火针四花穴对乳腺癌术后化疗的毒副反应研究

发布时间：2018-06-03 00:14

本文选题：火针 + 四花穴　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的：本研究采用前瞻性的临床研究,观察火针四花穴对乳腺癌化疗患者生存质量及抗癌药物毒性毒性反应(外周血WBC、胃肠道反应)的影响。本研究通过对乳腺癌化疗患者治疗前后生存质量的评价,观察火针四花穴对乳腺癌化疗患者生存质量的影响,同时观察火针四花穴对乳腺癌化疗患者治疗后外周血WBC数值及分度的影响及对胃肠道反应(呕吐、恶心、食欲)的影响,为火针四花穴治疗乳腺癌化疗患者提供临床依据。方法：一般需行葸环类化疗的乳腺癌患者,符合标准的60例,采用简单随机法分为两组,设立Ⅰ组为治疗组,在接受常规应用预防化疗毒副反应的西药基础上,进行火针四花穴处理,Ⅱ组为对照组,只接受化疗和常规应用预防化疗毒副反应的西药，每组30例。从化疗前一天开始火针四花穴,火针每天1次,3天为一疗程。化疗方案：以采用葸环类治疗为主(EC、CEF、AC方案)。火针四花穴：患者坐位,取双侧膈俞、胆俞穴,用安尔碘消毒后再涂上万花油,点燃酒精灯,右手持火针,针下3分烧至通红,速速点刺穴位,深度约0.1mm,每穴点7下,点完后用棉球按该穴位,再涂上万花油。从化疗前1天开始火针治疗,每天1次,3天为1疗程,治疗一疗程。化疗前1天及服用化疗药第21天进行Karnofasky体力状况评分、生存质量表评分、外周血WBC采用WHO抗癌药物毒性反应分级。另外,于服用化疗药第1、2、7天采用欧洲临床肿瘤会议推荐的标准评价,对化疗后的胃肠反应(呕吐、恶心、食欲)进行评分。结果：Karnofasky体力状况评分比较：治疗组化疗前评分81.83±6.50,化疗后评分76.67±5.47；对照组治疗前评分81.17±6.39,化疗后评分73.33±6.61。两组治疗前评分P=0.666,P0.05差异无统计学意义；两组组内自身前后比较P=0.00,P0.01,差异有统计学意义；故可认为两组治疗后Karnofasky体力状况评分均有所下降。两组治疗前后差值比较P=0.018,P0.05,差异有统计学意义,治疗组对Karnofasky体力状况评分减少较对照组少。生存质量评分比较：两组治疗前评分比较P=0.428,P0.05,差异无统计学意义；两组组内自身前后比较,P=0.00,P0.01,差异有统计学意义,故可认为两组治疗后生存质量评分均有所下降。两组治疗前后差值比较,P=0.00,P0.01,差异有统计学意义,化疗后治疗组生存质量下降程度较对照组低。抗癌药物毒性反应比较—外周血WBC数比较：治疗前两组外周血WBC数比较P=0.97,P0.05,差异无统计学意义；两组组内自身前后比较,P=0.00,P0.01,差异有统计学意义,两组治疗后外周血WBC均较治疗前有所下降；治疗后两组比较P=0.026,P0.05,差异有统计学意义,治疗后治疗组WBC数的下降情况较对照组低。两组的治疗前后差值比较P=0.018,P0.05,差异有统计学意义,化疗后治疗组外周血WBC数下降程度较对照组低。治疗后两组外周血WBC分度比较P=0.048,P0.05,差异有统计学意义,治疗后治疗组WBC分度的的下降情况较对照组低。胃肠道反应比较(急性—服用化疗药后24小时之内发生)：两组化疗后第一天呕吐比较P=0.598,P0.05,差异无统计学意义。两组化疗后第一天恶心比较P=0.577,P0.05,差异无统计学意义。两组化疗后第一天食欲比较P=0.045,P0.05,差异有统计学意义,治疗组病人的第一天食欲情况较对照组好。胃肠道反应比较(延迟性)：两组化疗后第二天呕吐比较P=0.037,PO.05,差异有统计学意义,治疗组第二天呕吐情况较对照组轻。两组化疗后第二天恶心比较P=0.049,P0.05差异有统计学意义。两组化疗后第七天恶心比较P=0.04,P0.05,差异有统计学意义,治疗组第二天及第七天恶心情况较对照组轻。两组化疗后第二天、第七天食欲比较分别为P=0.028及P=0.021,P0.05,差异有统计学意义,提示化疗后第二天、第七天治疗组病人的食欲情况较对照组好。结论：接受蒽环类化疗的乳腺癌患者于治疗时配合火针四花穴治疗,一定程度上可减轻化疗引起的Karnofasky体力状况的下降、生存质量的下降、外周血WBC数的下降情况。同时对于化疗后食欲、延迟性呕吐、恶心都有改善作用,能减轻胃肠道反应。
[Abstract]:Objective: To observe the effect of fire needle four flower point on the quality of life and the toxic and toxic reaction of anticancer drugs (peripheral blood WBC, gastrointestinal reaction) in patients with breast cancer chemotherapy. This study was to observe the quality of survival of the chemotherapy patients before and after the treatment of breast cancer, and to observe the four points of fire needle on the patients with breast cancer chemotherapy. The effect of the quality of life, and the effect of the four flower point on the WBC value and degree of peripheral blood after the chemotherapy of breast cancer patients, and the effect on the gastrointestinal reaction (vomiting, nausea, appetite), and to provide the clinical basis for the treatment of breast cancer chemotherapy patients with the four flower point of fire needle. 60 cases were divided into two groups by simple random method. Group I was set up as the treatment group. On the basis of Western medicine that received routine use of chemotherapy and side effects of chemotherapy, four flower points were treated with fire needle. Group II was the control group. Only chemotherapy and routine use of Western Medicine to prevent chemotherapy and side effects were accepted, and 30 cases in each group were started from the day before chemotherapy, and four Hua points were started from the day before chemotherapy, Fire needle 1 times a day, 3 days for a course of treatment. Chemotherapy regimen: the chemotherapy regimen: EC, CEF, AC scheme. The patient's sitting position, bilateral diaphragm Yu, gallbladder Yu Xue, after aniodide disinfection, then smear tens of thousands of oil, light alcohol lamp, hand holding fire needle, 3 points under the needle to red, speed point pricking point, depth about 0.1mm, 7 points at each point, After the point, use the cotton ball at the point, then apply thousands of oil. From 1 days before the chemotherapy, fire needle treatment, 1 times a day, 3 days for a course of treatment, treatment for a course of treatment. 1 days before chemotherapy and twenty-first days of chemotherapy for twenty-first days of Karnofasky physical status score, the quality of life score, the peripheral blood WBC using WHO anticancer drug toxicity classification. In addition, in the chemotherapy of chemotherapy On day 1,2,7, the drug was evaluated by the standard evaluation recommended by the European Conference on clinical oncology. The gastrointestinal response (vomiting, nausea, appetite) after chemotherapy was scored. Results: the scores of Karnofasky physical status were compared: the score of pre chemotherapy in the treatment group was 81.83 + 6.50, after chemotherapy, the score was 76.67 + 5.47; the scores of the group before the treatment were 81.17 + 6.39 and the score of chemotherapy was 73.33 + 6.. 61. two groups before treatment score P=0.666, P0.05 difference was not statistically significant; the two groups were compared with P=0.00, P0.01, the difference was statistically significant; therefore, after the treatment of two groups of Karnofasky physical status scores were reduced. The two groups were compared before and after the difference P=0.018, P0.05, the difference was statistically significant, Karnofasky treatment group to Karnofasky The score of physical condition decreased less than that of the control group. The score of quality of life was compared: the score of two groups before treatment was P=0.428, P0.05, the difference was not statistically significant; the difference between the two groups was compared, P=0.00, P0.01, and the difference was statistically significant. Therefore, the scores of the quality of life in the two groups were all decreased. The difference of the two groups before and after treatment was compared, P=0 .00, P0.01, the difference was statistically significant, after chemotherapy, the quality of life of the treatment group was lower than the control group. The comparison of the toxic reaction of the anticancer drug - the number of peripheral blood WBC: the number of WBC in the peripheral blood of the two groups was P=0.97, P0.05, the difference was not statistically significant; the difference of P=0.00, P0.01 in the two groups was statistically significant, two After treatment, the peripheral blood WBC was lower than that before the treatment. After treatment, the two groups were compared with P=0.026, P0.05, and the difference was statistically significant. The decrease of WBC in the treatment group was lower than that of the control group. The difference between the two groups was P=0.018, P0.05, and the difference was statistically significant. The decrease of the number of WBC in the peripheral blood after chemotherapy was more than that of the control group. After treatment, the WBC fraction of the peripheral blood in the two groups was compared with P=0.048, P0.05, and the difference was statistically significant. The decrease of WBC degree in the treatment group was lower than that of the control group. The gastrointestinal reaction was compared (acute after taking chemotherapy drugs within 24 hours): the two group after chemotherapy was P=0.598 and P0.05, the difference was not statistically significant. The difference was not statistically significant. Two groups were not statistically significant. The first day after chemotherapy was compared with P=0.577, P0.05, the difference was not statistically significant. The first day after chemotherapy, the appetite was P=0.045, P0.05, and the difference was statistically significant. The first day of the treatment group was better than the control group. The gastrointestinal reaction was compared (delayed): the vomiting of the two groups after second days of chemotherapy was P=0.037, PO.05, the difference was statistically significant. Second days of vomiting in the treatment group was lighter than that in the control group. Two groups of nausea after second days of chemotherapy compared P=0.049, P0.05 difference was statistically significant. Two groups of nausea after seventh days of chemotherapy compared with P=0.04, P0.05, the difference was statistically significant, second days and seven days in the treatment group were less than the control group. Two group after second days, seventh days after the chemotherapy. The difference was P=0.028, P=0.021, P0.05, and the difference was statistically significant. It suggested that second days after chemotherapy and seventh days in the treatment group, the appetite of the patients was better than that of the control group. Conclusion: the patients receiving anthracycline chemotherapy were treated with the treatment of four Hua points with the fire needle, which could reduce the physical status of Karnofasky induced by chemotherapy. Decrease, decrease of quality of life, decrease of WBC number in peripheral blood. It also improves appetite, delayed vomiting and nausea after chemotherapy, and can relieve gastrointestinal reaction.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.5

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