易筋经导引联合益气健脾补肾方治疗肺癌术后癌因性疲乏临床研究

目的:观察易筋经导引联合益气健脾补肾方治疗肺癌术后癌因性疲乏(CRF)肺脾气虚证的临床疗效。方法:选取76例肺癌术后CRF肺脾气虚证患者,按密闭信封法随机分为治疗组和对照组各38例。研究期间,治疗组剔除3例、脱落1例,最终纳入34例,对照组剔除5例、脱落1例,最终纳入32例。治疗组给予易筋经导引联合益气健脾补肾方治疗,对照组仅给予益气健脾补肾方治疗,2组均治疗2个月。比较2组治疗前后多维度疲乏症状量表-简表(MFSI-SF)、肺癌患者生存质量测定量表(FACT-L)评分及细胞免疫功能。结果:治疗后,2组一般疲乏、情绪疲乏、身体疲乏、心理疲乏评分及疲乏总分均较治疗前降低,活力评分均较治疗前升高,差异均有统计学意义(P<0.05);治疗组一般疲乏、身体疲乏、心理疲乏评分及疲乏总分均低于对照组(P<0.05),活力评分高于对照组(P<0.05);2组情绪疲乏评分比较,差异无统计学意义(P>0.05)。2组生理状况(PWB)、情感状况(EWB)、功能状况(FWB)、肺癌相关症状(LCS)评分,总分,以及治疗组社会/家庭状况(SWB)均较治疗前升高,治疗组PWB、EWB、FWB、LCS评分及总分均高于对照组,差异均有统计学意义(P<0.05);2组SWB评分比较,差异无统计学意义(P>0.05)。治疗组血清CD3^(+)水平改善情况优于对照组,差异有统计学意义(P<0.05)。2组CD4^(+)/CD8^(+)值及血清自然杀伤细胞(NK)水平改善情况比较,差异均无统计学意义(P>0.05)。结论:易筋经导引联合益气健脾补肾方治疗能有效缓解肺癌术后CRF肺脾气虚证患者的临床症状,提高其生活质量和细胞免疫功能。

A pilot study of precision treatment for patients with lung cancer pain by Longteng Tongluo recipe(龙藤通络方)using serum genomics

OBJECTIVE:To investigate the efficacy of Longteng Tongluo recipe(龙藤通络方,LTTL)combined with threestep analgesia for the treatment of lung cancer pain,and the changes in serum miRNA expressions before-and after treatment with LTTL and its correlation with lung cancer pain.The possible mechanism underlying LTTL effects on the treatment of lung cancer pain was conducted.METHODS:The pilot study was conducted at the oncology ward of the Yueyang Hospital and the Longhua Hospital between March 2018 and October 2019.A prospective,single-blind,placebo controlled,randomized clinical trial of LTTL or placebo combined with three-step analgesia treatments were administered to 24 cancer pain patients diagnosed with lung cancer.Analgesic efficacy was investigated as the primary outcome.Equivalent morphine consumption and numerical rating scale(NRS)scores were used as the secondary outcome.In the present study,we utilized deep sequencing techniques to compare the differential miRNA expressions in serum samples obtained from two groups:the lung cancer pain treatment group(LTTL+three-step analgesia)and the control group(placebo+three-step analgesia).Next,we employed the target prediction database to investigate the target genes for differential miRNA expressions and Gene Ontology(GO)analysis along with Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis to examine the roles and the major biochemical and signaling pathways related to the differentially expressed target genes,respectively.RESULTS:LTTL treatment significantly reduces the NRS score(P=0.021)as compared to those before treatment,along with significant reductions in the total morphine equivalent consumption(P=0.007)and the average daily equivalent morphine consumption(P=0.003)as opposed to the control group.The expressions of 31 miRNAs differed considerably between the two groups of patients(≥2 times up-modulated or down-regulated between these groups,P<0.05).For instance,the miRNAs expression levels for patients before treatment(has-miR-2110 and has-miR-7d-3p)were significantly enhanced as compared to the healthy people,after LTTL treatment,the expressions of miR-2110 and miR-7d-3p in patients with lung cancer pain reduced significantly.Studies show that the above two miRNAs were significantly associated with lung cancer pain,which could mediate lung cancer pain.Furthermore,we identified 355 genes as potential targets of the 31 differentially expressed miRNAs.Pathway enrichment analyses using KEGG and GO analysis indicated that these target genes may play a crucial role in the development and modulation of lung cancer pain.CONCLUSION:LTTL demonstrated a discernible impact on alleviating lung cancer pain and its mechanism of action may be related to the downregulation of has-miR-2110 and has-miR-7d-3p expressions.This pilot study provides support for further exploration of LTTL in patients with lung cancer pain.