after chemotherapy.