补中益气固本汤联合雷火灸治疗肺癌化疗后癌因性疲乏临床研究

Clinical Study on Buzhong Yiqi Guben Decoction Combined with Thunder-Fire Moxi⁃ bustion for Cancer-Related Fatigue After Lung Cancer Chemotherapy

摘要:

目的：观察补中益气固本汤联合雷火灸治疗肺癌化疗后癌因性疲乏的疗效。方法：选择温岭市中 医院2024年1月—2025年5月收治的108例肺癌化疗后脾气虚型癌因性疲乏患者作为研究对象，按照随机数字 表法分为联合组与对照组，每组54例。2组均接受GP化疗方案治疗，对照组予雷火灸治疗，联合组予补中益 气固本汤联合雷火灸治疗，2组疗程均为6周。治疗前后评估癌因性疲乏程度（Piper疲乏量表评分）、中医证 候评分、睡眠质量［匹兹堡睡眠质量指数（PSQI） 评分］，检测免疫功能指标（CD4+、CD8+、CD4+/CD8+比值）， 比较2组不良反应发生率。结果：治疗后，2组Piper疲乏量表认知、感觉、情绪、行为评分均较治疗前下 降（P＜0.05），联合组4项评分均低于对照组（P＜0.05）。2组中医证候积分、PSQI评分均较治疗前下降（P＜ 0.05）；联合组中医证候积分、PSQI评分均低于对照组（P＜0.05）。2组CD4+水平及CD4+/CD8+比值均较治疗前 下降，CD8+水平均较治疗前升高，差异均有统计学意义（P＜0.05）。联合组CD4+水平及CD4+/CD8+比值均高于 对照组，CD8+水平低于对照组，差异均有统计学意义（P＜0.05）。联合组胃肠道反应、周围神经病变发生率均 低于对照组（P＜0.05）。结论：补中益气固本汤联合雷火灸可有效减轻肺癌化疗后癌因性疲乏程度，改善患者 的脾气虚证相关证候及睡眠质量，调节机体免疫功能，并可减少化疗相关不良反应的发生。

Abstract:

Abstract：Objective：To observe the clinical effect of Buzhong Yiqi Guben Decoction combined with thunderfire moxibustion in the treatment of cancer-related fatigue （CRF） after lung cancer chemotherapy. Methods：A total of 108 patients with CRF of spleen qi deficiency type after lung cancer chemotherapy， admitted to Wenling Hospital of Traditional Chinese Medicine from January 2024 to May 2025， were selected as the subjects. They were randomly divided into the combination group and the control group by a random number table method， with 54 cases in each group. Both groups received the GP chemotherapy regimen. The control group was treated with thunder-fire moxibustion， while the combination group received Buzhong Yiqi Guben Decoction combined with thunder-fire moxibustion. The treatment course for both groups was six weeks. The degree of CRF （Piper Fatigue Scale score）， traditional Chinese medicine syndrome scores， sleep quality [Pittsburgh Sleep Quality Index （PSQI） score]， and immune function indicators （CD4⁺， CD8⁺， CD4⁺/CD8⁺ ratio） were evaluated before and after treatment. The incidence of adverse reactions was compared between the two groups. Results：After treatment，the cognitive，sensory，emotional，and behavioral scores of the Piper Fatigue Scale were decreased in both groups when compared with those before treatment （P＜0.05），and the scores in the combination group were lower than those in the control group （P＜0.05）. The traditional Chinese medicine syndrome scores and PSQI scores were decreased in both groups when compared with those before treatment （P＜0.05）， and the scores in the combination group were lower than those in the control group （P＜0.05）. The levels of CD4⁺ and CD4⁺/CD8⁺ ratio were decreased，and the levels of CD8⁺ were increased in both groups when compared with those before treatment， differences being significant （P＜0.05）. The levels of CD4⁺ and CD4⁺/CD8⁺ ratio in the combination group were higher than those in the control group，while the CD8⁺ level was lower than that in the control group， differences being significant （P＜0.05）.The incidence rates of gastrointestinal reactions and peripheral neuropathy in the combination group were both lower than those in the control group （P＜0.05）. Conclusion：Buzhong Yiqi Guben Decoction combined with thunder-fire moxibustion can effectively reduce the degree of CRF after lung cancer chemotherapy， improve symptoms related to spleen qi deficiency type and sleep quality， regulate immune function，and reduce the incidence of chemotherapy-related adverse reactions.