放化疗后白细胞减少症的针刺治疗

吴晋芳 陈高峰 曾科学

摘要 放化疗作为恶性肿瘤治疗中的常规治疗手段，在发挥抗肿瘤作用的同时，也产生白细胞减少症等一系列不良反应，降低放化疗的治疗效果，妨碍放化疗的疗程。近年来，针刺在治疗放化疗后白细胞减少症等方面的重要性日益受到重视。本研究检索了近十年（2009—2019）有关针刺治疗白细胞减少症的文献，发现针刺治疗效果显著，大致分为单一针刺、针刺配合中药口服、针刺配合艾灸治疗;取穴共涉及11条经脉22个穴位，其中以足阳明胃经（94.45%）、足太阴脾经（72.72%）及足三里（95.45%）和三阴交（72.72%）最为常用。以上诸穴及诸经共奏补益脾胃气血，通调全身气机，调和阴阳平衡之功。

关键词 针刺;恶性肿瘤;放化疗;白细胞减少症;治疗现状;经穴分析;补泻方法;穴位配伍

Current Advances of Acupuncture in the Treatment of Leukopenia After Chemoradiotherapy

WU Jinfang1，CHEN Gaofeng2，ZENG Kexue2

（1 The Fifth Clinical Medical College of Guangdong University of Traditional Chinese Medicine，Guangzhou 510080，China; 2 Oncology Department of the Second Guangdong Hospital of Traditional Chinese Medicine，Guangzhou 510095，China）

Abstract Chemoradiotherapy is one of conventional treatment for malignant tumor，playing an anti-tumor role，and it also produces a series of adverse reactions.It also produces a series of adverse reactions such as leukopenia，which reduces the therapeutic effect of radiotherapy and chemotherapy and hinders the course of radiotherapy and chemotherapy.In recent years，acupuncture has been attracting more and more attention in the treatment of leukopenia.In this paper，we retrieved papers in the past decade （2009-2019）.It was found that in the literature on acupuncture treatment of leukopenia that acupuncture has a significant effect and can be divided into single acupuncture，acupuncture combined with oral Chinese medicine，acupuncture in cooperation with moxibustion.All 22 acupoints in 11 meridians were used，among which，stomach meridian （94.45%），spleen meridian （72.72%），and Zusanli （S36） （94.45%），Sanyinjiao （SP6） （72.72%） in acupoints were widely used.All above mentioned meridians and acupoints were play the efficacy of supplement spleen and stomach，regulating body qi activity，and harmonizing yin and yang.

Keywords Acupuncture; Malignant tumor; Chemoradiotherapy; Leukopenia; Current status of treatment; Analysis of meridians and acupoints; Purging methods; Acupoints for acupuncture

中圖分类号：R245;R733文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.04.027

放化疗是目前最常见的恶性肿瘤治疗手段，然而由于抗癌药物本身存在的不良反应以及正常细胞和肿瘤细胞之间存在代谢差异，其在发挥抗肿瘤作用时也会对正常细胞产生一系列损害[1]。其产生的不良反应使患者被迫减量或停用抗癌药，这成为目前化学治疗限制剂量的原因，而化疗药物的剂量强度与化疗疗效之间存在正相关[2]。骨髓抑制是最常见的不良反应，由于白细胞的半衰期较短，白细胞减少症则更常见[3]。在放化疗过程中监测白细胞计数，必要时使用升白药物是目前治疗放化疗后白细胞减少症的主要治疗方案。然而有研究表明，在放化疗过程中同时运用升白药物重组人粒细胞集落刺激因子可能会出现发热、骨骼疼痛等不良反应，加重骨髓抑制程度[4]。……