火龙灸联合推拿治疗脾肾阳虚型慢性疲劳综合征的疗效观察

Clinical efficacy of fire dragon moxibustion combined with massage for chronic fatigue syndrome with spleen-kidney yang deficiency

关键词:  慢性疲劳综合征  火龙灸  推拿  炎症因子  临床疗效

Key words:  chronic fatigue syndrome  moxibustion  massage  inflammatory factor  clinical efficacy

摘要:

目的 探讨火龙灸联合推拿治疗慢性疲劳综合征（CFS）的临床疗效。方法 选取2022年1月——2024年7月就诊于四川省中医院推拿科符合脾肾阳虚型的CFS患者153例，按1∶1∶1的比例随机分为观察组、对照1组和对照2组，每组各51例。观察组接受火龙灸联合推拿治疗，对照1组单纯接受火龙灸治疗，对照2组单纯接受推拿治疗，连续治疗6周后随访12周。比较3组治疗前、治疗后及随访期疲劳严重程度量表（FSS）、躯体及心理健康报告量表（SPHERE）和生活质量量表（SF-36）评分变化，同时检测血清炎症因子水平并评估临床疗效。结果 在治疗后及随访时3组患者的FSS评分、SPHERE、SF-36评分均较治疗前改善（P＜0.05），其中观察组FSS评分和SPHERE评分优于对照组（P＜0.05），生活质量评分比较3组差异无统计学意义。治疗后对照2组的FSS评分和SPHERE评分优于对照1组（P＜0.05）。炎症因子水平方面，治疗结束后观察组降幅高于对照组（P＜0.05），而对照组间比较差异无统计学意义。有效率的比较上，观察组的有效率高于对照组（P＜0.05），两对照组间有效率比较差异无统计学意义。结论 火龙灸联合推拿可以有效改善脾肾阳虚证CFS患者的疲劳程度、躯体症状、心理状态和炎症因子水平，其疗效优于单纯火龙灸或推拿。

Abstract:

Objective To observe the clinical effect of fire dragon moxibustion combined with massage on chronic fatigue syndrome (CFS). Methods A total of 153 patients diagnosed with yang deficiency-type CFS who were treated in the Tuina Department of Sichuan Provincial Hospital of Traditional Chinese Medicine from January 2022 to July 2024 were enrolled. Using a random number method, participants were allocated in a 1∶1∶1 ratio into an observation group, control group 1, and control group 2, with 51 cases in each group. The observation group received combined fire dragon moxibustion and massage therapy, control group 1 received fire dragon moxibustion alone, and control group 2 received massage alone. All interventions were administered for 6 weeks, followed by a 12-week follow-up period. Changes in Fatigue Severity Scale (FSS), Somatic and Psychological Health Report (SPHERE), and Short Form-36 Health Survey (SF-36) scores were compared among the three groups before treatment, after treatment, and during follow-up. Serum inflammatory cytokine levels and overall clinical efficacy were also assessed. Results After treatment and during follow-up, scores on the FSS, SPHERE, and SF-36 showed improvement in all three groups compared with baseline (P < 0.05). The observation group demonstrated greater improvement in FSS and SPHERE scores than the control groups, whereas no marked differences were observed among the three groups with respect to quality-of-life scores (P < 0.05). Following treatment, patients in control group 2 exhibited more pronounced reductions in FSS and SPHERE scores than those in control group 1 (P < 0.05). Regarding inflammatory markers, greater decreases were observed in the observation group after treatment (P < 0.05), while no obvious differences were noted between the two control groups. In terms of overall clinical efficacy, the total effective rate was higher in the observation group than in the control groups (P < 0.05), with no clear difference between the two control groups. Conclusion Fire dragon moxibustion combined with massage can effectively improve the fatigue degree, physical symptoms, and psychological state of patients with yang deficiency of spleen and kidney syndrome of CFS, and its curative effect is better than fire-dragon moxibustion or massage alone.