Prevention and treatment of acupuncture for cancer-related fatigue caused by chemotherapy of intestinal cancer: a randomized controlled trial

针刺防治肠癌化疗所致癌因性疲乏的随机对照研究

Xiu-ting DU (杜秀婷)a, Wan-peng TIAN (田万朋)b, Bo LIU (刘柏)c, Liu-ning LI (李柳宁)c,*

a Department of Oncology, Shunde Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine, Foshan 528000, China (广州中医药大学顺德医院肿瘤科, 佛山528000, 中国)

b Second Clinical Medical School, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510000, China (广州中医药大学第二临床医学院，广州 510000，中国)

c No.3 Department of Internal Medicine, Daxuecheng Branch of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510006, China (广东省中医院大学城医院内三科，广州 510006，中国)

✰Supported by National Key Research and Development Plan: Research on academic viewpoints, characteristic diagnosis and treatment methods of the experiences of famous Chinese medicine physicians and the prevention and treatment of critical illness in eastern China：2018YFC1704102.

 *Corresponding author.

E-mail address: liliuning97@126.com (L.-n. LI)

ABSTRACT

Objective: To observe the clinical therapeutic effect and safety on cancer-related fatigue (CRF) after chemotherapy treated with the reinforcing technique of acupuncture at Qìhăi (气海CV6), Guānyuán (关元CV4) and bilateral Zúsānlĭ (足三里ST36) in the patients with colorectal cancer.

Methods: A total of 61 cases of CRF after chemotherapy for colorectal cancer were included in the trial and randomized into a control group (30 cases) and an observation group (31 cases). The patients of the two groups all accepted the regular chemotherapy. Each duration of chemotherapy was 3 weeks. In the observation group, 8 treatments with acupuncture were combined before chemotherapy and from the day 1 to 3 of chemotherapy separately, once daily, 30 min in each time, for two courses totally. Acupoints included bilateral ST36, CV6 and CV4. Separately, 1 day before the first cycle of chemotherapy, 1 day before the second cycle of chemotherapy and in 3 weeks after the second cycle of chemotherapy, the score of Piper fatigue scale (PFS) and the score of the scale for quality of life (QOL) were adopted to evaluate the improvement degree of cancer-related fatigue.

Results: Regarding PFS score, in 3-week followup after acupuncture treatment, compared with the control group, the mean value of the score of perception dimension was reduced obviously in the acupuncture treatment group, indicating the significant difference (P < 0.05). Compared with the values before treatment, after acupuncture, the mean values of the scores in behavior dimension, affection dimension, perception dimension, cognition dimension and the overall score were all reduced obviously, indicating the significant differences in the treatment group (all P < 0.05). But the differences were not significant in the control group in the mean values of the scores in behavior dimension, affection dimension, perception dimension and cognition dimension as well as in the overall score (all P > 0.05). Regarding the score of QOL scale, compared with the control group, in the treatment group, the mean value of physical function score was increased significantly (P < 0.05) and the mean values of the scores for overall health, fatigue and dyspnea were all reduced significantly, indicating the statistical differences (all P < 0.05). Compared with the values before treatment, after treatment, the mean values of the scores for physical function, role function and social function, as well as the scores of overall health, fatigue and dyspnea were all different significantly in the treatment group (all P < 0.05). But the mean values of the scores for each item as well as for overall health, fatigue and dyspnea were not different significantly in the control group (all P > 0.05).

Conclusion: In terms of the evaluation with PFS, acupuncture alleviates fatigue degree to the mild from the moderate in the patients with CRF, especially brings a positive effect on perception dimension, meaning the improvement of mental state. Regarding the evaluation of QOL scale, acupuncture improves overall health and physical function and alleviates fatigue and dyspnea. Acupuncture therapy has no obvious toxic side effect and achieves the definite therapeutic effect. 

Keywords:

Acupuncture therapy

Colorectal cancer

Chemotherapy

Cancer-related fatigue

Randomized controlled trial(RCT)

【摘要】

目的：观察针刺气海CV6、关元CV4、足三里ST36治疗化疗所致的癌因性疲乏（CRF）的临床疗效及安全性在结直肠癌患者中的表达。

方法：将61例结直肠癌化疗后CRF患者随机分为对照组30例和观察组31例。两组患者均接受常规化疗。每次化疗3周。观察组在化疗前和化疗第1～3天分别采用针刺治疗8次，每日1次，每次30min，共2个疗程。穴位包括双侧ST36、CV6、CV4。分别于第一周期化疗前1天、第二周期化疗前1天和第二周期化疗后3周，采用Piper疲劳量表（PFS）评分和生活质量量表（QOL）评分评价癌症相关疲劳的改善程度。

结果：在PFS评分方面，针刺治疗后3周随访中，针刺治疗组知觉维度评分均值较对照组明显降低，差异有显著性（P<0.05）。与治疗前相比，针刺后行为维度、情感维度、知觉维度、认知维度及总分的平均值均明显降低，说明治疗组间有显著性差异（均P<0.05）。而对照组在行为维度、情感维度、知觉维度、认知维度的得分均值及总分上差异均不显著（均P>0.05）。生活质量评分方面，治疗组与对照组相比，躯体功能评分均值显著提高（P<0.05），总体健康、疲劳、呼吸困难评分均值均显著降低，差异有统计学意义（均P<0.05）。与治疗前、治疗后比较，治疗组躯体功能、角色功能、社会功能评分均值及总体健康、疲劳、呼吸困难评分均差异有显著性意义（均P<0.05）。而对照组各项评分及总体健康、疲劳、呼吸困难评分均值无显著性差异（均P>0.05）。

结论：在PFS评定中，针刺可减轻CRF患者由轻到中的疲劳程度，尤其对感知维度有积极作用，有改善心理状态的意义。从生活质量量表的评估来看，针刺能改善整体健康和身体功能，缓解疲劳和呼吸困难。针刺疗法无明显毒副作用，疗效确切。

[关键词]针刺疗法、肠癌、化疗、癌因性疲劳、随机对照试验