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针刺预防肺癌患者放射性肺炎的疗效和安全性:一项前瞻性、单盲、随机验证性初步研究。

The Efficacy and Safety of Acupuncture for Preventing Radiation Pneumonitis in Patients With Lung Cancer: A Prospective, Single-Blinded, Randomized Pilot Proof-of-Principle Study.

机构信息

College of Medicine, Kyung Hee University, Seoul, Republic of Korea.

College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.

出版信息

Integr Cancer Ther. 2020 Jan-Dec;19:1534735420908327. doi: 10.1177/1534735420908327.

Abstract

We evaluated the efficacy and safety of acupuncture for prevention of radiation pneumonitis in patients with lung cancer. Twenty-five patients were prospectively enrolled in this study and randomized to either intervention group or control group. The patients assigned to the intervention group received 15 minutes of acupuncture treatment twice a week. The patients assigned to the control group received RT alone without acupuncture treatment. The primary endpoint was incidence of radiation pneumonitis. The secondary endpoints were FEV1 (forced expiratory volume in 1 second), DLCO (diffusing capacity for carbon monoxide), 6-minute walk distance, and modified Borg scale. The intervention group showed lower incidences of grade 3 and grade ≥2 radiation pneumonitis than the control group (10% vs 30% for grade 3 and 50% vs 60% for grade ≥2). In the control group, mean DLCO value was decreased from 62.1% at baseline to 49.1% after RT ( = .004). The DLCO was also decreased after RT in the intervention group, but the decrement was not statistically significant (56.7% at baseline and 50.9% after RT, = .204). The FEV1 and 6-minute walk distance were decreased after RT in the control group. However, FEV1 and 6-minute walk distance were increased after RT in the intervention group. This study found that patients who received acupuncture treatment showed a lower incidence of radiation pneumonitis and a protective effect against aggravation of pulmonary function after RT in patients with lung cancer. To confirm the results of this study, well-designed randomized studies with large sample sizes will be required.

摘要

我们评估了针刺预防肺癌患者放射性肺炎的疗效和安全性。 本研究前瞻性纳入 25 例患者,并将其随机分为干预组和对照组。干预组患者每周接受 2 次 15 分钟的针刺治疗。对照组患者仅接受 RT 治疗,不接受针刺治疗。主要终点是放射性肺炎的发生率。次要终点是 FEV1(第 1 秒用力呼气量)、DLCO(一氧化碳弥散量)、6 分钟步行距离和改良 Borg 量表。 干预组发生 3 级和≥2 级放射性肺炎的比例低于对照组(3 级分别为 10%和 30%,≥2 级分别为 50%和 60%)。在对照组中,DLCO 均值从基线时的 62.1%下降到 RT 后时的 49.1%(=0.004)。干预组在 RT 后 DLCO 也下降,但下降无统计学意义(基线时为 56.7%,RT 后为 50.9%,=0.204)。对照组 FEV1 和 6 分钟步行距离在 RT 后下降。然而,干预组在 RT 后 FEV1 和 6 分钟步行距离增加。 这项研究发现,接受针刺治疗的患者放射性肺炎发生率较低,肺癌患者 RT 后肺功能恶化程度得到保护。为了证实本研究的结果,需要进行设计良好、样本量大的随机研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8199/7045295/505233880e4a/10.1177_1534735420908327-fig1.jpg

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