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常规治疗、中药及经皮穴位电刺激对小细胞肺癌初治化疗后骨髓抑制影响的随机对照疗效试验

Randomized Efficacy Trial of Conventional, TCM Herb, and TEAS on Bone Marrow Suppression in Patients with Small Cell Lung Cancer after Initial Chemotherapy.

作者信息

Zhao Fangchao, Wang Zengying, Gao Yanlin, Wu Yusi, Liu Jianming, He Shuangliang

机构信息

Department of Thoracic Surgery, Tangshan People's Hospital, North China University of Science and Technology, Tangshan 063000, China.

The Graduate School of Hebei Medical University, Shijiazhuang 050000, China.

出版信息

Evid Based Complement Alternat Med. 2021 Feb 2;2021:2693472. doi: 10.1155/2021/2693472. eCollection 2021.

Abstract

OBJECTIVE

To compare the efficiency of transcutaneous electrical acupoint stimulation (TEAS) with those of conventional and TCM herb on bone marrow suppression in small cell lung cancer (SCLC) patients after initial chemotherapy.

METHODS

We recruited 139 participants with pathologically confirmed SCLC who had not received chemotherapy. The conventional group ( = 37) received gemcitabine and cisplatin chemotherapy and routine care. The TCM herb group ( = 35) received 3 Diyushengbai tablets thrice a day for one day prior to chemotherapy and maintained during the trial. The TEAS group ( = 42) received TEAS at a frequency of 65-100 Hz with a pulse width of 100-200 sec. Acupoints were selected from Dazhui (DU14), Geshu (BL17), Zusanli (ST36), Sanyinjiao (SP6), and Hegu (LI4) and were treated on days 1, 2, 3, 5, 8, 14, 21, and 28 of chemotherapy for 30 min each day. All three groups underwent a 28-day treatment for a total of one treatment course. Changes in the white blood cell, neutrophil, platelet, and hemoglobin indices on day 1 before chemotherapy and days 5, 8, 11, 14, 21, and 28 days after chemotherapy were compared among the groups. Comfort levels of patients on day 1 before chemotherapy and days 5, 11, and 21 after chemotherapy were observed.

RESULTS

Compared with the conventional group, the white blood cell counts in the TEAS group on days 8 (7.07 ± 2.11 vs. 5.97 ± 2.10 × 10/L) and 14 (6.14 ± 1.51 vs. 5.07 ± 2.41 × 10/L) of chemotherapy and that in the TCM herb group on day 14 (6.63 ± 3.44 vs. 5.07 ± 2.41 × 10/L) of chemotherapy were increased ( < 0.05). Compared with the conventional group, the neutrophil count in the TEAS group on days 5 (4.28 ± 1.54 vs. 3.01 ± 1.41 × 10/L), 8 (3.75 ± 1.21 vs. 2.77 ± 1.17 × 10/L), 11 (3.46 ± 1.31 vs. 2.31 ± 1.24 × 10/L), 14 (3.18 ± 1.29 vs. 2.07 ± 1.14 × 10/L), and 21 (4.67 ± 1.31 vs. 3.58 ± 1.23 × 10/L) of chemotherapy and that in the TCM herb group on day 5 (3.88 ± 1.05 vs. 3.01 ± 1.41 × 10/L) of chemotherapy were increased ( < 0.05). Compared with the conventional group, the platelet count of patients in the TEAS group increased on days 5 (264.7 ± 64.1 vs. 201.0 ± 55.7 × 10/L), 8 (251.3 ± 74.9 vs. 188.2 ± 65.8 × 10/L), 11 (236.7 ± 74.9 vs. 181.3 ± 84.3 × 10/L), and 14 (238.3 ± 75.9 vs. 192.8 ± 95.8 × 10/L) of chemotherapy ( < 0.05). Compared with the TCM herb group, the platelet count in the TEAS group increased on days 5 (264.7 ± 64.1 vs. 216.3 ± 57.9 × 10/L), 8 (251.3 ± 74.9 vs. 213.7 ± 70.3 × 10/L), 11 (236.7 ± 74.9 vs. 181.3 ± 84.3 × 10/L), and 21 (254.8 ± 81.8 vs. 213.9 ± 82.6 × 10/L) of chemotherapy ( < 0.05). Compared with the conventional group, the hemoglobin level in the TCM herb group increased on day 14 (135.03 ± 28.06 vs. 122.09 ± 12.63 g/L) of chemotherapy ( < 0.05). Compared with the conventional group, the comfort score of the TEAS group increased on days 5 (78.31 ± 10.21 vs. 70.18 ± 9.34 score) and 11 (80.07 ± 10.44 vs. 72.11 ± 9.47 score) of chemotherapy ( < 0.05).

CONCLUSION

TEAS is an effective and safe treatment modality for improving bone marrow suppression in SCLC patients after initial chemotherapy. TEAS improved comfort levels more effectively than did conventional and TCM herb.

摘要

目的

比较经皮穴位电刺激(TEAS)与传统疗法及中药对小细胞肺癌(SCLC)患者初次化疗后骨髓抑制的疗效。

方法

招募139例经病理确诊且未接受过化疗的SCLC患者。传统组(n = 37)接受吉西他滨和顺铂化疗及常规护理。中药组(n = 35)在化疗前1天开始每天3次服用3片地榆升白片,并在试验期间持续服用。TEAS组(n = 42)以65 - 100Hz的频率、100 - 200微秒的脉宽接受TEAS治疗。选取大椎(DU14)、膈俞(BL17)、足三里(ST36)、三阴交(SP6)和合谷(LI4)进行治疗,在化疗的第1、2、3、5、8、14、21和28天每天治疗30分钟。三组均进行为期28天的治疗,共一个疗程。比较三组化疗前1天及化疗后第5、8、11、14、21和28天白细胞、中性粒细胞、血小板和血红蛋白指标的变化。观察化疗前1天及化疗后第5、11和21天患者的舒适度。

结果

与传统组相比,TEAS组化疗第8天(7.07 ± 2.11 vs. 5.97 ± 2.10×10⁹/L)和第14天(6.14 ± 1.51 vs. 5.07 ± 2.41×10⁹/L)的白细胞计数以及中药组化疗第14天(6.63 ± 3.44 vs. 5.07 ± 2.41×10⁹/L)的白细胞计数升高(P < 0.05)。与传统组相比,TEAS组化疗第5天(4.28 ± 1.54 vs. 3.01 ± 1.41×10⁹/L)、第8天(3.75 ± 1.21 vs. 2.77 ± 1.17×10⁹/L)、第11天(3.46 ± 1.31 vs. 2.31 ± 1.24×10⁹/L)、第14天(3.18 ± 1.29 vs. 2.07 ± 1.14×10⁹/L)和第21天(4.67 ± 1.31 vs. 3.58 ± 1.23×10⁹/L)的中性粒细胞计数以及中药组化疗第5天(3.88 ± 1.05 vs. 3.01 ± 1.41×10⁹/L)的中性粒细胞计数升高(P < 0.05)。与传统组相比,TEAS组患者化疗第5天(264.7 ± 64.1 vs. 201.0 ± 55.7×10⁹/L)、第8天(251.3 ± 74.9 vs. 188.2 ± 65.8×10⁹/L)、第11天(236.7 ± 74.9 vs. 181.3 ± 84.3×10⁹/L)和第14天(238.3 ± 75.9 vs. 192.8 ± 95.8×10⁹/L)的血小板计数升高(P < 0.05)。与中药组相比,TEAS组化疗第5天(264.7 ± 64.1 vs. 216.3 ± 57.9×10⁹/L)、第8天(251.3 ± 74.9 vs. 213.7 ± 70.3×10⁹/L)、第11天(236.7 ± 74.9 vs. 181.3 ± 84.3×10⁹/L)和第21天(254.8 ± 81.8 vs. 213.9 ± 82.6×10⁹/L)的血小板计数升高(P < 0.05)。与传统组相比,中药组化疗第14天(135.03 ± 28.06 vs. 122.09 ± 12.63g/L)的血红蛋白水平升高(P < 0.05)。与传统组相比,TEAS组化疗第5天(78.31 ± 10.21 vs. 70.18 ± 9.34分)和第11天(80.07 ± 10.44 vs. 72.11 ± 9.47分)的舒适度评分升高(P < 0.05)。

结论

TEAS是改善SCLC患者初次化疗后骨髓抑制的一种有效且安全的治疗方式。TEAS比传统疗法和中药更有效地提高了舒适度。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b8e/7872749/e8df6b4b2608/ECAM2021-2693472.001.jpg

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