针刺研究2024，Vol.49Issue(11)：1190-1197,8.DOI:10.13702/j.1000-0607.20230821
热敏灸联合胸腔灌注顺铂治疗恶性胸腔积液的临床疗效观察
Clinical efficacy observation of heat-sensitive moxibustion combined with intrapleural perfusion of cisplatin in treatment of malignant pleural effusion
摘要
Abstract
Objective To investigate the clinical efficacy of heat-sensitive moxibustion combined with intrapleural perfusion of cisplatin in comparison with simple intrapleural perfusion of cisplatin on malignant pleural effusion(MPE).Methods Forty patients with MPE,in compliance with the inclusion criteria,were randomly divided into an observation group(20 cases)and a control group(20 cases).In the control group,cisplatin solution(60 mg/m2)was injected into the thoracic cavity after pleural drainage under B-ultrasound positioning,once a week for 4 weeks.In the observation group,based on the intervention as the control group,the heat-sensitive moxibustion was delivered at the back and lumbar region(where Feishu[BL13],Pishu[BL20]and Shenshu[BL23]are located)and the chest-abdomen region(where Danzhong[CV17],Guanyuan[CV4]and Shuidao[ST28]are located),for 30 min to 90 min,once daily(the treatment was discontinued on Saturday and Sunday)and for 4 weeks.Before and after treatment,in the two groups,the pleural effusion volume was detected using B ultrasound,the activity of daily living was evaluated with Karnofsky performance statue(KPS)scale and TCM symptoms with TCM syndrome grading scale.The clinical therapeutic effect was evaluated in the two groups.According to the classification criteria table for acute and subacute toxicity of anticancer drugs made by WHO,the toxic and side reaction was judged.Results After treatment,the pleural effusion volume was reduced in comparison with that before treatment in the two groups(P＜0.01,P＜0.001),and the volume in the observation group was lower than that of the control group(P＜0.05).KPS score was increased in the two groups after treatment compared with that before treatment(P＜0.001),and the score in the observation group was higher than that of the control group(P＜0.05).After treatment,the total score of TCM syndromes and the scores for dyspnea,cough and chest pain were lower than those before treatment in the two groups(P＜0.001),and the scores in the observation group were lower than those of the control group(P＜0.001,P＜0.05).The scores for anorexia and lassitude were reduced in comparison with those before treatment in the observation group(P＜0.001);and the scores in the observation group were lower than those in the control group after treatment(P＜0.001,P＜0.01).After treatment,the effective rate of the observation group was 65.0％(13/20),which was higher than that of the control group(30.0％,6/20,P＜0.05).The incidence of bone marrow suppression in the observation group was 15.0％(3/20),lower than that in the control group(55.0％,11/20,P＜0.05).The incidence of gastrointestinal reactions in the observation group was 30.0％,lower than that in the control group(65.0％,13/20,P＜0.05).Conclusion Heat-sensitive moxibustion combined with intrapleural infusion of cisplatin is superior to intrapleural infusion of cisplatin in the aspects of the amelioration of pleural effusion,daily-living activity and TCM syndromes in patients with MPE.This combined therapy presents the synergism by cooperating with chemotherapeutics and reduces the incidence of toxic and side effects implicated in chemotherapy so as to attenuate the toxicity of chemotherapeutics.关键词
恶性胸腔积液/热敏灸/胸腔灌注顺铂/随机对照试验Key words
Malignant pleural effusion/Heat-sensitive moxibustion/Intrapleural infusion of cisplatin/Randomized controlled trial引用本文复制引用
周梅,杨硕,陈日新,杨孝芳,赵静,谢雯璇,廖越,刘冬..热敏灸联合胸腔灌注顺铂治疗恶性胸腔积液的临床疗效观察[J].针刺研究,2024,49(11):1190-1197,8.基金项目
贵州省贵阳市科技计划项目(No.筑科合同[2019]-9-4-32号) （No.筑科合同[2019]-9-4-32号）
贵州省"十四五"中医药、民族医药重点学科建设项目[No.QZYYZDXK(JS)-2021-07] （JS）
