直接灸足三里、气海对肿瘤化疗患者免疫T细胞影响的临床研究

发布时间：2018-05-15 21:10

本文选题：直接灸 + 足三里　；参考：《安徽中医药大学》2016年硕士论文

【摘要】：目的:初步探讨直接灸足三里、气海对肿瘤化疗患者免疫T细胞及生存质量的影响,为临床治疗肿瘤患者化疗后免疫功能低下,提供一定的借鉴和参考。方法:全部病例共60例,均为2015年1月至2016年1月在安徽中医药大学第二附属医院肿瘤科住院的病人。将60例肿瘤化疗患者,按就诊顺序编号为01-60号,按照随机分组原则,分为治疗组和对照组,每组30例。治疗组:采用常规化疗+直接灸,取穴足三里、气海。施灸时待艾炷燃到2/5-1/5左右,患者感到灼热不可耐受时,及时更换艾炷,连续灸5壮,每日1次,从患者化疗前1天开始,至下次化疗为1个疗程,共30天。对照组:只化疗,不灸。治疗期间,停用其它相关的治疗方法,所有患者在治疗前、治疗后各做1次外周血化验,数据进行统计处理。选取生存量表QLQ-C30,CD4+、CD8+及Th17细胞作为观察指标,观察直接灸足三里、气海对肿瘤化疗患者免疫T细胞及生存质量的影响。结果:1.治疗组和对照组,患者的年龄、病程以及性别、癌种,经卡方检验,两组比较差异无统计学意义(P0.05),提示两组具有可比性。2.治疗组和对照组外周血中CD4+含量,治疗前,组间比较差异无统计学意义(P0.05),提示两组具有可比性;治疗后,治疗组CD4+含量上升,组内比较差异有明显的统计学意义(P0.01);对照组CD4+含量下降,组内比较差异有统计学意义(P0.05);组间比较,差异有明显的统计学意义(P0.01)。3.治疗组和对照组外周血中CD8+含量,治疗前,组间比较差异无统计学意义(P0.05),提示两组具有可比性;治疗后,治疗组CD8+含量下降,组内比较差异有明显的统计学意义(P0.01);对照组CD8+含量上升,组内比较差异有统计学意义(P0.05);组间比较,差异有明显的统计学意义(P0.01)。4.治疗组和对照组外周血中Th17表达水平,治疗前,组间比较差异无统计学意义(P0.05),提示两组具有可比性;治疗后,治疗组Th17表达水平下降,组内比较差异有明显的统计学意义(P0.01);对照组Th17表达水平下降,组内比较差异有统计学意义(P0.01);组间比较,差异有明显的统计学意义(P0.01)。5.治疗前,治疗组和对照组患者的生存质量评分,组间比较差异无统计学意义(P0.05),提示两组具有可比性;治疗后,治疗组患者的生存质量评分增加,对照组患者的生存质量评分下降,组内和组间比较差异有统计学意义(P0.05),提示化疗会导致患者生存质量下降,而直接灸可以提高患者的生存质量。结论:研究结果显示,直接灸可升高肿瘤化疗患者外周血中CD4+含量,降低CD8+含量及Th17细胞表达水平,改善肿瘤化疗患者的免疫功能并提高生存质量,可作为肿瘤患者化疗后的辅助手段,提高化疗的疗效。研究方案操作简单,方便患者掌握,可自行在家中操作治疗。不仅减轻家庭的经济负担,而且能提高患者的依从性。直接灸具有安全有效、经济简便的优势,可降低医疗成本,具有良好的经济效益和社会效益。
[Abstract]:Objective: to explore the effect of direct moxibustion on immune T cells and quality of life of tumor patients after chemotherapy. Methods: all 60 cases were hospitalized in Oncology Department of the second affiliated Hospital of Anhui University of traditional Chinese Medicine from January 2015 to January 2016. 60 patients with tumor chemotherapy were divided into treatment group (n = 30) and control group (n = 30) according to the principle of random grouping. Treatment group: routine chemotherapy direct moxibustion, point Zusanli, Qihai. When the moxibustion burns to about 2 / 5 / 1 / 5 and the patient feels that the burning heat is intolerable, change the moxa stick in time, moxibustion continuously 5 strong, once a day, from the first day before the patient chemotherapy, to the next chemotherapy as a course of treatment, a total of 30 days. Control group: chemotherapy only, moxibustion. During the course of treatment, other related treatment methods were stopped. All patients were tested for peripheral blood before and after treatment, and the data were statistically processed. The survival scale QLQ-C30 CD 4, CD 4, CD 8 and Th17 cells were used to observe the effect of direct moxibustion in Zusanli and Qihai on immune T cells and quality of life of tumor chemotherapy patients. The result is 1: 1. Treatment group and control group, the patient's age, course of disease, sex, cancer species, chi-square test, the two groups were not statistically significant difference (P 0.05), suggesting that the two groups have comparability. 2. The levels of CD4 in peripheral blood of the treatment group and the control group were not significantly different before and after treatment, suggesting that the two groups were comparable, and that the CD4 content in the treatment group increased after treatment, and there was no significant difference between the two groups before and after treatment. There was a significant difference between the two groups (P 0.01), the content of CD4 in the control group was decreased, and the difference between the two groups was statistically significant (P 0.05), and the difference between the two groups was statistically significant (P 0.01) .3.In the control group, the content of CD4 in the control group was significantly lower than that in the control group (P < 0.05). The levels of CD8 in peripheral blood of the treatment group and the control group were not significantly different before and after treatment, suggesting that the two groups were comparable, and that the CD8 content in the treatment group decreased after treatment, and there was no significant difference between the two groups before and after treatment. There was a significant difference between the two groups (P 0.01), the content of CD8 in the control group was higher than that in the control group (P 0.05), and the difference between the two groups was significant (P 0.01). 4. The level of Th17 expression in peripheral blood of the treatment group and the control group was not significantly different before and after treatment, suggesting that the two groups were comparable, and the expression of Th17 in the treatment group decreased after treatment. There was a significant difference between the two groups (P 0.01), the expression of Th17 in the control group was decreased, and the difference between the two groups was statistically significant (P 0.01), and the difference between the two groups was significant (P 0.01). Before treatment, the scores of quality of life of the patients in the treatment group and the control group were not significantly different between the two groups, indicating that the two groups were comparable, and the scores of the patients in the treatment group increased after the treatment. The scores of quality of life of the patients in the control group decreased, and the difference between the two groups was statistically significant (P 0.05), which suggested that chemotherapy would lead to the decrease of the quality of life of the patients, and direct moxibustion could improve the quality of life of the patients. Conclusion: direct moxibustion can increase the content of CD4, decrease the content of CD8 and the expression of Th17 cells, improve the immune function and improve the quality of life of patients with tumor chemotherapy. It can be used as a adjuvant method for tumor patients after chemotherapy to improve the curative effect of chemotherapy. The research program is simple, convenient for patients to master, and can be operated at home. Not only to reduce the financial burden of families, but also to improve the compliance of patients. Direct moxibustion has the advantages of safe, effective, economical and simple, can reduce the medical cost, and has good economic and social benefits.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.5

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