黄芪建中汤联合雷火灸治疗气虚型结直肠癌伴癌因性疲乏疗效观察及对血清神经递质水平的影响

Observation on Efficacy of Huangqi Jianzhong Decoction Combined with Thunder- Fire Moxibustion for Colorectal Cancer with Cancer-Related Fatigue of Qi Deficiency Type and Its Effects on Serum Neurotransmitter Levels

摘要:

目的：观察黄芪建中汤联合雷火灸治疗气虚型结直肠癌伴癌因性疲乏（CRF） 临床疗效及对血清神经递质水平的影响。方法：选取2022年10月—2025年10月在北京中医药大学东直门医院洛阳医院就诊的100例气虚型结直肠癌伴CRF患者作为研究对象，按随机数字表法分为研究组与对照组各50例。对照组给予黄芪建中汤治疗，研究组在对照组基础上加用雷火灸进行治疗。疗程均为4周，比较2组临床疗效、中医证候评分、Piper疲乏修订量表（RPFS） 评分、卡氏功能状态评分量表（KPS） 评分及血清神经递质［5-羟色胺（5-HT）、去甲肾上腺素（NE）、多巴胺（DA）］ 水平变化。结果：治疗后，研究组总有效率为86.00% （43/50），对照组为64.00% （32/50），2组比较，差异有统计学意义（P＜0.05）。治疗后，2组中医证候评分均较治疗前降低（P＜0.05），且研究组中医证候评分低于对照组（P＜0.05）。治疗后，2组RPFS评分均较治疗前降低（P＜0.05），且研究组RPFS评分低于对照组（P＜0.05）。治疗后，2组血清5-HT、DA水平均较治疗前升高（P＜0.05），NE水平较治疗前降低（P＜0.05）；且研究组5-HT、DA水平高于对照组（P＜0.05），NE水平低于对照组（P＜0.05）。治疗后，2组KPS评分均较治疗前升高（P＜0.05），且研究组KPS评分高于对照组（P＜0.05）。结论：黄芪建中汤联合雷火灸治疗气虚型结直肠癌伴CRF可提高临床疗效，联合治疗方案在改善病情及神经递质方面较单用黄芪建中汤具有一定的优势。

Abstract:

Abstract： Objective： To observe the efficacy of Huangqi Jianzhong Decoction combined with thunder-fire moxibustion in the treatment of colorectal cancer with cancer-related fatigue （CRF） of qi deficiency type， and to explore its effects on serum neurotransmitter levels. Methods：A total of 100 patients with colorectal cancer with CRF of qi deficiency type treated at Luoyang Branch of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from October 2022 to October 2025 were enrolled. They were randomly divided into the study group and the control group using the random number table method，with 50 cases in each group. The control group received Huangqi Jianzhong Decoction， while the study group received thunder-fire moxibustion in addition to Huangqi Jianzhong Decoction. Both groups were treated for four weeks. The clinical efficacy， changes in traditional Chinese medicine syndrome scores，Revised Piper Fatigue Scale （RPFS） scores，Karnofsky Performance Status （KPS） scores，and serum levels of neurotransmitters [5-hydroxytryptamine （5-HT）， norepinephrine （NE）， dopamine （DA） ] were compared between the two groups. Results： After treatment， the total effective rate was 86.00% （43/50） in the study group and 64.00% （32/50） in the control group， with a statistically significant difference between the two groups （P＜0.05） . After treatment， traditional Chinese medicine syndrome scores in both groups decreased compared with those before treatment （P＜0.05），and the traditional Chinese medicine syndrome score in the study group was lower than that in the control group （P＜0.05） . After treatment， RPFS scores in both groups decreased compared with those before treatment （P＜0.05），and the RPFS score in the study group was lower than that in the control group （P＜0.05） . After treatment， serum levels of 5-HT and DA in both groups increased compared with those before treatment （P＜0.05），while NE levels decreased （P＜0.05）；the study group showed higher levels of 5- HT and DA （P＜0.05） and a lower level of NE （P＜0.05） than the control group. After treatment，KPS scores in both groups increased compared with those before treatment （P＜0.05）， and the KPS score in the study group was higher than that in the control group （P＜0.05）. Conclusion：Huangqi Jianzhong Decoction combined with thunderfire moxibustion can improve the clinical efficacy in the treatment of colorectal cancer with CRF of qi deficiency type. The combined treatment regimen has certain advantages over Huangqi Jianzhong Decoction alone in alleviating the condition and regulating neurotransmitter levels.