| Neutropenia has been considered to have the most serious haematological toxicityin myelosuppressive chemotherapy.It is also a common dose-limiting toxicityin the treatment of solid tumors and hematologic malignancies.It increases the number of days that cancer patientsstay hospitalized to some extent as well as infection rates,mortality rates,and incurs significant treatment costs.Modern medical treatment for chemotherapy-related neutropenia has made rapid progress.In particular,a recombinant human granulocyte colony-stimulating factor(G-CSF)and granulocyte-macrophage colony-stimulating factor(GM-CSF)treatment has a rapid onset.It increases leukocyte and neutrophil counts significantly,and is already widely used around the world.However,it has many adverse reactions,and patients who use this treatment do not see significant improvement in their symptoms.Its application is stilllimited.Chinese medicine is playing an increasingly important role in the prevention and treatment of chemotherapy-related neutropenia.It has many methods of treatment,involving medicinal herbs,acupuncture,moxibustion,acupoint injection etc.,used either alone or in combination with each other.Overall,it has goodlasting efficacy and its results are stable,however,its rate of increasing granulocyte count is slow,thusmaking it difficult to meet clinical needs.By previous clinical observations,we found that not only meridian scraping therapy(Gua Sha)on a patient’s backside has increases neutrophil count quickly and significantly,it also has goodlasting efficacy and stable results.It can increase a patient’s neutrophil count to the normal clinical range in a short amount of time,and has successfully helped patients complete their chemotherapy treatments,and thus there is clinical significance in this method.To further explore themechanism of increasing granulocytecount and the duration of increased granulocyte count,we used recombinant human granulocyte colony stimulating factor(Filgrastim),a commonly used medicine to treat neutropenia,as the control group.We compare the two treatment methods to observe the extent in which they can raise granulocyte count,the speed in which they can raise granulocyte count,the amount of time they can maintain the granulocyte count within a range,their safety,as well as how well they can relieve patients’ symptoms etc.Objective:To observe the efficacy and safety of using meridian scraping therapy on patients’ backsideto treat Ⅰ-Ⅱ degree neutropenia syndrome induced by chemotherapy.Methods:We gathered 49 case patients who have solid tumors and I-II degree neutropenia induced by chemotherapy at the China-Japan Friendship Hospital Integrative Medicine Oncology Department,and split them randomly into 2 groups.25 patients were assigned to the Gua Sha group,and 24 were assigned to the Filgrastim group.The Gua Sha group received Gua Sha on the following meridians in sequential order:Du,Bladder(both sides),sides of the torso along the ribcage(both sides),and the iliac region(both sides).We scraped until red dots appeared on the skin.The patients were only treated once.The Filgrastim group was given subcutaneous injection of Filgrastim 100ug once.We observed the routine blood test results,changes in symptoms,rate of infection,and adverse reactions of both groups on the day before treatment or on the day of the treatment,and then again on the first day,the first week,and the second week after treatment.We observed changes to their cardiograms,liver,and kidney functions on the day before treatment or on the day of the treatment,and one week after treatment.Research results:1.Efficacy①Leukocyte count change:For both groups,white blood cell counts were significantly elevated compared to pre-treatment counts on the first day after treatment,the first week,and the second week.The difference was statistically significant(P<0.05).②Change in neutrophil count:For both groups,the neutrophil count on the first day after treatment and the first week after treatment were significantly higher than that of pre-treatment.It is statistically significant(P<0.05).For the Gua Sha group,the neutrophil count 2 weeks after treatment was still significantly higher than that of pre-treatment.The difference is statistically significant(P<0.05).However,the neutrophil count for the Filgrastim group 2 weeks after treatment was only slightly higher than that of pre-treatment.The difference was not statistically significant(P>0.05).③Comparison:For both groups,neutrophil counts were significantly increased after treatment.The Gua Sha group/Filgrastim group have the following stats for amount of neutrophil increased;the first day(84.0%/96.0%),the first week(92.0%/87.5%)the second week(68.0%/75.0%);Gua Sha group’s neutrophils’ rise and decline change intervals were(3.2%,431.0%),(-64.1%-0.5%);The Filgrastim group’s neutrophils’ rise and decline change intervals were(9.1%,1348.7%),(-923%,-1.1%).④Hemodilution Problem:After Gua Sha therapy,RBC,HGB,and PLT counts decreased slightly.This decline was statistically significant(P<0.05).After Filgrastim treatment,RBC and HGB counts increased slightly after the first day.This increase was not statistically significant(P>0.05);PLT values varied in their increase anddecrease.The difference was not statistically significant(P>0.05).To summarize,Western medicine is more advantageous at increasingthe speed and amplitude of the rise of white blood cell and neutrophil count than Gua Sha treatment.However,it has large amplitude changes and has a short duration;While under the effect of hemodilution,Gua Sha treatmentcan increase granulocyte and white blood cell count in a short amount of time.It can maintain and continue increasing this elevated count for a certain period of time,and can keep this count within the normal range.It has a lasting and stable effect in increasing granulocyte count.2.Safety⑤Infection:There was no neutropenic fever case in either group.The infection rate was 0%.⑥Liver and kidney function:After Gua Sha treatment,the total bilirubin and indirect bilirubin levels were increased within the normal physiological range,the difference is statistically significant(P<0.05);ALP values were lower than before,and the difference is statistically significant(P<0.05);No significant effect was noted on other indicators(P>0.05).Western medicine had little effect on the liver and kidney function.There was no statistical significances for any indicators before and after treatment(P>0.05).⑦Adverse reactions:Both groups showed common adverse reactions such as bone pain,painat the treatment site,heart palpitations,fever,fatigue and so on.The incidence of adverse reactions between the two groups were about the same,the difference was not statistically significant(P>0.05).Conclusion:Meridian scraping therapy on patients’ backsideto treat I-II degree neutropenia syndrome induced by chemotherapy is fast,safe,effective,on par with western medicine treatment methods,more economic,and has even better stability.It can help cancer patients successfully finish their current chemotherapy cycle and is worthy of being popularized as a clinical treatment method. |
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