本文選題：直接灸 + 足三里��； 參考：《安徽中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:初步探討直接灸足三里、氣海對(duì)腫瘤化療患者免疫T細(xì)胞及生存質(zhì)量的影響,為臨床治療腫瘤患者化療后免疫功能低下,提供一定的借鑒和參考。方法:全部病例共60例,均為2015年1月至2016年1月在安徽中醫(yī)藥大學(xué)第二附屬醫(yī)院腫瘤科住院的病人。將60例腫瘤化療患者,按就診順序編號(hào)為01-60號(hào),按照隨機(jī)分組原則,分為治療組和對(duì)照組,每組30例。治療組:采用常規(guī)化療+直接灸,取穴足三里、氣海。施灸時(shí)待艾炷燃到2/5-1/5左右,患者感到灼熱不可耐受時(shí),及時(shí)更換艾炷,連續(xù)灸5壯,每日1次,從患者化療前1天開(kāi)始,至下次化療為1個(gè)療程,共30天。對(duì)照組:只化療,不灸。治療期間,停用其它相關(guān)的治療方法,所有患者在治療前、治療后各做1次外周血化驗(yàn),數(shù)據(jù)進(jìn)行統(tǒng)計(jì)處理。選取生存量表QLQ-C30,CD4+、CD8+及Th17細(xì)胞作為觀(guān)察指標(biāo),觀(guān)察直接灸足三里、氣海對(duì)腫瘤化療患者免疫T細(xì)胞及生存質(zhì)量的影響。結(jié)果:1.治療組和對(duì)照組,患者的年齡、病程以及性別、癌種,經(jīng)卡方檢驗(yàn),兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組具有可比性。2.治療組和對(duì)照組外周血中CD4+含量,治療前,組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組具有可比性;治療后,治療組CD4+含量上升,組內(nèi)比較差異有明顯的統(tǒng)計(jì)學(xué)意義(P0.01);對(duì)照組CD4+含量下降,組內(nèi)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);組間比較,差異有明顯的統(tǒng)計(jì)學(xué)意義(P0.01)。3.治療組和對(duì)照組外周血中CD8+含量,治療前,組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組具有可比性;治療后,治療組CD8+含量下降,組內(nèi)比較差異有明顯的統(tǒng)計(jì)學(xué)意義(P0.01);對(duì)照組CD8+含量上升,組內(nèi)比較差異有統(tǒng)計(jì)學(xué)意義(P0.05);組間比較,差異有明顯的統(tǒng)計(jì)學(xué)意義(P0.01)。4.治療組和對(duì)照組外周血中Th17表達(dá)水平,治療前,組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組具有可比性;治療后,治療組Th17表達(dá)水平下降,組內(nèi)比較差異有明顯的統(tǒng)計(jì)學(xué)意義(P0.01);對(duì)照組Th17表達(dá)水平下降,組內(nèi)比較差異有統(tǒng)計(jì)學(xué)意義(P0.01);組間比較,差異有明顯的統(tǒng)計(jì)學(xué)意義(P0.01)。5.治療前,治療組和對(duì)照組患者的生存質(zhì)量評(píng)分,組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),提示兩組具有可比性;治療后,治療組患者的生存質(zhì)量評(píng)分增加,對(duì)照組患者的生存質(zhì)量評(píng)分下降,組內(nèi)和組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),提示化療會(huì)導(dǎo)致患者生存質(zhì)量下降,而直接灸可以提高患者的生存質(zhì)量。結(jié)論:研究結(jié)果顯示,直接灸可升高腫瘤化療患者外周血中CD4+含量,降低CD8+含量及Th17細(xì)胞表達(dá)水平,改善腫瘤化療患者的免疫功能并提高生存質(zhì)量,可作為腫瘤患者化療后的輔助手段,提高化療的療效。研究方案操作簡(jiǎn)單,方便患者掌握,可自行在家中操作治療。不僅減輕家庭的經(jīng)濟(jì)負(fù)擔(dān),而且能提高患者的依從性。直接灸具有安全有效、經(jīng)濟(jì)簡(jiǎn)便的優(yōu)勢(shì),可降低醫(yī)療成本,具有良好的經(jīng)濟(jì)效益和社會(huì)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.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R246.5

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