【摘要】 目的 探究基于子午流注理论的耳穴动态贴压联合雷火灸对肺癌化疗患者骨髓抑制、癌因性疲乏及生活质量的影响，为临床减轻化疗不良反应提供优化方案。方法 选择2023年1月—2024年12月期间在河南中医药大学第二附属医院就诊接受化疗的肺癌患者120例，按照随机数字表法分为对照组(60例)实施常规化疗措施，观察组(60例)则在上述基础上行子午流注理论的耳穴动态贴压联合雷火灸治疗，所有患者化疗及干预周期为2周。对两组患者干预前后骨髓抑制指标进行比较，包括白细胞(white blood cell, WBC)、血红蛋白(hemoglobin, Hb)、血小板(blood platelet, PLT);比较两组干预前后癌因性疲乏(piper fatigue score, Piper)、中医症候评分数据；比较两组干预前后生活质量(quality of life questionnaire-core 30,QLQ-C30)数据，包括躯体功能、角色功能、社会功能。结果 干预前两组肺癌化疗患者的WBC等骨髓抑制指标差异无统计学意义(P>0.05);干预后观察组患者的WBC(4.27±1.12)×10~9/L、Hb(106.68±9.27)g/L、PLT(132.25±18.43)×10~9/L,均高于对照组的(3.18±0.86)×10~9/L、(92.56±8.35)g/L、(98.61±15.03)×10~9/L,差异有统计学意义(P<0.05)。干预前两组肺癌化疗患者的Piper疲乏评分、中医症候差异无统计学意义(P>0.05);干预后观察组患者的Piper疲乏评分(3.27±0.82)分、中医症候评分(3.45±0.83)分，均低于对照组的(4.82±1.08)分、(5.56±1.21)分，差异有统计学意义(P<0.05)。干预前两组肺癌化疗患者的躯体功能等QLQ-C30量表数据差异无统计学意义(P>0.05);干预后观察组患者的QLQ-C30量表数据中的躯体功能、角色功能、社会功能分别为(78.72±10.23)分、(72.35±9.69)分、(75.82±9.16)分，均高于对照组的(62.24±9.16)分、(60.13±8.82)分、(63.56±8.51)分，差异有统计学意义(P<0.05)。结论 对肺癌化疗患者实施常规化疗的过程中行基于子午流注理论的耳穴动态贴压联合雷火灸，可减轻其骨髓抑制程度，有利于癌因性疲乏的缓解，改善了生活质量及中医症状，值得临床借鉴。更多还原

【Abstract】 Objective To investigate the effects of auricular point dynamic pressing combined with thunder-fire moxibustion based on the midnight-noon ebb-flow theory on myelosuppression, cancer-related fatigue, and quality of life in lung cancer patients receiving chemotherapy, so as to provide an optimized clinical regimen for alleviating chemotherapy-related adverse reactions.Methods A total of 120 lung cancer patients who received chemotherapy in the Second Affiliated Hospital of Henan University of Chinese Medicine from January 2023 to December 2024 were selected and divided into two groups according to the random number table method: the control group(60 cases) was given routine chemotherapy, while the observation group(60 cases) was treated with dynamic auricular point pressing combined with thunder-fire moxibustion based on the midnight-noon ebb-flow theory on the basis of routine chemotherapy. The chemotherapy and intervention cycle for all patients was 2 weeks. The myelosuppression indexes of the two groups were compared before and after intervention, including white blood cell(WBC), hemoglobin(Hb), and blood platelet(PLT). The cancer-related fatigue(piper fatigue score, Piper) and traditional Chinese medicine(TCM) syndrome scores of the two groups were compared before and after intervention. The quality of life data(quality of life questionnaire-core 30, QLQ-C30) of the two groups were compared before and after intervention, including physical function, role function, and social function.Results Before intervention, there were no statistically significant differences in myelosuppression indexes such as WBC between the two groups of lung cancer patients undergoing chemotherapy(P>0.05). After intervention, the levels of WBC [(4.27±1.12)×10~9/L], Hb [(106.68±9.27) g/L] and PLT [(132.25±18.43)×10~9/L] in the observation group were significantly higher than those in the control group [(3.18±0.86)×10~9/L,(92.56±8.35) g/L,(98.61±15.03)×10~9/L, respectively], and the differences were statistically significant(P<0.05).Before intervention, there were no significant differences in Piper fatigue scores and TCM syndrome scores between the two groups(P>0.05). After intervention, the Piper fatigue score(3.27±0.82) points and TCM syndrome score(3.45±0.83) points of the observation group were significantly lower than those of the control group [(4.82±1.08) points and(5.56±1.21) points, respectively], and the differences were statistically significant(P<0.05). Before intervention, there were no statistically significant differences in QLQ-C30 scale data such as physical function between the two groups(P>0.05). After intervention, the scores of physical function(78.72±10.23) points, role function(72.35±9.69) points and social function(75.82±9.16) points in the QLQ-C30 scale of the observation group were significantly higher than those of the control group [(62.24±9.16) points,(60.13±8.82)points and(63.56±8.51)points, respectively], and the differences were statistically significant(P<0.05).Conclusion The application of dynamic auricular point pressing combined with thunder-fire moxibustion based on the midnight-noon ebb-flow theory during routine chemotherapy for lung cancer patients can alleviate the degree of myelosuppression, relieve cancer-related fatigue, improve quality of life and TCM symptoms, which is worthy of clinical reference.更多还原