解郁除乏汤联合针灸对乳腺癌化疗后癌性疲劳患者SAS、SDS和FACT-F评分及血清CRP、IL-6和sTNF-R1表达水平的影响研究

Effects of Jieyu Chufa Decoction Combined with Acupuncture on SAS,SDS,FACT-F scores and Serum CRP,IL-6,sTNF-R1 Expression Levels in Patients with Cancer-Related Fatigue After Chemotherapy for Breast Cancer

目的:探讨解郁除乏汤联合针灸对乳腺癌化疗后癌性疲劳患者焦虑自评量表(SAS)、抑郁自评量表(SDS)和中文版癌症治疗功能评估疲乏量表(FACT-F)评分,血清C反应蛋白(CRP)、白细胞介素6(IL-6)和可溶性肿瘤坏死因子受体-1(sTNF-R1)表达水平的影响。方法:选取2019年7月至2022年7月该院收治的乳腺癌化疗后癌性疲劳患者117例,按照随机数字表法分为对照组(化疗后给予常规对症治疗)58例与观察组(化疗后给予解郁除乏汤联合针灸治疗)59例,治疗周期为3周。观察两组患者的临床疗效、中医症状积分(健忘、精神疲惫、失眠多梦和精力不足)和血清学指标(CRP、IL-6和sTNF-R1),以及SAS、SDS和FACT-F评分,并记录不良反应。结果:观察组患者治疗后临床总有效率为94.92%(56/59),高于对照组的65.52%(38/58),差异有统计学意义(P<0.05)。治疗后,观察组患者健忘、精神疲惫、失眠多梦和精力不足等中医症状积分低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者CRP、IL-6和sTNF-R1表达水平低于对照组,SAS、SDS和FACT-F评分低于对照组,差异均有统计学意义(P<0.05)。对照组、观察组患者的不良反应发生率分别为5.17%(3/58)、8.47%(5/59),差异无统计学意义(P>0.05)。结论:解郁除乏汤联合针灸可改善乳腺癌化疗后癌性疲劳患者的SAS、SDS和FACT-F评分,降低血清CRP、IL-6和sTNF-R1表达水平。

OBJECTIVE:To probe into the effects of Jieyu Chufa decoction combined with acupuncture on the scores of self-rating anxiety scale(SAS),self-rating depression scale(SDS),Chinese version of fatigue scale for evaluation of cancer treatment function(FACT-F)and the expression levels of serum C-reactive protein(CRP),interleukin-6(IL-6),soluble tumor necrosis factor receptor-1(sTNF-R1)in patients with cancer-related fatigue after chemotherapy for breast cancer.METHODS:A total of 117 patients cancer-related fatigue after chemotherapy for breast cancer admitted into the hospital from Jul.2019 to Jul 2022 were selected to be divided into 58 cases in the control group(given conventional symptomatic treatment after chemotherapy)and 59 cases in the observation group(given Jieyu Chufa decoction combined with acupuncture after chemotherapy)via the random number table method.The course of treatment was 3 weeks.The clinical efficacy,traditional Chinese medicine(TCM)syndrome integrals(amnesia,mental fatigue,insomnia and dreaminess,anenergia),serological indicators(CRP,IL-6 and sTNF-R1),SAS,SDS and FACT-F scores of two groups were observed,and the incidences of adverse drug reactions were recorded.RESULTS:The clinical total effective rate of the observation group was 94.92%(56/59),higher than that of the control group(65.52%,38/58),with statistically significant difference(P<0.05).After treatment,the TCM syndrome integrals such as amnesia,mental fatigue,insomnia and dreaminess and anenergia in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).After treatment,the expression levels of CRP,IL-6 and sTNF-R1 were lower in the observation group were lower than those in the control group,the scores of SAS,SDS and FACT-F in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The incidences of adverse drug reactions of control group and observation group were respectively 5.17%(3/58)and 8.47%(5/59),the difference was not statistically significant(P>0.05).CONCLUSIONS:Jieyu Chufa decoction combined with acupuncture can improve the SAS,SDS and FACT-F scores,reduce the expression levels of serum CRP,IL-6,sTNF-R1 in patients with cancer-related fatigue after chemotherapy for breast cancer.