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Article(id=1322923080347168818, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.03.020, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339041076, onlineDateStr=2026-10-30, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339041076, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339041076, creator=13701087609, updateTime=1793339041076, updator=13701087609, issue=Issue{id=1322923011518628427, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='3', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1741536000000', pubDateStr='2025-03-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339024666, creator='13701087609', updateTime=1793340602374, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929628976906432, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929628981100737, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923011518628427, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=116, endPage=119, ext={EN=ArticleExt(id=1322923082431737907, articleId=1322923080347168818, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Study on Shenqi Guben Pobi Decoction（参芪固本破壁饮）Combined with Moxibustion at Du Meridian Treating Fatigue Caused by Liver Cancer, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To observe the clinical effect of Shenqi Guben Pobi Decoction（参芪固本破壁饮）combined with moxibustion at Du meridian on liver cancer fatigue.

Methods

A total of 120 patients with fatigue due to liver cancer admitted to the hospital from October 2020 to May 2023 were divided into traditional Chinese medicine（TCM）group and conventional group by means of random number table，with 60 patients in each group. The conventional group received routine treatment such as sleep management，nutritional guidance，exercise therapy and psychological counseling. On the basis of conventional treatment，the patients in the TCM group were given Shenqi Guben Pobi Decoction combined with moxibustion at Du meridian treatment. In the course of treatment，3 cases fell off in the conventional group and 5 cases in the TCM group. There were 57 cases remained in the conventional group and 55 cases in the TCM group. The clinical data observation of patients in each group included the clinical efficacy，the changes of TCM symptom scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.）and Piper's Fatigue Scale（PFS）scores before and after treatment. Hamilton Anxiety Scale-14（HAMA-14）and Hamilton Depression Scale-17（HAMD-17）were used to assess the negative emotions of the patients in each group. The Pittsburgh sleep quality index（PSQI）was used to evaluate the sleep quality of the patients before and after treatment，and the Spitzer Quality of life index（SQLI）was used to evaluate the changes of patients'quality of life before and after treatment，and voluntary treatment satisfaction questionnaire was adopted to investigate the satisfaction rate of patients in each group.

Results

The total effective rate of the TCM group（96.36%）was higher than that of the conventional group（84.21%）（P<0.05）. Before treatment，TCM syndrome scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.），PFSscore，HAMA-14 score，HAMD-17 score，PSQI score and SQLI score were not significant between two groups（P>0.05）. After treatment，TCM syndrome scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.），PFSscores，HAM-14 scores，HAMD-17 scores，PSQI scores and SQLI scores were significantly improved in both groups. After treatment，TCM syndrome scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.），PFSscores，HAMA-14 scores，HAMD-17，PSQI scores，SQLI scores and other indicators in the TCM group were better than those in the conventional group（P<0.05）. The treatment satisfaction rate of the TCM group（93.36%）was higher than that of the conventional group（84.21%）（P<0.05）.

Conclusion

Shenqi Guben Pobi Decoction combined with moxibustion at Du meridian in the treatment of liver cancer fatigue has better clinical effect. After treatment，the symptoms，negative emotions，sleep quality and quality of life of the patients all improved and the patients were satisfied and recognized. It is worthy of applying.

, authors=Xiaoai MO, Kaiping JIANG, Youqing XIE, Jian REN, Kaizhou HUANG, authorsList=Xiaoai MO, Kaiping JIANG, Youqing XIE, Jian REN, Kaizhou HUANG, authorCompany=null, correspAuthors=Kaiping JIANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923083962658878, articleId=1322923080347168818, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

观察参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床效果。

方法

将医院收治的120例肝癌癌因性疲乏患者（2020年10月—2023年5月）以随机数字表法分为中医组与常规组，各组60例患者，常规组患者采取睡眠管理、营养指导及运动疗法、心理疏导等常规治疗，中医组在常规治疗基础上给予患者参芪固本破壁饮片结合督灸治疗，治疗及研究过程中常规组脱落3例，中医组脱落5例，常规组剩余患者57例，中医组剩余患者55例，各组患者临床数据观察：临床疗效、治疗前后患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）变化及Piper疲乏修正量表评分（Piper's Fatigue Scale，PFS）变化，并采取汉密尔顿焦虑量表-14（Hamilton Anxiety Scale-14，HAMA-14）与汉密尔顿抑郁量表-17（Hamilton Depression Scale-17，HAMD-17）评估各组患者负面情绪，采取匹兹堡睡眠指数（Pittsburgh Sleep Quality Index，PSQI）评估患者治疗前后睡眠质量情况，采取Spitzer生活质量指数（Spitzer Quality of Life Index，SQLI）评估各组患者治疗前后生活质量变化，采取医院自愿治疗满意度问卷调查各组患者满意率情况。

结果

中医组患者治疗总有效率（96.36%）比常规组患者（84.21%）更高，P<0.05；治疗前各组患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分比较，P>0.05，治疗后各组患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分均明显改善，而中医组患者治疗后中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分等指标均改善优于常规组患者，P<0.05；中医组患者治疗满意率（93.36%）比常规组患者治疗满意率（84.21%）更高，P<0.05。

结论

参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床效果甚佳，患者治疗后症状及负面情绪、睡眠质量和生活质量均改善，且患者满意及认可，值得应用。

, authors=莫小艾, 蒋开平, 谢悠青, 任健, 黄凯舟, authorsList=莫小艾, 蒋开平, 谢悠青, 任健, 黄凯舟, authorCompany=null, correspAuthors=蒋开平, authorNote=

莫小艾（1980-），女，广东江门人，副主任中医师，学士，研究方向：内科学。

, correspAuthorsNote=
蒋开平（1967-），男，四川广元人，主任医师，硕士，研究方向：肝病学。
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莫小艾（1980-），女，广东江门人，副主任中医师，学士，研究方向：内科学。

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莫小艾（1980-），女，广东江门人，副主任中医师，学士，研究方向：内科学。

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articleTitle=四花穴治疗癌因性疲乏的理论基础, refAbstract=null), Reference(id=1322923097266991255, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, doi=null, pmid=null, pmcid=null, year=2022, volume=37, issue=7, pageStart=3877, pageEnd=3880, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=李奕, 刘福栋, 庞博, journalName=中华中医药杂志, refType=null, unstructuredReference=李奕，刘福栋，庞博，等. 理脾阴法在癌因性疲乏治疗中的应用［J］. 中华中医药杂志，2022，37（7）：3877-3880., articleTitle=理脾阴法在癌因性疲乏治疗中的应用, refAbstract=null), Reference(id=1322923097338294424, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, doi=null, pmid=null, pmcid=null, year=2021, volume=40, issue=1, pageStart=44, pageEnd=48, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=陈露, 孔天东, 王留晏, journalName=上海针灸杂志, refType=null, unstructuredReference=陈露，孔天东，王留晏，等. 督灸对化疗期间肿瘤患者癌因性疲乏的影响［J］. 上海针灸杂志，2021，40（1）：44-48., articleTitle=督灸对化疗期间肿瘤患者癌因性疲乏的影响, refAbstract=null), Reference(id=1322923097413791897, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, doi=null, pmid=null, pmcid=null, year=2021, volume=36, issue=8, pageStart=1674, pageEnd=1678, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=陈梦利, 邵帅, 许彦超, journalName=中医学报, refType=null, unstructuredReference=陈梦利，邵帅，许彦超，等. 督灸治疗恶性肿瘤研究概况［J］. 中医学报，2021，36（8）：1674-1678., articleTitle=督灸治疗恶性肿瘤研究概况, refAbstract=null), Reference(id=1322923097518649498, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, doi=null, pmid=null, pmcid=null, year=2021, volume=22, issue=5, pageStart=454, pageEnd=456, url=null, language=null, rfNumber=［32］, rfOrder=31, authorNames=邓丽蓉, 郭军军, 雷亚华, journalName=中国中西医结合肾病杂志, refType=null, unstructuredReference=邓丽蓉，郭军军，雷亚华，等. 督灸床治疗CKD3～5期脾肾气虚型患者疲乏症状的临床效果观察［J］. 中国中西医结合肾病杂志，2021，22（5）：454-456., articleTitle=督灸床治疗CKD3～5期脾肾气虚型患者疲乏症状的临床效果观察, refAbstract=null)], funds=[Fund(id=1322923091797618807, 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language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Foshan Hospital of Traditional Chinese Medicine，Foshan 528000，Guangdong，China), AuthorCompanyExt(id=1322923084281425985, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, companyId=1322923084252065855, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=佛山市中医院，广东 佛山 528000)])], figs=[ArticleFig(id=1322923088949686376, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数痊愈显效有效无效总有效率
常规组5727（47.37）12（21.05）9（15.79）9（15.79）84.21
中医组5535（63.64）12（21.82）6（10.91）2（3.64）96.36
χ2值-----4.6678
P值-----0.0307
), ArticleFig(id=1322923089029378153, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=CN, label=表1, caption=

中医组和常规组患者治疗效果比较

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组别例数痊愈显效有效无效总有效率
常规组5727（47.37）12（21.05）9（15.79）9（15.79）84.21
中医组5535（63.64）12（21.82）6（10.91）2（3.64）96.36
χ2值-----4.6678
P值-----0.0307
), ArticleFig(id=1322923089125847146, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间神疲气短乏力自汗懒言失眠心悸头晕眼花
常规组57治疗前2.43±0.262.39±0.181.98±0.361.89±0.261.78±0.302.02±0.26
治疗后0.64±0.13a0.59±0.12a0.60±0.15a0.56±0.13a0.61±0.15a0.58±0.14a
中医组55治疗前2.46±0.242.41±0.201.99±0.401.91±0.291.80±0.282.00±0.24
治疗后0.20±0.06ab0.18±0.04ab0.16±0.05ab0.15±0.03ab0.19±0.04ab0.17±0.05ab
), ArticleFig(id=1322923089213927531, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=CN, label=表2, caption=

两组患者治疗前后中医证候积分比较（）

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组别例数治疗时间神疲气短乏力自汗懒言失眠心悸头晕眼花
常规组57治疗前2.43±0.262.39±0.181.98±0.361.89±0.261.78±0.302.02±0.26
治疗后0.64±0.13a0.59±0.12a0.60±0.15a0.56±0.13a0.61±0.15a0.58±0.14a
中医组55治疗前2.46±0.242.41±0.201.99±0.401.91±0.291.80±0.282.00±0.24
治疗后0.20±0.06ab0.18±0.04ab0.16±0.05ab0.15±0.03ab0.19±0.04ab0.17±0.05ab
), ArticleFig(id=1322923089306202220, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间情感疲乏行为疲乏认知疲乏躯体疲乏疲乏总分
常规组57治疗前5.89±0.575.93±0.494.69±0.355.99±0.265.82±0.36
治疗后4.23±0.46a4.16±0.52a3.03±0.38a4.85±0.40a4.20±0.31a
中医组55治疗前5.91±0.595.95±0.514.71±0.306.00±0.245.81±0.34
治疗后3.26±0.39ab3.19±0.36ab2.85±0.30ab3.96±0.50ab3.16±0.37ab
), ArticleFig(id=1322923090983923821, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=CN, label=表3, caption=

两组患者治疗前后PFS评分比较（）

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组别例数治疗时间情感疲乏行为疲乏认知疲乏躯体疲乏疲乏总分
常规组57治疗前5.89±0.575.93±0.494.69±0.355.99±0.265.82±0.36
治疗后4.23±0.46a4.16±0.52a3.03±0.38a4.85±0.40a4.20±0.31a
中医组55治疗前5.91±0.595.95±0.514.71±0.306.00±0.245.81±0.34
治疗后3.26±0.39ab3.19±0.36ab2.85±0.30ab3.96±0.50ab3.16±0.37ab
), ArticleFig(id=1322923091088781422, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间HAMA-14HAMD-17PSQI
常规组57治疗前35.76±6.2325.76±7.2312.52±2.65
治疗后22.64±3.77a20.15±5.23a6.23±2.02a
中医组55治疗前35.73±6.2625.79±7.1812.56±2.68
治疗后18.56±5.23ab15.02±2.65ab3.96±1.21ab
), ArticleFig(id=1322923091189444720, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=CN, label=表4, caption=

两组患者治疗前后HAMA-14、HAMD-17、PSQI评分比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间HAMA-14HAMD-17PSQI
常规组57治疗前35.76±6.2325.76±7.2312.52±2.65
治疗后22.64±3.77a20.15±5.23a6.23±2.02a
中医组55治疗前35.73±6.2625.79±7.1812.56±2.68
治疗后18.56±5.23ab15.02±2.65ab3.96±1.21ab
), ArticleFig(id=1322923091281719410, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗时间家庭支持健康感受日常生活活动能力生活感受总分
常规组57治疗前1.69±0.250.84±0.161.16±0.350.95±0.210.99±0.205.58±0.67
治疗后1.86±0.22a1.10±0.14a1.24±0.23a1.09±0.18a1.13±0.17a6.08±0.78a
中医组55治疗前1.65±0.230.86±0.141.14±0.310.97±0.191.01±0.185.61±0.65
治疗后2.22±0.37ab1.25±0.10ab1.61±0.25ab1.38±0.20ab1.41±0.16ab7.14±0.47ab
), ArticleFig(id=1322923091390771316, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=CN, label=表5, caption=

两组患者治疗前后SQLI评分比较（）

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组别例数治疗时间家庭支持健康感受日常生活活动能力生活感受总分
常规组57治疗前1.69±0.250.84±0.161.16±0.350.95±0.210.99±0.205.58±0.67
治疗后1.86±0.22a1.10±0.14a1.24±0.23a1.09±0.18a1.13±0.17a6.08±0.78a
中医组55治疗前1.65±0.230.86±0.141.14±0.310.97±0.191.01±0.185.61±0.65
治疗后2.22±0.37ab1.25±0.10ab1.61±0.25ab1.38±0.20ab1.41±0.16ab7.14±0.47ab
), ArticleFig(id=1322923091608875125, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数满意例数满意率
常规组5748（84.21）
中医组5553（96.36）
χ2值-4.6678
P值-0.0307
), ArticleFig(id=1322923091713732726, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923080347168818, language=CN, label=表6, caption=

中医组和常规组患者治疗满意率比较

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组别例数满意例数满意率
常规组5748（84.21）
中医组5553（96.36）
χ2值-4.6678
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参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床研究
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莫小艾 , 蒋开平 , 谢悠青 , 任健 , 黄凯舟
中华中医药学刊 | 国家项目点击 2025,43(3): 116-119
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中华中医药学刊 |国家项目点击 2025 , 43 (3) : 116 -119
参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床研究
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莫小艾, 蒋开平, 谢悠青, 任健, 黄凯舟
作者信息
  • 佛山市中医院，广东 佛山 528000
通讯作者:
蒋开平（1967-），男，四川广元人，主任医师，硕士，研究方向：肝病学。
作者简介:

莫小艾（1980-），女，广东江门人，副主任中医师，学士，研究方向：内科学。

Clinical Study on Shenqi Guben Pobi Decoction（参芪固本破壁饮）Combined with Moxibustion at Du Meridian Treating Fatigue Caused by Liver Cancer
Xiaoai MO, Kaiping JIANG, Youqing XIE, Jian REN, Kaizhou HUANG
Affiliations
  • Foshan Hospital of Traditional Chinese Medicine，Foshan 528000，Guangdong，China
出版时间: 2025-03-10 doi: 10.13193/j.issn.1673-7717.2025.03.020
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摘要
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目的

观察参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床效果。

方法

将医院收治的120例肝癌癌因性疲乏患者（2020年10月—2023年5月）以随机数字表法分为中医组与常规组，各组60例患者，常规组患者采取睡眠管理、营养指导及运动疗法、心理疏导等常规治疗，中医组在常规治疗基础上给予患者参芪固本破壁饮片结合督灸治疗，治疗及研究过程中常规组脱落3例，中医组脱落5例，常规组剩余患者57例，中医组剩余患者55例，各组患者临床数据观察：临床疗效、治疗前后患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）变化及Piper疲乏修正量表评分（Piper's Fatigue Scale，PFS）变化，并采取汉密尔顿焦虑量表-14（Hamilton Anxiety Scale-14，HAMA-14）与汉密尔顿抑郁量表-17（Hamilton Depression Scale-17，HAMD-17）评估各组患者负面情绪，采取匹兹堡睡眠指数（Pittsburgh Sleep Quality Index，PSQI）评估患者治疗前后睡眠质量情况，采取Spitzer生活质量指数（Spitzer Quality of Life Index，SQLI）评估各组患者治疗前后生活质量变化，采取医院自愿治疗满意度问卷调查各组患者满意率情况。

结果

中医组患者治疗总有效率（96.36%）比常规组患者（84.21%）更高，P<0.05；治疗前各组患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分比较，P>0.05，治疗后各组患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分均明显改善，而中医组患者治疗后中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分等指标均改善优于常规组患者，P<0.05；中医组患者治疗满意率（93.36%）比常规组患者治疗满意率（84.21%）更高，P<0.05。

结论

参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床效果甚佳，患者治疗后症状及负面情绪、睡眠质量和生活质量均改善，且患者满意及认可，值得应用。

肝癌癌因性疲乏  /  督灸  /  参芪固本破壁饮片  /  临床疗效  /  中医症候积分  /  负面情绪
Objective

To observe the clinical effect of Shenqi Guben Pobi Decoction（参芪固本破壁饮）combined with moxibustion at Du meridian on liver cancer fatigue.

Methods

A total of 120 patients with fatigue due to liver cancer admitted to the hospital from October 2020 to May 2023 were divided into traditional Chinese medicine（TCM）group and conventional group by means of random number table，with 60 patients in each group. The conventional group received routine treatment such as sleep management，nutritional guidance，exercise therapy and psychological counseling. On the basis of conventional treatment，the patients in the TCM group were given Shenqi Guben Pobi Decoction combined with moxibustion at Du meridian treatment. In the course of treatment，3 cases fell off in the conventional group and 5 cases in the TCM group. There were 57 cases remained in the conventional group and 55 cases in the TCM group. The clinical data observation of patients in each group included the clinical efficacy，the changes of TCM symptom scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.）and Piper's Fatigue Scale（PFS）scores before and after treatment. Hamilton Anxiety Scale-14（HAMA-14）and Hamilton Depression Scale-17（HAMD-17）were used to assess the negative emotions of the patients in each group. The Pittsburgh sleep quality index（PSQI）was used to evaluate the sleep quality of the patients before and after treatment，and the Spitzer Quality of life index（SQLI）was used to evaluate the changes of patients'quality of life before and after treatment，and voluntary treatment satisfaction questionnaire was adopted to investigate the satisfaction rate of patients in each group.

Results

The total effective rate of the TCM group（96.36%）was higher than that of the conventional group（84.21%）（P<0.05）. Before treatment，TCM syndrome scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.），PFSscore，HAMA-14 score，HAMD-17 score，PSQI score and SQLI score were not significant between two groups（P>0.05）. After treatment，TCM syndrome scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.），PFSscores，HAM-14 scores，HAMD-17 scores，PSQI scores and SQLI scores were significantly improved in both groups. After treatment，TCM syndrome scores（fatigue，shortness of breath，spontaneous sweating，lazy speech，insomnia palpitation，dizziness，etc.），PFSscores，HAMA-14 scores，HAMD-17，PSQI scores，SQLI scores and other indicators in the TCM group were better than those in the conventional group（P<0.05）. The treatment satisfaction rate of the TCM group（93.36%）was higher than that of the conventional group（84.21%）（P<0.05）.

Conclusion

Shenqi Guben Pobi Decoction combined with moxibustion at Du meridian in the treatment of liver cancer fatigue has better clinical effect. After treatment，the symptoms，negative emotions，sleep quality and quality of life of the patients all improved and the patients were satisfied and recognized. It is worthy of applying.

fatigue due to liver cancer  /  moxibustion at Du meridian  /  Shenqi Guben Pobi Decoction（参芪固本破壁饮）  /  clinical effect  /  TCM syndrome score  /  negative emotion
莫小艾, 蒋开平, 谢悠青, 任健, 黄凯舟. 参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床研究. 中华中医药学刊, 2025 , 43 (3) : 116 -119 . DOI: 10.13193/j.issn.1673-7717.2025.03.020
Xiaoai MO, Kaiping JIANG, Youqing XIE, Jian REN, Kaizhou HUANG. Clinical Study on Shenqi Guben Pobi Decoction（参芪固本破壁饮）Combined with Moxibustion at Du Meridian Treating Fatigue Caused by Liver Cancer[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (3) : 116 -119 . DOI: 10.13193/j.issn.1673-7717.2025.03.020
正文
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肝癌为临床常见的恶性肿瘤，近年该病发病率显著上升，患者发病后病死率以及致残率高，对患者危害较大，故而需积极治疗[1-3]。癌因性疲乏是指由于癌症本身或者治疗癌症所致的持续性主观疲劳，恶性肿瘤疾病发生率较高，对临床治疗效果、患者预后及生存期、生活质量造成严重影响[4-6]。肝癌患者采取化疗及放疗、手术治疗等方式治疗均可能损伤患者正气，破坏机体阴阳平衡，导致正气亏虚，气血不和，导致“虚劳”发生，中医治疗该病具有丰富经验，取得较好治疗效果[7-8]。临床发现，给予肝癌癌因性疲乏患者参芪固本破壁饮片结合督灸治疗取得较好效果，有助于患者病情好转。故而本次纳入120例肝癌癌因性疲乏患者进行分组，观察参芪固本破壁饮片结合督灸治疗效果，报道如下。
1　资料与方法
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1.1　一般资料
将我院收治的120例肝癌癌因性疲乏患者（2020年10月—2023年5月）以随机数字表法分为中医组与常规组，各组60例患者。治疗及研究过程中常规组脱落3例，中医组脱落5例，常规组剩余患者57例，中医组剩余患者55例。常规组：57例，女24例，男33例，年龄<60岁35例，>60岁22例，肿瘤数量≥3个40例，<3个17例。中医组：55例，女24例，男31例，年龄<60岁36例，>60岁19例，肿瘤数量≥3个41例，<3个14例。中医组与常规组患者临床资料比较，P>0.05，分组可比。
1.2　诊断标准
西医诊断肝癌癌因性疲乏参考《中国癌症相关性疲乏临床实践诊疗指南（2021年版）》[9]：患者日常生活上出现乏力及疲劳感，具体以下5个及以上症状。①疲乏症状持续，无法缓解；②患者无法完成日常活动；③患者记忆力减退；④患者活动困难；⑤患者存在情绪反应；⑥患者情绪低落；⑦患者注意力无法集中；⑧患者全身无力；⑨患者失眠或者嗜睡；⑩患者休息以后仍然感觉到疲乏等。中医诊断肝癌癌因性疲乏参考《中医内科学》[10]：神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花、面色萎黄、手足麻木、月经异常、舌淡、脉虚等。
1.3　纳入排除标准
纳入标准：①均为服用靶向药仑伐替尼3期及4期的肝癌患者；②患者确诊为肝癌癌因性疲乏；③患者年龄70岁以下；④患者理解能力良好，可进行沟通，无听力及语言障碍；⑤患者预计生存时间6个月以上；⑥家属及患者知情，自愿接受本次治疗及研究；⑦伦理会批准研究进行。排除标准：①严重心脑血管疾病者；②合并凝血功能异常及认知障碍患者；③血小板减少患者；④依从性差及自愿退出患者等。
1.4　治疗方法
常规组：给予患者睡眠管理、营养指导及运动疗法、心理疏导等常规治疗。中医组：患者在常规组治疗基础上结合参芪固本破壁饮片结合督灸治疗。参芪固本破壁饮片：黄芪2 g，党参2 g，白术3 g，茯苓3 g，五味子2 g，淫羊藿1 g，女贞子3 g。水煎煮，每日服药，治疗1个月时间。督灸治疗：取患者大椎、中枢、脊中、陶道及悬枢、命门、长强穴、腰俞，轻摇发热包使其升温，以医用无纱布平铺贴于发热包上，将托布上方黏纸撕下，将发热包置于托布上，贴压于相应穴位，隔日1次，每次3 h，治疗1个月。
1.5　观察指标
①患者治疗效果评估[11]：采取尼莫地平法进行评估，疗效指数＝（治疗前症候总积分-治疗后症候总积分）/治疗前症候总积分×100.00%。痊愈-治疗后患者疗效指数较治疗前减少95%及以上；显效-治疗后患者疗效指数较治疗前减少70%及以上；好转-治疗后患者疗效指数较治疗前减少30%及以上；无效-治疗后患者疗效指数较治疗前减少30%以内。总有效率＝痊愈率+显效率+有效率。②比较各组患者治疗前后神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等中医症候积分变化，各项积分0～3分，分值越高表示症候越严重[12]。③比较各组患者治疗前后Piper疲乏修正量表评分（Piper's Fatigue Scale，PFS）变化。PFS评分标准[13]：量表共计4个维度，分别为行为与情感、躯体及认知疲乏，各维度分值0～10分，分值越高表示患者的疲乏程度越严重。0分表示无疲乏，1～3分表示轻度疲乏，4～6分表示中度疲乏，7～10分表示重度疲乏。④比较各组患者治疗前后汉密尔顿焦虑量表-14（Hamilton Anxiety Scale-14，HAMA-14）与汉密尔顿抑郁量表-17（Hamilton Depression Scale-17，HAMD-17）评分变化[14]。HAMA-14评分标准：包括14个项目，采取五级评分法，总分0～56分，分值越高表示患者的焦虑情况越严重。HAMD-17评分标准：包括17个项目，总分0～68分，分值越高表示患者的抑郁情况越严重。⑤比较各组患者治疗前后匹兹堡睡眠指数（Pittsburgh Sleep Quality Index，PSQI）变化。PSQI评分标准[15]：包括7个条目，分值0～21分，分值越高表示患者睡眠质量越差。⑥比较各组患者治疗前后Spitzer生活质量指数（Spitzer Quality of Life Index，SQLI）变化。SQLI评分标准[16]：包括活动能力与日常生活、家庭支持以及健康感受、生活感受等五个维度，总分0～10分，分值越低表示患者的生活质量越差。⑦比较各组治疗满意率，采取问卷进行调查，患者填写问卷，分值0～100分，60分以上为治疗满意。
1.6　统计学方法
经用SPSS 26.0软件对中医组与常规组数据资料进行处理。计量资料（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等中医症候积分、PFS评分、HAMA-14评分、HAMD-17、PSQI评分以及SQLI评分等）以均数±标准差（）表示，组间比较用t检验；计数资料（疗效与治疗满意率等）比较用χ2检验，以P<0.05，为差异具有统计学意义。
2　结果
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2.1　中医组和常规组患者治疗效果比较
中医组患者治疗总有效率（96.36%）比常规组患者（84.21%）更高，P<0.05。见表1。
2.2　中医组和常规组患者治疗前后中医症候积分变化
各组患者治疗前中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）比较，P>0.05，治疗后各组患者中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）均下降，中医组患者治疗后中医症候积分（神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等）下降程度高于常规组，P<0.05。见表2。
2.3　中医组和常规组患者治疗前后PFS评分变化
各组患者治疗前PFS评分比较，P>0.05，治疗后各组患者PFS评分均下降，中医组患者治疗后PFS评分下降程度高于常规组，P<0.05。见表3。
2.4　中医组和常规组患者治疗前后HAMA-14评分、HAMD-17、PSQI评分变化
各组患者治疗前HAMA-14评分、HAMD-17、PSQI评分比较，P>0.05，治疗后各组患者HAMA-14评分、HAMD-17、PSQI评分下降，中医组患者治疗后HAMA-14评分、HAMD-17、PSQI评分下降程度高于常规组，P<0.05。见表4。
2.5　中医组和常规组患者治疗前后SQLI评分变化
各组患者治疗前SQLI评分比较，P>0.05，治疗后各组患者SQLI评分均上升，中医组患者治疗后SQLI评分上升程度高于常规组，P<0.05。见表5。
2.6　中医组和常规组患者治疗满意率比较
中医组患者治疗满意率（93.36%）比常规组患者治疗满意率（84.21%）更高，P<0.05。见表6。
3　讨论
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肝癌属于中医“臌胀”“癥瘕”及“积聚”等范畴[17-19]。中医将肝癌癌因性疲乏归属于“虚劳”范畴。肝癌病理改变属“虚、痰、毒、瘀”，而虚劳之症主要病机为脏腑功能衰竭与气血亏虚[20-21]。中医认为[22]，“邪之所凑，其气必虚”“壮人无积，虚则有之。”肝癌癌因性疲乏患者五脏虚损，主要病变在于脾肾，患者脾肾亏虚则无法生化气血，气血亏虚，故而治疗当以扶正、祛邪、养血益气、健脾益肾等方法[23-25]。参芪固本破壁饮片是由黄芪、党参、白术、茯苓、五味子、淫羊藿、女贞子等中药组成，方中黄芪具有补气升阳、益气固表等功效；党参具有补中益气、健脾益肺及生津等功效；白术具有固表止汗、燥湿健脾、利尿消肿等功效；茯苓具有利水渗湿、健脾和胃以及养心安神等功效；五味子具有益气生津以及补肾宁心功效；淫羊藿具有补肾阳、祛风除湿及抗抑郁等功效；女贞子具有补益肝肾以及滋阴益寿等功效。本方中，以黄芪与党参为君药，共行益气养血及健脾补中功效。女贞子及淫羊藿共为臣药，具有生血、补肾强精功效。茯苓及白术为佐药，可助党参补脾胃之气，增强患者脾胃功能。五味子为使药，可载药入脾肾，本方诸药配伍共行益气养血、健脾补肾及祛邪之功效[26-28]。现代药理指出，参芪固本破壁饮片具有较好调节机体免疫功能作用，利于患者病情好转[29]。
督脉总督机体一身阳气，属于机体“阳脉之海”，行于背脊正中，上通达脑髓，络于肾，总督全身阳经经气，为阳经总属[30]。《扁鹊心书》指出“大病宜灸”。《针灸问对》记载：“虚者灸之，使火气以助元气也。”可见，中医灸法具有较好扶助元阳功效[31]。中医认为，“阳气者，精则养神”，神得养则疲乏症状改善。肝癌癌因性疲乏者进行督灸，刺激大椎、中枢、脊中、陶道及悬枢、命门、长强穴、腰俞等，灸法可以温热刺激机体穴位，具有较好温煦脏腑以及培固本元、调和气血以及温补脾胃、平衡阴阳等作用，可较好改善患者癌因性疲乏，且操作简单，值得应用[32]。分析本次研究数据发现，中医组患者治疗总有效率（96.36%）比常规组患者（84.21%）更高，P<0.05，可见参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏临床效果显著。肝癌癌因性疲乏患者发病后表现出神疲、气短乏力、自汗、懒言、失眠心悸、头晕眼花等中医症候，本次发现，患者经参芪固本破壁饮片结合督灸治疗后，各项症候积分均下降，可见本次治疗可较好改善患者的症候。中医组患者治疗后PFS评分下降，且低于常规组，P<0.05，可见参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏可有效改善患者疲乏症状。中医组患者治疗后HAMA-14、HAMD-17、PSQI以及SQLI评分等指标均改善优于常规组患者，P<0.05，提示参芪固本破壁饮片结合督灸可改善肝癌癌因性疲乏患者负面情绪及睡眠质量、生活质量；中医组患者治疗满意率（93.36%）比常规组患者治疗满意率（84.21%）更高，P<0.05，提示肝癌癌因性疲乏患者较为认可参芪固本破壁饮片结合督灸治疗方法。
综上所述，参芪固本破壁饮片结合督灸治疗肝癌癌因性疲乏效果显著，患者疲乏等症候、负面情绪、睡眠质量与生活质量均改善，患者对治疗认可及满意，值得进行应用。
基金
收起
  • 国家中医药管理局全国名老中医药专家传承工作室项目(国中医药人教发〔2017〕29号)
  • 广东省中医药局科研项目(20202187)
  • 佛山市医学类科技攻关项目(1920001000800)
文献
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2025年第43卷第3期
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doi: 10.13193/j.issn.1673-7717.2025.03.020
  • 首发时间：2026-10-30
  • 出版时间：2025-03-10
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出版历史
基金
国家中医药管理局全国名老中医药专家传承工作室项目(国中医药人教发〔2017〕29号)
广东省中医药局科研项目(20202187)
佛山市医学类科技攻关项目(1920001000800)
作者信息
    佛山市中医院，广东 佛山 528000

通讯作者:

蒋开平（1967-），男，四川广元人，主任医师，硕士，研究方向：肝病学。
参考文献
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https://castjournals.cast.org.cn/joweb/zhzyyxk/CN/10.13193/j.issn.1673-7717.2025.03.020
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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