艾灸联合加味升阳益胃汤治疗肺鳞癌化疗后骨髓抑制及对免疫功能的影响

Effect of Moxibustion Combined with Modified Shengyang Yiwei Decoction(加味升阳益胃汤)on Bone Marrow Suppression and Immune Function of Lung Squamous Cell Carcinoma after Chemotherapy

目的探讨艾灸联合加味升阳益胃汤治疗肺鳞癌化疗后骨髓抑制及对免疫功能的影响。方法选择2021年1月—2022年1月于河北北方学院附属第一医院中医肿瘤科住院的肺鳞癌化疗病人100例作为研究对象,采用随机数字表法分为治疗组与对照组,每组50例。对照组行化疗治疗,治疗组行化疗治疗同时,给予艾灸联合加味升阳益胃汤治疗。对比两组患者骨髓抑制以及免疫功能情况。结果治疗前,两组患者的白细胞、粒细胞、血红蛋白、血小板指标差异无统计学意义(P>0.05);治疗后,两组患者的白细胞、粒细胞、血红蛋白、血小板指标均显著下降(P<0.05),治疗组白细胞、粒细胞、血红蛋白、血小板指标水平高于对照组(P<0.05);治疗后治疗组患者的骨髓抑制分度情况优于对照组,且差异有统计学意义(P<0.05)。治疗前,两组患者的卡氏评分(Karnofsky Performance Status,KPS)差异无统计学意义(P>0.05);治疗后,两组患者的KPS评分均下降,且治疗组KPS评分水平高于对照组(P<0.05);治疗后治疗组患者的总生存期与无进展生存期长于对照组,且差异有统计学意义(P<0.05);治疗前,两组患者的CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)差异无统计学意义(P>0.05);治疗后,两组患者的CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)均下降,且治疗组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平高于对照组(P<0.05);两组患者在治疗期间均未出现严重的不良反应。治疗组不良反应发生率为8.0%(4/50)低于对照组24.0%(12/50),差异有统计学意义(χ^(2)=4.761,P=0.029)。结论艾灸联合加味升阳益胃汤能够改善肺鳞癌化疗骨髓抑制情况,提高免疫功能,不良反应较小,而且不会增加不良反应,临床应用价值显著。

Objective To investigate the effect of moxibustion combined with Modified Shengyang Yiwei Decoction(加味升阳益胃汤)on bone marrow suppression and immune function of lung squamous cell carcinoma after chemotherapy.Methods A total of 100 patients with lung squamous cell carcinoma who were hospitalized in the Department of Traditional Chinese Medicine Oncology,the First Affiliated Hospital of Hebei North University from January 2021 to January 2022 were selected as the research object.They were randomly divided into treatment group and control group,with 50 patients in each group.The control group was treated with chemotherapy,while the treatment group was treated with moxibustion combined with Modified Shengyang Yiwei Decoction.Bone marrow suppression and immune function were compared between the two groups.Results Before treatment,there was no significant difference in the indexes of leukocyte,granulocyte,hemoglobin or platelet between the two groups(P<0.05).After treatment,the indexes of white blood cells,granulocytes,hemoglobin and platelets in both groups decreased significantly(P<0.05),and the indexes of white blood cells,granulocytes,hemoglobin and platelets in the treatment group were higher than those in the control group(P<0.05).After treatment,the grade of bone marrow suppression in the treatment group was better than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in(Karnofsky Performance Status(KPS)score between the two groups(P>0.05).After treatment,the KPS score of the two groups decreased,and the KPS score of the treatment group was higher than that of the control group(P<0.05).After treatment,the overall survival and progression free survival in the treatment group were longer than those in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)between the two groups(P>0.05).After treatment,the levels of CD_(3)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)in the treatment group were higher than those in the control group(P<0.05).There were no serious adverse reactions in both groups during treatment.The incidence of adverse reactions in the treatment group was 8.0%(4/50),lower than 24.0%(12/50)in the control group,the difference was statistically significant(χ^(2)=4.761,P=0.029).Conclusion Moxibustion combined with Modified Shengyang Yiwei Decoction can improve the bone marrow suppression in chemotherapy of lung squamous cell carcinoma,improve the immune function,have less toxic and side effects,and will not increase adverse reactions,and have significant clinical application value.