摘要
目的探讨艾灸治疗对胃癌伴幽门梗阻患者新辅助化疗(NACT)耐受性的影响,并分析NACT成功实施的其余影响因素。方法回顾性分析江苏省中医院肿瘤外科2011年1月至2015年5月间收治的72例接受NACT的胃癌伴幽门梗阻患者临床资料,记录化疗不良反应、手术情况及术后生存时间,主要分析影响MACT成功的相关因素,同时根据患者是否规范进行艾灸治疗,且艾灸治疗天数≥80%住院天数,分为艾灸组与对照组,对比两组NACT的不良反应发生率、成功率及术后生存时间。结果72例患者中41例(56.94%)的患者因化疗无法耐受,及时终止化疗后直接手术探查,其余31例(43.06%)患者术前均接受2~4个疗程的NACT。Logistic回归分析发现,幽门梗阻时间(HR=16.925)、营养支持方式(HR=15.861)及艾灸治疗(HR=5.583)是影响结局的独立因素。其中艾灸组为29例,对照组为43例,艾灸组在成功率及不良反应发生率方面明显优于对照组(P<0.05),艾灸组术后中位生存时间为38个月,5年生存率为20.68%,对照组为36个月,5年生存率为20.93%,两组差异无统计学意义(χ^2=0.221,P=0.638)。结论此类病患NACT的耐受性较差,不良反应多;其中梗阻时间<1周、肠内营养支持和实施艾灸疗法的患者在进行NACT时的耐受性和成功率更高,且艾灸治疗可明显减轻不良反应发生,提高NACT成功率,值得临床推广。
Objective:To investigate the effect of moxibustion on the tolerance of neoadjuvant chemotherapy(NACT)in patients with gastric cancer with pyloric obstruction,and to analyze the remaining influencing factors on the successful implementation of NACT.Methods:The clinical data of 72 patients with gastric cancer with pyloric obstruction who underwent NACT from January 2011 to May 2015 in the Department of Oncology Surgery in Jiangsu Province Hospital of Traditional Chinese Medicine were retrospectively analyzed.Adverse effects of chemotherapy,surgical conditions and postoperative survival time were recorded.The main factors affecting the success of MACT were analyzed.At the same time,moxibustion therapy was carried out according to whether the patients were standardized,and the number of moxibustion treatment days was more than 80%of hospital days.For the moxibustion group and the control group,the incidence of adverse reactions,success rate and postoperative survival time of NACT in the two groups were compared.Results:41(56.94%)of the 72 patients were intolerant of chemotherapy,and immediate surgical exploration after timely termination of chemotherapy was performed.The remaining 31(43.06%)patients received 2~4 courses of NACT before surgery.Logistic regression analysis found that time of pyloric obstruction(HR=16.925),nutritional support(HR=15.861)and moxibustion treatment(HR=5.583)were independent factors affecting the outcome.Among them,there were 29 cases in the moxibustion group and 43 cases in the control group.The success rate and the incidence of adverse reactions in the moxibustion group were significantly better than those in the control group(P<0.05).The median survival time was 38 months,the 5-year survival rate was 20.68%in the moxibustion group,36 months(32.795~39.205)in the control group,and the 5-year survival rate was 20.93%in the moxibustion group.There was no statistical difference between the two groups(χ^2=0.221;P=0.638).Conclusion:Patients with NACT have poor tolerance and more adverse reactions,among which the patients with obstruction time less than 1 week,enteral nutrition support and moxibustion therapy have higher tolerance and success rate when NACT is performed;moxibustion therapy can significantly reduce the occurrence of adverse reactions and improve the success rate of NACT,which is worthy of clinical promotion.
作者
吴艳红
袁思成
吴震峰
芮庆林
Wu Yanhong;Yuan Sicheng;Wu Zhenfeng;Rui Qinglin(Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210029,China)
出处
《中国中医急症》
2020年第11期1921-1925,共5页
Journal of Emergency in Traditional Chinese Medicine
基金
江苏省中医药局中医重点学科项目(K2013XK03)
江苏省中医院创新发展基金项目(Y2017CX44)。
关键词
胃恶性肿瘤
幽门梗阻
新辅助化疗
艾灸
5年生存率
Gastric malignancy
Pyloric obstruction
Neoadjuvant chemotherapy
Moxibustion
5-year survival rate
作者简介
通信作者:芮庆林,电子邮箱:149110374l@qq.com。
