健脾益气消瘀法联合化疗治疗老年中晚期胃癌临床研究
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摘要
目的:观察自拟方剂(健脾益气消瘀)联合化疗治疗老年中晚期胃癌的效果。方法:回顾性分析2015年1月～2016年9月期间收治入院的76例中晚期胃癌患者病例资料,其中32例行奥沙利铂+5-FU+CF化疗,纳入对照组,44例在对照组治疗基础上联合自拟方剂(健脾益气消瘀),纳入观察组,观察两组患者临床疗效、中医证候疗效及西医疗效和安全性。结果:治疗前两组中医症状积分未见统计学差异(P>0. 05);治疗2个月后均显著较治疗前改善,组内P<0. 05,且治疗2个月后观察组各中医症状评分均较对照组低,组间统计差异显著(P<0. 05)。治疗前组间生活质量积分差异未见显著性差异(P>0. 05);治疗2个月后均显著提高,且观察组明显高于对照组,组间统计差异显著(P<0. 05)。治疗前两组患者血清CEA及CA199水平均未见显著性差异(P>0. 05),治疗后均显著改善,且观察组治疗2个月后CEA及CA199水平均显著低于对照组,组间差异显著(P<0. 05)。治疗2个月后两组患者临床总有效率为84. 09%,高于对照组的53. 13%,组间统计差异显著(P<0. 05);观察组中医证候疗效显著较对照组高(88. 64%vs37. 50%),组间比较有显著性差异(P<0. 05)。此外,观察组恶性、呕吐、腹泻及中性粒细胞减少和血小板下降情况发生率明显低于对照组,组间差异显著(P<0. 05)。结论:自拟方剂(健脾益气消瘀)联合化疗治疗中晚期胃癌可有效改善中医症状,提高疗效,还可减轻化疗不良反应。
Objective: Exploring the effect of applying Jianpi Yiqi Xiaoyu Method combined with chemotherapy in the treatment of advanced gastric cancer in the elderly. Methods: Retrospectively analyzed the data of 76 patients with advanced gastric cancer admitted to our hospital from January 2015 to September 2016,included 32 cases treated with oxaliplatin+5-FU +CF into controlled group,and included 44 cases treated with self-made prescription(Jianpi,Yiqi,Xiaoyu) on the basis of the controlled group into observation group. Observed the clinical efficacy,TCM syndromes,efficacy of TCM syndrome and western medicine treatment and safety in the two groups. Results: There was no significant difference in symptom scores between the two groups before treatment(P>0. 05),which were significantly improved after 2months treatment(P< 0. 05). The scores of TCM symptoms in the observation group were lower than those in the controlled group,and the difference between the two groups was statistically significant after 2months treatment(P<0. 05). There was no significant difference in quality of life scores between the two groups before the treatment(P>0. 05). After 2months of treatment,the observation group was significantly higher than that of the controlled group,and the difference between the two groups was statistically significant(P<0. 05). There was no significant difference in serum CEA and CA199 levels between the two groups before treatment(P>0. 05). After treatment,the levels of CEA and CA199 in the observation group were significantly lower than those in the controlled group(P<0. 05). After 2months of treatment,the total effective rate of the two groups was 84. 09%,higher than of the controlled group which was 53. 13%,the difference between the two groups was statistically significant(P< 0. 05). The curative effect of TCM syndromes in observation group was significantly higher than that in the controlled group(88. 64%,vs,37. 50%),and there was significant difference between the two groups(P<0. 05). In addition,the incidence of malignant,vomiting,diarrhea and neutropenia and thrombocytopenia in the observation group was significantly lower than that in the controlled group(P<0. 05). Conclusion: Appying self-made prescription(Jianpi Yiqi Xiaoyu) combined with chemotherapy in the treatment of advanced gastric cancer can effectively improve the symptoms of TCM,improve efficacy,but also reduce the adverse reactions of chemotherapy.
Objective: Exploring the effect of applying Jianpi Yiqi Xiaoyu Method combined with chemotherapy in the treatment of advanced gastric cancer in the elderly. Methods: Retrospectively analyzed the data of 76 patients with advanced gastric cancer admitted to our hospital from January 2015 to September 2016,included 32 cases treated with oxaliplatin+5-FU +CF into controlled group,and included 44 cases treated with self-made prescription(Jianpi,Yiqi,Xiaoyu) on the basis of the controlled group into observation group. Observed the clinical efficacy,TCM syndromes,efficacy of TCM syndrome and western medicine treatment and safety in the two groups. Results: There was no significant difference in symptom scores between the two groups before treatment(P>0. 05),which were significantly improved after 2months treatment(P< 0. 05). The scores of TCM symptoms in the observation group were lower than those in the controlled group,and the difference between the two groups was statistically significant after 2months treatment(P<0. 05). There was no significant difference in quality of life scores between the two groups before the treatment(P>0. 05). After 2months of treatment,the observation group was significantly higher than that of the controlled group,and the difference between the two groups was statistically significant(P<0. 05). There was no significant difference in serum CEA and CA199 levels between the two groups before treatment(P>0. 05). After treatment,the levels of CEA and CA199 in the observation group were significantly lower than those in the controlled group(P<0. 05). After 2months of treatment,the total effective rate of the two groups was 84. 09%,higher than of the controlled group which was 53. 13%,the difference between the two groups was statistically significant(P< 0. 05). The curative effect of TCM syndromes in observation group was significantly higher than that in the controlled group(88. 64%,vs,37. 50%),and there was significant difference between the two groups(P<0. 05). In addition,the incidence of malignant,vomiting,diarrhea and neutropenia and thrombocytopenia in the observation group was significantly lower than that in the controlled group(P<0. 05). Conclusion: Appying self-made prescription(Jianpi Yiqi Xiaoyu) combined with chemotherapy in the treatment of advanced gastric cancer can effectively improve the symptoms of TCM,improve efficacy,but also reduce the adverse reactions of chemotherapy.
引文
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[14]樊江丽,李东芳,焦蕉,等.胃复方联合化疗对中晚期脾虚瘀毒型胃癌患者生活质量的影响[J].中医杂志,2015,56(2):120~123
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[2]邱作成,李志钢,闫宏宇,等.健脾益气、化瘀解毒法治疗慢性萎缩性胃炎探讨[J].中医学报,2014,29(1):94~95
[3]薛兴存,郭锐.健脾益气化瘀方配合西药治疗早期胃癌术后疗效观察[J].陕西中医,2012,33(7):843~844
[4]李岩,王垂杰.中药不同组方对胃癌前病变模型大鼠胃黏膜细胞ROS、Ca2+表达的影响[J].中国中西医结合消化杂志,2012,20(10):447~449
[5]刘华蓉,刘尚义.黄芪颗粒联合化疗治疗对老年胃癌患者生活质量及外周血T淋巴细胞亚群水平的影响[J].中国老年学杂志,2016,36(15):3733~3734,3735
[6]中华人民共和国卫生部医政司.中国常见恶性肿瘤诊治规范[S].第2版.北京:北京医科大学中国协和医科大学联合出版社,1991:7~9
[7]中华人民共和国卫生部.中药新药临床研究指导原则[M].北京:人民卫生出版社,1997:3~36
[8]徐力,许斌.健脾益气养阴活血方联合改良DCF方案对中晚期胃癌患者生活质量影响研究[J].长春中医药大学学报,2012,28(6):1059~1060
[9]程纬,葛亮,孟宪杰,等.中西医结合治疗中晚期胃癌64例报告[J].临床医学工程,2014,21(4):467~468
[10]刘英志,郭权来.健脾益气法联合早期肠内营养对胃癌术后患者营养状况及免疫功能的影响[J].深圳中西医结合杂志,2016,26(11):12~15
[11]王宏星,李建平,顾元龙,等.八珍汤加减辅助早期肠内营养对重症急性胰腺炎免疫功能、炎症反应和营养状况的影响[J].中华胰腺病杂志,2012,12(3):196~197
[12]王鹂,汤炜炜.健脾祛瘀汤联合化疗治疗晚期胃癌30例[J].长春中医药大学学报,2013,29(3):400~401
[13]舒鹏,武雯.健脾养胃方联合化疗对胃癌Ⅱ、Ⅲ期术后干预作用的临床研究[J].实用临床医药杂志,2013,17(3):16~18
[14]樊江丽,李东芳,焦蕉,等.胃复方联合化疗对中晚期脾虚瘀毒型胃癌患者生活质量的影响[J].中医杂志,2015,56(2):120~123
[15]顾群浩,胡波,张晓东,等.消痰散结方联合化疗治疗晚期胃癌患者32例临床观察[J].中医杂志,2013,54(23):2008~2011,2017
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