针刺联合TP化疗治疗食管癌进食哽噎患者的疗效及对其生存率和生活质量的影响

Efficacy of Acupuncture Combined with TP Chemotherapy on Esophageal Cancer Patients with Dysphagia and Its Effect on Survival Rate and Quality of Life of Patients

目的探讨针刺联合TP化疗治疗食管癌进食哽噎患者的疗效及对其生活质量的影响。方法选取2020年5月—2021年5月期间衡水市中医医院收治的食管癌进食哽噎患者86例进行研究,按照随机数字表法分为对照组和观察组,每组各43例。两组患者均接受TP化疗方案治疗,观察组联合针刺治疗。42 d为两个疗程,共治疗两个疗程。观察比较两组患者前后卡氏评分(Karnofsky′s评分,KPS评分)、进食哽噎评分,治疗后生活质量、体质量变化、近期疗效、1年生存率及治疗期间不良反应发生率。结果治疗后两组患者KPS评分较治疗前升高,差异有统计学意义(P<0.05);且观察组KPS评分高于对照组,差异有统计学意义(P<0.05)。治疗后观察组生活质量总改善率74.42%(32/43)明显高于对照组46.51%(20/43),差异有统计学意义(P<0.05)。治疗后两组患者呕吐、饮食、胸痛评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组进食哽噎评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组体质量好转率53.49%(23/43)明显高于对照组30.23%(13/43),差异有统计学意义(P<0.05)。治疗后观察组总有效率58.14%(25/43)与对照组51.16%(22/43)比较,差异无统计学意义(χ2=0.422,P>0.05)。观察组不良反应发生率明显低于对照组,差异有统计学意义(χ2=6.824,P<0.05)。观察组1年生存率明显高于对照组,差异有统计学意义(χ2=4.440,P<0.05)。结论针刺法联合TP化疗治疗食管癌进食哽噎,能够快速缓解患者进食哽噎症状,增加患者体质量,改善生活质量,降低化疗不良反应,并有助于延长患者1年生存率。

Objective To investigate the efficacy of acupuncture combined with TP chemotherapy in treating dysphagia caused by esophageal cancer and its impact on quality of life of patients.Methods A study was conducted on 86 patients with esophageal cancer-induced dysphagia admitted to the Fifth Department of Internal Medicine(Oncology)of Hengshui Hospital of Traditional Chinese Medicine between May 2020 and May 2021.The patients were randomly divided into a control group and an observation group according to a random number table,with 43 patients in each group.Both groups received TP chemotherapy,while the observation group additionally received acupuncture treatment.Two courses of treatment were administered,lasting 42 days.The Karnofsky Performance Status(KPS)score,dysphagia score,post-treatment quality of life,body weight changes,short-term efficacy,1-year survival rate,and incidence of adverse reactions during treatment were observed and compared between the two groups.Results After treatment,both groups showed a significant increase in KPS scores compared to those before treatment(P<0.05).The KPS score in the observation group was significantly higher than that in the control group(P<0.05).The overall improvement rate in quality of life in the observation group was 74.42%(32/43),significantly higher than 46.51%(20/43)in the control group(P<0.05).After treatment,both groups showed a significant reduction in vomiting,eating difficulties,and chest pain scores compared to those before treatment(P<0.05).The dysphagia score in the observation group was significantly lower than that in the control group(P<0.05).The improvement rate in body weight in the observation group was 53.49%(23/43),significantly higher than 30.23%(13/43)in the control group(P<0.05).The overall effective rates in the observation group and the control group were 58.14%(25/43)and 51.16%(22/43),with no statistically significant difference(χ~2=0.422,P>0.05).The incidence of adverse reactions in the observation group was significantly lower than that in the control group(χ~2=6.824,P<0.05).The 1-year survival rate in the observation group was significantly higher than that in the control group(χ~2=4.440,P<0.05).Conclusion Acupuncture combined with TP chemotherapy is effective in rapidly relieving dysphagia symptoms in patients with esophageal cancer,increasing body weight,improving quality of life,reducing chemotherapy-related adverse reactions,and helping to extend the 1-year survival rate.It is recommended for clinical use.