【目的】 观察芪归补血汤联合择时揿针疗法对肺脾气虚型非小细胞肺癌（NSCLC）化疗患者的骨髓抑制与癌因性疲乏的影 响。【方法】 选取2022年1月至2024年6月河北省沧州中西医结合医院放化疗科收治的124例肺脾气虚型非小细胞肺癌患者为 研究对象。按随机数字表将患者随机分为观察组和对照组，每组各62例。2组患者均采用以铂类为基础的两药联合方案进行 化疗。对照组在化疗基础上，给予择时揿针治疗。观察组在对照组治疗的基础上，给予芪归补血汤治疗。3周为 1个疗程， 共治疗 2 个疗程。治疗 2 个疗程后，观察 2 组患者治疗前后血常规以及淋巴细胞亚群 CD3+ 、CD4+ 、CD8+ 、NK 细胞的含量、 CD4+ /CD8+ 比值的变化情况，以及骨髓抑制发生率的情况。比较2组患者治疗前后Piper疲乏量表和卡氏评分量表（KPS）积分 的变化情况。【结果】（1）治疗后，观察组白细胞计数明显改善（P＜0.05），且观察组在改善白细胞计数方面明显优于对照组， 差异有统计学意义（P＜0.05）。（2）治疗后，2组患者的CD3+ 、CD4+ 、CD4+ /CD8+ 、NK水平均明显改善（P＜0.05），且观察组在 改善CD3+ 、CD4+ 、CD4+ /CD8+ 、NK水平方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）观察组的骨髓抑制发生率为 58.06（36/62），对照组为 77.42（48/62），观察组的骨髓抑制发生率明显低于对照组，差异有统计学意义（P＜0.05）。（4）治疗 后，2组患者的 Piper量表评分包括行为、情感、躯体及总分均明显改善（P＜0.05），且观察组在改善 Piper量表评分包括行 为、情感、躯体及总分方面明显优于对照组，差异有统计学意义（P＜0.05）。治疗后，2组患者的Piper量表评分在认知方面 稍有改善，但与治疗前比较，差异无统计学意义（P＞0.05）。（5）治疗后，2组患者的KPS量表评分与中医证候积分均明显改善 （P＜0.05），且观察组在改善KPS量表评分与中医证候积分方面明显优于对照组，差异均有统计学意义（P＜0.05）。【结论】 芪 归补血汤联合择时揿针疗法能有效改善肺脾气虚型NSCLC患者化疗后的骨髓抑制情况，改善患者的免疫功能，并有效缓解 患者的癌因性疲乏状态，从而提高患者的生活质量。

Objective To observe the effects of Qigui Buxue Decoction combined with timed press-needle therapy on myelosuppression and cancer-related fatigue in chemotherapy patients with non-small cell lung cancer （NSCLC） of lung-spleen qi deficiency type. Methods A total of 124 NSCLC patients with lung-spleen qi deficiency type admitted to the Department of Radiotherapy and Chemotherapy at Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province from January 2022 to June 2024 were selected as the study subjects. The patients were randomly divided into an observation group and a control group using a random number table， with 62 cases in each group. Both groups received platinum-based two-drug combination chemotherapy. The control group received timed press-needle therapy in addition to chemotherapy， while the observation group received Qigui Buxue Decoction in addition to the control group's treatment. The treatment course was 3 weeks，with a total of 2 courses. After 2 courses of treatment，changes in blood routine，lymphocyte subsets （CD3+， CD4+， CD8+， NK cells）， CD4+ /CD8+ ratio， and the incidence of myelosuppression were observed. Changes in Piper Fatigue Scale and Karnofsky Performance Scale （KPS） scores before and after treatment were compared between the two groups. Results （1） After treatment， the white blood cell count in the observation group significantly improved （P＜0.05）， and the observation group showed significantly better improvement in white blood cell count compared to the control group，with a statistically significant difference（P＜0.05）.（2）After treatment，the levels of CD3+，CD4+，CD4+ /CD8+，and NK cells in both groups significantly improved （P＜ 0.05），and the observation group showed significantly better improvement in these levels compared to the control group， with a statistically significant difference（P＜0.05）. （3） The incidence of myelosuppression in the observation group was 58.06%（36/62）， while it was 77.42%（48/62） in the control group. The incidence of myelosuppression in the observation group was significantly lower than that in the control group，with a statistically significant difference（P＜0.05）.（4） After treatment， the Piper Fatigue Scale scores， including behavioral， emotional，physical，and total scores，significantly improved in both groups （P＜0.05），and the observation group showed significantly better improvement in these scores compared to the control group，with a statistically significant difference （P＜0.05）. The cognitive scores of the Piper Fatigue Scale showed slight improvement in both groups， but there was no statistically significant difference compared to before treatment （P＞0.05）.（5） After treatment，the KPS scores and TCM syndrome scores significantly improved in both groups （P＜0.05），and the observation group showed significantly better improvement in these scores compared to the control group，with a statistically significant difference （P＜0.05）. Conclusion Qigui Buxue Decoction combined with timed pressneedle therapy can effectively improve myelosuppression，enhance immune function，and alleviate cancer-related fatigue in NSCLC patients with lung-spleen qi deficiency type after chemotherapy，thereby improving their quality of life. This approach is worthy of clinical promotion.

R246.9

河北省中医药管理局资助项目（编号：2022587）