Peer Reviewed Research: Effect of Zhang Zhuang Qigong on Complete Blood Cell Counts in Breast Cancer Patients Treated With Chemotherapy
The study, authored by Yeh, Lee, Chen, and Chao (2006), explores the therapeutic potential of Chan-Chuang (also known as Zhang Zhuang) Qigong therapy in managing chemotherapy-induced leukopenia, anemia, and thrombocytopenia among breast cancer patients. Chemotherapy, while crucial for reducing cancer recurrence and metastases, often causes significant side effects such as bone marrow suppression, leading to a decline in white blood cells (WBCs), platelets, and hemoglobin (Hb). This quasi-experimental study aimed to evaluate whether a 21-day regimen of Chan-Chuang Qi-Gong could mitigate these adverse effects, improving patients' overall hematological profile.
Methodology
The study recruited 67 breast cancer patients undergoing their first chemotherapy cycle at a Taiwanese medical center. Participants were divided into an experimental group (n = 32), practicing Chan-Chuang Qi-Gong daily for 15–60 minutes, and a control group (n = 35) receiving standard care. Complete blood counts were measured at baseline (before chemotherapy) and on days 8, 15, and 22 post-chemotherapy initiation. A repeated-measures analysis of variance (ANOVA) was employed to assess changes in WBCs, platelets, and Hb levels across the study period.
Results
The study found that Chan-Chuang Qi-Gong therapy significantly influenced hematological parameters:
White Blood Cells (WBCs): The experimental group demonstrated a significant increase in WBC counts compared to the control group (F = 115.76, P < .001). The therapy appeared to counteract the expected nadir in WBCs observed during weeks 1 and 2 of chemotherapy, potentially reducing the risk of neutropenia-associated complications.
Platelets: While both groups showed improvements in platelet counts, the within-group analysis revealed significant increases (F = 25.29, P < .001). However, between-group differences were not statistically significant.
Hemoglobin (Hb): The experimental group exhibited better maintenance of Hb levels, although the differences between the two groups were not statistically significant (F = 15.39, P < .001 for within-group analysis).
Discussion
The study aligns with prior research suggesting Qi-Gong’s efficacy in enhancing immune and circulatory functions. Chan-Chuang Qi-Gong’s simplicity, adaptability, and minimal physical demand make it particularly suited for physically compromised populations like chemotherapy patients. By fostering relaxation and improving lymphatic and circulatory functions, this practice may support hematopoiesis and immune regulation.
Notably, the intervention seemed more effective in maintaining WBCs than platelets or Hb. The authors hypothesize that Qi-Gong may enhance the physiological processes governing immune cell production and turnover, possibly via mechanisms linked to the sympathetic nervous system's modulation and improved oxygenation of tissues. However, the therapy's limited effect on platelets and Hb may reflect the shorter duration of the intervention or the multifactorial nature of chemotherapy-induced anemia and thrombocytopenia.
Strengths and Limitations
Strengths:
The study’s quasi-experimental design and use of repeated measures provide robust insights into temporal trends in hematological parameters.
The choice of Chan-Chuang Qi-Gong, a simple and accessible intervention, underscores its practical utility in clinical settings.
The study’s rigorous methodology, including the use of standardized blood analyzers and comprehensive statistical analyses, enhances the reliability of the findings.
Limitations:
The quasi-experimental design, while valuable, lacks the randomization needed to fully control for confounding variables.
The relatively small sample size and single-center design limit the generalizability of findings.
The study did not explore potential psychosocial benefits of Qi-Gong, such as reduced anxiety or improved quality of life, which could further elucidate its holistic effects.
Implications for Clinical Practice
This study advocates for integrating Chan-Chuang Qi-Gong into supportive care for breast cancer patients undergoing chemotherapy. Given its minimal cost, ease of implementation, and lack of adverse effects, Qi-Gong represents a promising adjunctive therapy to address chemotherapy-induced hematological toxicities. However, broader adoption would require additional randomized controlled trials to confirm efficacy and explore dose-response relationships.
Recommendations for Future Research
The authors recommend:
Conducting randomized controlled trials with larger, more diverse cohorts to validate findings.
Extending the duration of Qi-Gong interventions to examine long-term effects on hematological and psychosocial outcomes.
Investigating the molecular and physiological mechanisms underlying Qi-Gong’s benefits, potentially using biomarkers of immune and hematopoietic activity.
Conclusion
The study by Yeh et al. (2006) highlights the potential of Chan-Chuang Qi-Gong as a complementary intervention for managing chemotherapy-induced hematological toxicities in breast cancer patients. By improving WBC counts and possibly mitigating associated risks like infection and sepsis, Qi-Gong offers a holistic, patient-centered approach to cancer care. While further research is warranted, this study lays the groundwork for integrating traditional Chinese medicine practices into evidence-based oncology nursing.
Reference
Yeh, M.-L., Lee, T.-I., Chen, H.-H., & Chao, T.-Y. (2006). The influences of Chan-Chuang Qi-Gong therapy on complete blood cell counts in breast cancer patients treated with chemotherapy. Cancer Nursing, 29(2), 149–155.
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