| 引用本文: |
高雅丽, 王翠华, 赵子申, 高雅梅, 宋丽娜, 王志聪, 王洪兵.温针灸四关穴对中晚期宫颈癌癌性疼痛患者T淋巴细胞亚群调节作用研究[J].湖南中医药大学学报,2024,44(9):1633-1638[点击复制] |
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| 温针灸四关穴对中晚期宫颈癌癌性疼痛患者T淋巴细胞亚群调节作用研究 |
| 高雅丽,王翠华,赵子申,高雅梅,宋丽娜,王志聪,王洪兵 |
| (沧州市中心医院, 河北 沧州 061000) |
| 摘要: |
| 目的 探讨温针灸四关穴治疗气滞血瘀证中晚期宫颈癌癌性疼痛的疗效及对T淋巴细胞亚群的调节作用。方法 选定沧州市中心医院2021年10月至2023年10月就诊的84例气滞血瘀证中晚期宫颈癌癌性疼痛患者，按随机数字表法分为温针灸组、西药组，各42例。西药组给予三级止痛治疗，温针灸组在西药组基础上给予温针灸四关穴治疗，比较两组患者临床疗效、卡氏评分量表（Karnofsky, KPS）评分、视觉模拟评分量表（visual analogue scale, VAS）评分、一般自我效能感量表（general self-efficacy scale-schwarzer, GSES）评分、疼痛应激指标[5-羟色胺（5-hydroxytryptamine, 5-HT）、β内啡肽（β-endorphin, β-EP）、P物质（substance P, SP）]、T淋巴细胞亚群指标、生活质量综合评定问卷量表（generic quality of life inventory-74, GQOLI-74）评分。结果 温针灸组总有效率（95.24%）高于西药组（76.19%）（P＜0.05）。两组治疗后KPS评分、GSES评分、GQOLI-74评分、血清β-EP水平、CD3+、CD4+、CD4+/CD8+均较治疗前更高（P＜0.05），两组治疗后VAS评分、血清5-HT水平、SP水平、CD8+均较治疗前更低（P＜0.05）。温针灸组治疗后KPS评分、GSES评分、GQOLI-74评分、血清β-EP水平、CD3+、CD4+、CD4+/CD8+均较西药组更高（P＜0.05，P＜0.01），VAS评分、血清5-HT水平、SP水平、CD8+均较西药组更低（P＜0.01）。结论 在三级止痛的基础上联合温针灸四关穴可有效缓解气滞血瘀证中晚期宫颈癌癌性疼痛患者疼痛症状，改善身体状况、免疫功能，调节疼痛应激物质释放，提高生存质量，效果显著。 |
| 关键词: 宫颈癌 癌性疼痛 温针灸 四关穴 布洛芬 曲马多 吗啡 T淋巴细胞亚群 |
| DOI：10.3969/j.issn.1674-070X.2024.09.012 |
| 投稿时间：2024-03-02 |
| 基金项目:河北省中医药管理局科研计划项目（2022271）。 |
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| Regulatory effects of needle-warming moxibustion at Siguan acupoints on T lymphocyte subsets in patients with middle and late stage cervical cancer pain |
| GAO Yali, WANG Cuihua, ZHAO Zishen, GAO Yamei, SONG Lina, WANG Zhicong, WANG Hongbing |
| (Cangzhou Central Hospital, Cangzhou, Hebei 061000, China) |
| Abstract: |
| Objective To explore the therapeutic effects of needle-warming moxibustion at Siguan acupoints on cervical cancer pain in the middle and late stages of qi stagnation and blood stasis pattern and its regulatory effects on T lymphocyte subsets. Methods Eighty-four patients with cancer pain due to middle and late stages of qi stagnation and blood stasis pattern who visited Cangzhou Central Hospital from October 2021 to October 2023 were selected and divided into needle-warming moxibustion group and Western medicine group according to random number table method, with 42 cases in each group. The Western medicine group was given three-level pain relief treatment, and the needle-warming moxibustion group received needle-warming moxibustion at Siguan acupoints on the basis of the Western medicine group. The clinical efficacy, Karnofsky (KPS) score, visual analogue scale (VAS) score, general self-efficacy scale Schwarzer (GSES) score, pain stress indicators [5-hydroxytryptamine (5-HT), β-endorphin (β-EP), substance P (SP)], T lymphocyte subset indicators, and generic quality of life inventory-74 (GQOLI-74) score were compared between the two groups. Results The total effective rate of needle-warming moxibustion group (95.24%) was higher than that of Western medicine group (76.19%) (P＜0.05). After treatment, KPS score, GSES score, GQOLI-74 score, serum β-EP level, CD3+, CD4+, CD4+/CD8+ were all higher than those before treatment in both groups (P＜0.05), while VAS score, serum 5-HT level, SP level, and CD8+ were all lower than those before treatment in both groups (P＜0.05). After treatment, KPS score, GSES score, GQOLI-74 score, serum β-EP level, CD3+, CD4+, CD4+/CD8+ in the needle-warming moxibustion group were higher than those in the Western medicine group (P＜0.05, P＜0.01), while VAS score, serum 5-HT level, SP level, CD8+ were lower than those in the Western medicine group (P＜0.01). Conclusion The combination of needle-warming moxibustion at Siguan acupoints and three-level pain relief can effectively relieve the pain symptoms of patients with cervical cancer pain in the middle and late stages of qi stagnation and blood stasis pattern, improve physical condition and immune function, regulate the release of pain stress substances, and enhance quality of life, with significant effects. |
| Key words: cervical cancer cancer pain needle-warming moxibustion Siguan acupoints ibuprofen tramadol morphine T lymphocyte subsets |
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