發(fā)布時間：2018-06-03 00:14

  本文選題：火針 + 四花穴��； 參考：《廣州中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：本研究采用前瞻性的臨床研究,觀察火針?biāo)幕ㄑ▽θ橄侔┗熁颊呱尜|(zhì)量及抗癌藥物毒性毒性反應(yīng)(外周血WBC、胃腸道反應(yīng))的影響。本研究通過對乳腺癌化療患者治療前后生存質(zhì)量的評價,觀察火針?biāo)幕ㄑ▽θ橄侔┗熁颊呱尜|(zhì)量的影響,同時觀察火針?biāo)幕ㄑ▽θ橄侔┗熁颊咧委熀笸庵苎猈BC數(shù)值及分度的影響及對胃腸道反應(yīng)(嘔吐、惡心、食欲)的影響,為火針?biāo)幕ㄑㄖ委熑橄侔┗熁颊咛峁┡R床依據(jù)。方法：一般需行葸環(huán)類化療的乳腺癌患者,符合標(biāo)準(zhǔn)的60例,采用簡單隨機(jī)法分為兩組,設(shè)立Ⅰ組為治療組,在接受常規(guī)應(yīng)用預(yù)防化療毒副反應(yīng)的西藥基礎(chǔ)上,進(jìn)行火針?biāo)幕ㄑㄌ幚?Ⅱ組為對照組,只接受化療和常規(guī)應(yīng)用預(yù)防化療毒副反應(yīng)的西藥，每組30例。從化療前一天開始火針?biāo)幕ㄑ?火針每天1次,3天為一療程�；煼桨福阂圆捎幂攮h(huán)類治療為主(EC、CEF、AC方案)�；疳�?biāo)幕ㄑǎ夯颊咦?取雙側(cè)膈俞、膽俞穴,用安爾碘消毒后再涂上萬花油,點(diǎn)燃酒精燈,右手持火針,針下3分燒至通紅,速速點(diǎn)刺穴位,深度約0.1mm,每穴點(diǎn)7下,點(diǎn)完后用棉球按該穴位,再涂上萬花油。從化療前1天開始火針治療,每天1次,3天為1療程,治療一療程�；熐�1天及服用化療藥第21天進(jìn)行Karnofasky體力狀況評分、生存質(zhì)量表評分、外周血WBC采用WHO抗癌藥物毒性反應(yīng)分級。另外,于服用化療藥第1、2、7天采用歐洲臨床腫瘤會議推薦的標(biāo)準(zhǔn)評價,對化療后的胃腸反應(yīng)(嘔吐、惡心、食欲)進(jìn)行評分。結(jié)果：Karnofasky體力狀況評分比較：治療組化療前評分81.83±6.50,化療后評分76.67±5.47；對照組治療前評分81.17±6.39,化療后評分73.33±6.61。兩組治療前評分P=0.666,P0.05差異無統(tǒng)計學(xué)意義；兩組組內(nèi)自身前后比較P=0.00,P0.01,差異有統(tǒng)計學(xué)意義；故可認(rèn)為兩組治療后Karnofasky體力狀況評分均有所下降。 兩組治療前后差值比較P=0.018,P0.05,差異有統(tǒng)計學(xué)意義,治療組對Karnofasky體力狀況評分減少較對照組少。生存質(zhì)量評分比較：兩組治療前評分比較P=0.428,P0.05,差異無統(tǒng)計學(xué)意義；兩組組內(nèi)自身前后比較,P=0.00,P0.01,差異有統(tǒng)計學(xué)意義,故可認(rèn)為兩組治療后生存質(zhì)量評分均有所下降。兩組治療前后差值比較,P=0.00,P0.01,差異有統(tǒng)計學(xué)意義,化療后治療組生存質(zhì)量下降程度較對照組低�？拱┧幬锒拘苑磻�(yīng)比較—外周血WBC數(shù)比較：治療前兩組外周血WBC數(shù)比較P=0.97,P0.05,差異無統(tǒng)計學(xué)意義；兩組組內(nèi)自身前后比較,P=0.00,P0.01,差異有統(tǒng)計學(xué)意義,兩組治療后外周血WBC均較治療前有所下降；治療后兩組比較P=0.026,P0.05,差異有統(tǒng)計學(xué)意義,治療后治療組WBC數(shù)的下降情況較對照組低。兩組的治療前后差值比較P=0.018,P0.05,差異有統(tǒng)計學(xué)意義,化療后治療組外周血WBC數(shù)下降程度較對照組低。治療后兩組外周血WBC分度比較P=0.048,P0.05,差異有統(tǒng)計學(xué)意義,治療后治療組WBC分度的的下降情況較對照組低。胃腸道反應(yīng)比較(急性—服用化療藥后24小時之內(nèi)發(fā)生)：兩組化療后第一天嘔吐比較P=0.598,P0.05,差異無統(tǒng)計學(xué)意義。兩組化療后第一天惡心比較P=0.577,P0.05,差異無統(tǒng)計學(xué)意義。兩組化療后第一天食欲比較P=0.045,P0.05,差異有統(tǒng)計學(xué)意義,治療組病人的第一天食欲情況較對照組好。胃腸道反應(yīng)比較(延遲性)：兩組化療后第二天嘔吐比較P=0.037,PO.05,差異有統(tǒng)計學(xué)意義,治療組第二天嘔吐情況較對照組輕。兩組化療后第二天惡心比較P=0.049,P0.05差異有統(tǒng)計學(xué)意義。兩組化療后第七天惡心比較P=0.04,P0.05,差異有統(tǒng)計學(xué)意義,治療組第二天及第七天惡心情況較對照組輕。兩組化療后第二天、第七天食欲比較分別為P=0.028及P=0.021,P0.05,差異有統(tǒng)計學(xué)意義,提示化療后第二天、第七天治療組病人的食欲情況較對照組好。結(jié)論：接受蒽環(huán)類化療的乳腺癌患者于治療時配合火針?biāo)幕ㄑㄖ委?一定程度上可減輕化療引起的Karnofasky體力狀況的下降、生存質(zhì)量的下降、外周血WBC數(shù)的下降情況。同時對于化療后食欲、延遲性嘔吐、惡心都有改善作用,能減輕胃腸道反應(yīng)。
[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.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.5

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