扶阳解毒方联合针刺治疗结直肠癌术后化疗患者癌因性疲乏临床研究OA

Objective:To observe the clinical effect of Fuyang Jiedu Prescription combined with acupuncture on patients who developed cancer-related fatigue(CRF)during postoperative chemotherapy for colorectal cancer with spleen-kidney yang deficiency and blood stasis-toxin stagnation syndrome.Methods:A total of 102 patients with CRF during postoperative chemotherapy for colorectal cancer with spleen-kidney yang deficiency and blood stasis-toxin stagnation syndrome,were selected from the Department of Anorectal of Hangzhou Hospital of Traditional Chinese Medicine between January 2022 and December 2024.They were randomly divided into the observation group and the control group using the random number table method,with 51 cases each.Both groups received the XELOX chemotherapy regimen(Oxaliplatin for Injection combined with Capecitabine Tablets)postoperatively.The control group was treated with acupuncture,and the observation group received Fuyang Jiedu Prescription in addition to acupuncture.Both groups underwent eight courses of treatment(three weeks per course)and were followed up for three months.Clinical efficacy was compared between the two groups.Traditional Chinese medicine syndrome scores and CRF levels[Revised Piper Fatigue Scale(RPFS)scores]were assessed before treatment,after eight courses of treatment,and at one-month and three-month follow-ups.Cellular immune function indicators(CD3+,CD4+,CD8+,CD4+/CD8+ratio),serum tumor marker levels[carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 242(CA242),carbohydrate antigen 72-4(CA72-4),carcinoembryonic antigen(CEA)],and serum inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α),interferon-gamma(IFN-γ)]levels were detected.Results:After eight courses of treatment,the total effective rate of the observation group was higher than that of the control group(P＜0.05).The main symptom score,secondary symptom score,and total score of traditional Chinese medicine syndrome in the two groups at four time points(before treatment,after eight courses of treatment,and at one-month and three-month follow-ups)were compared as a whole,differences being significant(P＜0.001).The main symptom score,secondary symptom score,and total score of traditional Chinese medicine syndrome in the observation group decreased after eight courses of treatment,one month of follow-up,and three months of follow-up when compared with those before treatment(P＜0.05).The main symptom score,secondary symptom score,and total score of traditional Chinese medicine syndrome in the control group decreased after eight courses of treatment and one month follow-up when compared with those before treatment(P＜0.05).The main symptom score,secondary symptom score,and total score of traditional Chinese medicine syndrome in the control group at three months of follow-up increased when compared with those after eight courses of treatment and one month of follow-up(P＜0.05).The main symptom score,secondary symptom score,and total score in the observation group after eight courses of treatment,one month of follow-up,and three months of follow-up were all lower than those in the control group(P＜0.05).The overall comparison of RPFS for physical sensation,cognitive emotion,behavior,and emotion scores between the two groups at four time points showed significant differences(P＜0.001).The above four RPFS scores in the two groups after eight courses of treatment,one month of follow-up,and three months of follow-up decreased when compared with those before treatment(P＜0.05).The above four RPFS scores of the control group after a three-month follow-up increased when compared with those after eight courses of treatment and a one-month follow-up(P＜0.05).The above four RPFS scores of the observation group after eight courses of treatment,one month of follow-up,and three months of follow-up were lower than those of the control group at the same time point(P＜0.05).The overall comparison of CD3+,CD4+,CD8+levels and CD4+/CD8+ratio between the two groups at four time points showed significant differences(P＜0.001).After eight courses of treatment,as well as at one month and three months of follow-ups,the levels of CD3+and CD4+,and the CD4+/CD8+ratio in the two groups increased compared with those before treatment,while the CD8+level decreased compared with that before treatment,and all differences being significant(P＜0.05).The CD3+and CD4+levels,and the CD4+/CD8+ratio were higher in the observation group after eight courses of treatment,one month of follow-up,and three months of follow-up than those in the control group at the same time point,and the CD8+level was lower than that in the control group at the same time point,differences being significant(P＜0.05).The serum levels of CA19-9,CA242,CA72-4,and CEA in the two groups at the four time points were compared as a whole,differences being significant(P＜0.001).The serum levels of CA19-9,CA242,CA72-4,and CEA in the two groups after eight courses of treatment decreased when compared with those before treatment(P＜0.05).The serum levels of CA19-9,CA242,CA72-4,and CEA in the observation group after eight courses of treatment were lower than those in the control group(P＜0.05).The serum levels of IL-6,TNF-α,and IFN-γ in the observation group at four time points were compared as a whole,differences being significant(P＜0.001).The serum levels of IL-6,TNF-α,and IFN-γ in the observation group decreased after eight courses of treatment,one month of follow-up,and three months of follow-up when compared with those before treatment(P＜0.05),the serum levels of IL-6,TNF-α,and IFN-γ decreased after one month of follow-up and three months of follow-up when compared with those after eight courses of treatment(P＜0.05),and the serum levels of IL-6,TNF-α,and IFN-γ slightly increased after three months of follow-up when compared with those after one month of follow-up(P＜0.05).The levels of serum IL-6,TNF-α,and IFN-γ in the observation group were lower than those in the control group after eight courses of treatment(P＜0.05).Conclusion:The combination use of Fuyang Jiedu Prescription and acupuncture can effectively alleviate related traditional Chinese medicine symptoms and reduce fatigue in patients with CRF during postoperative chemotherapy for colorectal cancer with spleen-kidney yang deficiency and blood stasis-toxin stagnation syndrome.Its mechanism may be related to the enhancement of the systemic immune function,the reduction in tumor burden,and the alleviation of inflammatory reactions.