Application Research Of Chu Zhen And Moxibustion Therapy Based On The Theory Of Fu Zheng In Patients With Cancer-related Fatigue

ObjectiveBoth Chu Zhen and moxibustion therapy are in accord with the "Fu Zheng" fundamental principle of intervention for cancer-related fatigue(CRF),so they have their own unique advantages in the treatment of CRF.This paper systematically studies the efficacy and safety of the clinical nursing intervention for CRF with Chu Zhen and moxibustion therapy,which including Chu Zhen therapy,moxibustion therapy and Chu Zhen moxibustion combined therapy(CZMB therapy).Then we could get the comprehensive and systematic nursing evidence to provide the support for the application of Chu Zhen and moxibustion therapy in CRF patients,and to provide references for related researches.MethodsInnovativeness and scientificity are the primary criteria for the medical research,while the leading systematic reviews and meta-analyses are effective means of ensuring the innovativeness and scientificity.This master's thesis firstly completed the literatures research on the application of Chu Zhen and moxibustion therapy in CRF patients with the method of systematic review/ meta-analysis,and then designed and carried out the supplementary randomized controlled trial(RCT)based on the systematic review/ meta-analysis;then we could finally obtain comprehensive and systematic evidence in the research objectives.(1)The first section with literatures research carried out computer retrieval of foreign databases such as Web of Science,Pub Med,The Cochrane Library,EMBase,as well as Chinese databases,such as the Chinese Biomedical Literature Database(CBM),China National Knowledge Infrastructure(CNKI),VIP Literature Database(VIP)and Wan Fang Literature Database(Wan Fang);while we also performed supplementary retrieval with other sources.All relevant RCTs were collected to systematically research Chu Zhen and moxibustion therapy for the cancer patients with CRF.The literature screening and data extraction were carried out according to the research protocol of systematic review/ meta-analysis,then the quality of the included literature was evaluated according to the Cochrane quality evaluation standard,and then meta-analyses were performed with the Rev Man 5.3 software.(2)The RCT was designed according to the results of systematic review and meta-analysis.The research subjects were non-small cell lung cancer(NSCLC)patients with Qi Xu type of CRF from The Affiliated Hospital of Chengdu University of TCM from December 2018 to November 2019.Random number table method was used to randomly divide patients with CRF into conventional control group,Chu Zhen group and CZMB group,with 36 cases in each group.All CRF patients in the three groups received palliative chemotherapy and conventional nursing care and other basic treatments.The Chu Zhen group was supplemented with Chu Zhen therapy on the basis of the control group,and the CZMB group was supplemented with smokeless moxibustion therapy on the basis of the Chu Zhen group.The primary outcome indicators were selected as the Brief Fatigue Inventory(BFI)and the Revised Piper Fatigue Scale(PFS-R),and the auxiliary evaluation indicators were selected as the Quality of Life Questionnaire-Core 30(QLQ-C30)and the incidence of side effects after chemotherapy.All kinds of clinical data were collected before,during and after the intervention,and appropriate statistical methods were selected to analyze and evaluate the data.Statistical analysis of the data was implemented with Statistical Product and Service Solutions(SPSS)26.0 software.Results(1)A total of 28 RCTs(2249 patients with CRF)were included,comprising 1125 cases of the moxibustion combined group and 1124 cases of the control group.The results of systematic review and meta-analysis showed that compared with the conventional basic treatment,moxibustion combined therapy can significantly improve the total effective rate of treating CRF,significantly reduce the number of patients with medium or severe CRF,significantly ameliorate the CRF fatigue score and quality of life score of patients,and significantly reduce the incidence of myelosuppression and gastrointestinal reactions during chemotherapy;the differences between the groups were all statistically significant(P < 0.05).(2)There were no statistically significant differences in demographic sociology data,basic clinical characteristics,and pre-intervention efficacy indexes among the three groups of CRF patients(P > 0.05),therefore the baseline comparability was good among the three groups.(1)Evaluation of primary outcome indicators: CRF scores(including BFI score and PFS-R score)were not statistically significant differences before and after intervention in the control group(P > 0.05),and there were statistically significant differences in the Chu Zhen group and the CZMB group before and after the intervention(P < 0.05),the fatigue score decreased significantly in the Chu Zhen group and the CZMB group;CRF scores(including BFI score and PFS-R score)were statistically significant differences among the three groups after intervention(P < 0.05),the effect of the Chu Zhen group was better than that of the control group,the effect of the CZMB group was better than that of the Chu Zhen group.(2)Evaluation of auxiliary outcome indicators: the difference of QLQ-C30 score before and after intervention in each group was statistically significant(P < 0.05);the quality of life decreased in the control group,while improved in the Chu Zhen group and the CZMB group.The difference of QLQ-C30 score among the three groups after intervention was statistically significant(P < 0.05);the effect of the Chu Zhen group was better than that of the control group,the effect of the CZMB group was better than that of the Chu Zhen group.The incidence of myelosuppression and gastrointestinal reaction caused by chemotherapy was statistically significant among the three groups(P < 0.05).The incidence of the Chu Zhen group was lower than that of the control group,and the incidence of the CZMB group was lower than that of the Chu Zhen group.There was no statistically significant difference in the incidence of alopecia,hepatotoxicity and nephrotoxicity caused by chemotherapy among the three groups(P > 0.05).(3)No adverse events related to Chu Zhen or moxibustion occurred during the whole process of this RCT.ConclusionThe monotherapy with Chu Zhen or moxibustion and the combined therapy with Chu Zhen and moxibustion are both safe and effective in the intervention of CRF.They can significantly ameliorate the fatigue and quality of life of CRF patients,and can significantly reduce the incidence of myelosuppression,gastrointestinal reaction,and other side effects caused by routine chemotherapy.The combined therapy of Chu Zhen and smokeless moxibustion has a better clinical effect than the Chu Zhen monotherapy for NSCLC patients with CRF.Chu Zhen and moxibustion care are both in accord with the "Fu Zheng" fundamental principle of intervention for CRF,so they can achieve the unique therapeutic effect of Fu Zheng Qiang Shen in the intervention of CRF caused by cancer and its conventional treatments with western medicine.Chu Zhen and moxibustion therapy both have the characteristic advantages including simple,convenient,inexpensive and effective of Traditional Chinese Medicine(TCM),therefore Chu Zhen and moxibustion therapy should be widely popularized as the nursing technique of TCM in CRF intervention.