红外灸治疗乳腺癌癌性疲劳及其端粒长度机制研究

Cancer related fatigue (CRF) is a common and persistent symptom among cancer patients, severely disturbing cancer patients’ quality of life. Currently, cancer-related fatigue is getting increasing attention in clinic practice, and yetthere is no effective treatment for it. There have been some reports showing that acupuncture can treat cancer related fatigue, but its effects and mechanism warrant well-designed clinical research and in-depth mechanism research. Our research group found that the 10.6μm infrared laser moxibustion was effective in relieving cancer-related fatigue. This is a randomized, double-blind, controlled clinical trial to observe the effect of infrared laser moxibustionin treating CRF assessed by Brief Fatigue Inventory (BFI) and patients’ psychological condition will be assessed by Hospital Anxiety and Depression Scale (HADS). Meanwhile, we will measure leukocyte telomere length by using real-time fluorescent quantitative PCR, telomerase activity by using TRAP-ELISA and serum cortisol by using ELISA to explore the mechanism of infrared laser on cancer-related fatigue. This research will not only provide a safe and effective new treatment for cancer-related fatigue, but also explore its mechanism through telomere length, an objective biomarker for cancer-related fatigue, on a genetic level.

癌性疲劳是普遍存在于癌症患者中、严重影响患者生存质量的持久性疲劳，在肿瘤临床中越来越受重视，但目前临床尚缺乏有效的治疗手段。一些报道表明针灸对于该病的治疗有一定作用，但有效性和作用机制尚缺乏可靠的临床试验和系统深入的研究。本课题组前期研究初步发现，模拟传统隔物灸的10.6μm红外激光灸能改善癌性疲劳。本项目采用随机双盲对照临床设计观察红外激光灸对乳腺癌癌性疲劳的临床疗效，运用简明疲劳量表（BFI）作为为疗效评定工具， 医院焦虑抑郁量表（HADS）量表评价心理状况，同时采用荧光实时定量PCR方法测定患者外周血白细胞基因组DNA端粒长度，用酶免法测端粒酶活性和血清皮质醇水平，分析红外灸穴位照射抗癌性疲劳作用与端粒长度、心理压力的关系，探讨红外激光灸治疗癌性疲劳的疗效机制。本项目既能为癌性疲劳治疗提供安全有效的新治疗手段，又能够通过反映疲劳程度的客观指标——白细胞端粒，从基因水平探讨疗效机制。

癌性疲劳是普遍存在于癌症患者中、严重影响患者生存质量的持久性疲劳，在肿瘤临床中越来越受重视，但目前临床尚缺乏有效的治疗手段。一些报道表明针灸对于该病的治疗有一定作用，但有效性和作用机制尚缺乏可靠的临床试验和系统深入的研究。本项目采用随机对照临床设计观察红外激光灸对乳腺癌癌性疲劳的临床疗效，运用简明疲劳量表（BFI）作为为疗效评定工具，同时测定患者外周血白细胞基因组DNA端粒长度，血清皮质醇和雌二醇水平。研究结果表明，红外激光灸对乳腺癌患者癌性疲劳和睡眠质量均有有明显改善，且疗效持续改善到治疗结束后随访12周，同时发现红外激光灸可以降低乳腺癌患者血清皮质醇含量。白细胞端粒长度与患者年龄负相关，而血清皮质醇含量与患者年龄正相关。红外激光灸有效且安全，除了4名患者治疗局部皮肤出现轻微红晕且无需治疗自行消退外，无其他相关不良反应出现，且治疗前后患者血清雌二醇含量保持低水平，不增加乳腺癌复发风险。因此，红外激光灸治疗癌性疲劳可能与调节皮质醇分泌有关，且与改善睡眠相关。本项目既能为癌性疲劳治疗提供安全有效的新治疗手段，又从分子水平探讨其可能作用机制。