热敏灸调节中晚期非小细胞肺癌化疗后骨髓抑制及淋巴细胞亚群的临床研究

A clinical study on heat-sensitive moxibustion modulating myelosuppression and lymphocyte subsets after chemotherapy in advanced non-small cell lung cancer

目的:观察热敏灸治疗中晚期非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)化疗后骨髓抑制的疗效及特点,评价热敏灸对免疫相关指标的影响及热敏灸的安全性。方法:选取2021年9月―2022年9月潍坊市中医院收治的80例化疗结束后出现白细胞计数/粒细胞计数减少症患者,按照随机数字表法分为两组。对照组40例给予西医常规处理,研究组40例在对照组干预措施基础上加用热敏灸。对比两组治疗前后卡氏功能状态评分法(Karnofsky Performance Status,KPS)评分、中医症状评分、白细胞计数、中性粒细胞计数、淋巴细胞计数及CD4^(+)/CD8^(+)的表达情况,通过描绘两组的白细胞计数、中性粒细胞计数、淋巴细胞计数时间变化曲线分析热敏灸辅助治疗白细胞减少症的疗效及特点,通过比较两组的CD4^(+)/CD8^(+)的变化情况评估热敏灸辅助改善免疫抑制的能力。结果:与治疗前相比,研究组和对照组均能有效改善白细胞减少症,与对照组相比,研究组的起效时间为使用热敏灸后6~9 d,且12 d后增长趋势基本维持稳定,两组差异具有统计学意义(P<0.05)且研究组的不良反应少、作用时间持久;对照组中CD4^(+)/CD8^(+)值变化较小,研究组CD4^(+)/CD8^(+)值较对照组显著升高,两组差异具有统计学意义(P<0.05)。治疗前两组患者中医证候积分及KPS评分比较,差异无统计学意义(P>0.05),治疗后两组患者中医证候积分显著降低,KPS评分升高,且研究组变化幅度显著优于对照组(P<0.05)。结论:热敏灸能有效治疗白细胞减少症,改善患者生活质量,并可有效改善机体免疫功能。

Objective:To observe the efficacy and characteristics of heat-sensitive moxibustion in the treatment of myelosuppression after chemotherapy in advanced non-small cell lung cancer,and to evaluate the effect of heat-sensitive moxibustion on immune-related indexes and the safety of heat-sensitive moxibustion.Methods:A total of 80 patients with leukopenia/granulo cytopen after chemotherapy treated in Weifang Hospital of Traditional Chinese Medicine from September 2021 to September 2022 were selected and divided into 2 groups according to random number table method.Forty cases in the control group were treated by conventional Western medicine,and forty cases in the study group were treated by heat-sensitive moxibustion on the basis of the intervention measures in the control group.The Karnofsky score,TCM symptom score,WBC,NEU,LYM and CD4^(+)/CD8^(+)expression before and after treatment was compared between the two groups.The time change curves of WBC,NEU and LYM in the two groups were described to analyze the efficacy and characteristics of heat-sensitive moxibustion as the adjuvant treatment of leukopenia.The ability of heat-sensitive moxibustion to improve immunosuppression between the two groups was evaluated by comparing the changes of CD4^(+)/CD8^(+).Results:Compared with before treatment,both the study group and the control group could effectively improve leukopenia.Compared with the control group,the onset time in the study group was 6-9 days after the use of heat-sensitive moxibustion,and the growth trend was basically stable after 12 days,and the comparison between the two groups was statistically significant(P<0.05).The ratio of CD4^(+)/CD8^(+)in the control group changed little,and the CD4^(+)/CD8^(+)in the study group was significantly higher than that in the control group,and the comparison between the two groups was statistically significant(P<0.05).Before treatment,there was no significant difference in TCM syndrome score and KPS score between the two groups(P>0.05).After treatment,TCM syndrome score in the two groups were decreased significantly,and KPS score were increased,and the change range in the study group was significantly better than the control group(P<0.05).Conclusion:Heat-sensitive moxibustion can effectively treat leukopenia,improve quality of life,and effectively promote the body’s immune function.