回生口服液联合同步放化疗治疗局部晚期NSCLC的疗效观察

发布时间：2018-03-29 23:19

  本文选题：回生口服液　切入点：非小细胞肺癌　出处：《安徽医科大学》2017年硕士论文

【摘要】：目的:回生口服液由多种中药组份提炼而成,具有多种功效,药物副反应较少,临床上常作为肿瘤综合治疗种的辅助治疗手段,回生口服液中所含有的活血化瘀成分,可改善患者血凝状态,提高肿瘤组织的血供,起到增强放化疗疗效的作用。另有文献报道,回生口服液还可提高患者生活质量,减轻放化疗毒副反应[1-2],据此,本试验将探讨回生口服液联合同步放化疗治疗局部晚期NSCLC的疗效。方法:筛选2014年12月至2016年10月于我科治疗的局部晚期无手术指征的NSCLC患者68例,经纤支镜、肺穿或胸水脱落细胞学检查,细胞学或病理学明确诊断,且为首次确诊。通过随机方法分成两组,其中对照组34例,男20例,女14例;腺癌13例,鳞癌21例。实验组34例,男18例,女16例;腺癌15例,鳞癌19例。试验组患者给予同步放化疗和回生口服液,回生口服液由成都地奥集团天府药业股份有限公司生产。药品规格与性状:棕褐色液体;特臭,味苦、辛,10ml/支。回生口服液自放疗起日使用10 m L/次,3次/d,持续至放疗结束。而对照组单纯行放化疗。其中放疗采用6 MV-X三维适形放疗,2Gy/次,每周5次。总量60~70Gy。化疗皆采用包含铂类的一线化疗方案,并根据患者一般状况及临床实际,选择GP(顺铂+吉西他滨)、PP(顺铂+培美曲赛)、TP(顺铂+紫杉醇类)[3]。严格按照体表面积计算给药剂量,化疗期间常规予以止吐、抑酸、水化等对症处理。治疗过程中评价毒副反应,治疗至后程评价客观疗效。所有患者治疗前及治疗后程检测血浆凝血酶原时间、活化部分凝血酶原时间、D-二聚体、纤维蛋白(Fib)。结果:实验组客观反应率高于对照组(P0.05);对照组治疗前后各项凝血指标水平无统计学差异,实验组治疗后Fib水平低于对照组(P0.05);对照组不良反应、急性放射性损伤发生率均高于实验组。结论:采用回生口服液联合同步放化疗,可提高肿瘤近期疗效、改善患者凝血功能,降低放化疗不良反应发生率,提高患者生活质量,使患者治疗中的顺应性增加,以确保临床治疗计划按时定量完成。
[Abstract]:Objective: Huisheng oral liquid was extracted from a variety of traditional Chinese medicine components. It has many functions and few side effects. It is often used in clinic as an auxiliary treatment method for comprehensive treatment of tumor. The Huisheng oral liquid contains the components of promoting blood circulation and removing blood stasis. It can improve the state of hemagglutination, increase the blood supply of tumor tissue and enhance the curative effect of radiotherapy and chemotherapy. According to other literature, Huisheng oral liquid can also improve the quality of life of patients and alleviate the side effects of radiotherapy and chemotherapy [1-2]. The purpose of this study was to investigate the efficacy of Huisheng oral liquid combined with concurrent radiotherapy and chemotherapy in the treatment of local advanced NSCLC. Methods: 68 patients with locally advanced NSCLC who were treated in our department from December 2014 to October 2016 were selected and treated with fiberoptic bronchoscopy. Cytological examination of exfoliation of lung or pleural effusion, cytological or pathological diagnosis was confirmed for the first time. It was randomly divided into two groups: control group (n = 34), male (n = 20), female (n = 14), adenocarcinoma (n = 13), squamous cell carcinoma (n = 21) and experimental group (n = 34). There were 18 males and 16 females, 15 adenocarcinoma and 19 squamous cell carcinomas. The patients in the experimental group were given concurrent radiotherapy and chemotherapy and Huisheng oral liquid, which was produced by Chengdu Diao Group Tianfu Pharmaceutical Co., Ltd. Hisheng oral liquid was used 10 mL / d from the day of radiotherapy and lasted until the end of radiotherapy. The control group was treated with radiotherapy alone, in which 6 MV-X three-dimensional conformal radiotherapy was used for 2 Gy / time. Five times a week. The total amount of chemotherapy was 60,70Gy.All patients were treated with first-line chemotherapy regimen containing platinum, and according to the patients' general condition and clinical practice, GP( cisplatin gemcitabine) PPp (cisplatin pemetrexide) [3]. The dosage was calculated strictly according to the body surface area. During chemotherapy, the drug was routinely treated with antiemetic, acid suppression, hydration and other symptomatic treatments. The side effects were evaluated during the treatment. Objective curative effect was evaluated after treatment. Plasma prothrombin time and activated partial prothrombin time were measured before and after treatment in all patients. Results: the objective reaction rate in the experimental group was higher than that in the control group (P 0.05), the coagulation index level in the control group was not significantly different before and after treatment, the Fib level in the experimental group was lower than that in the control group after treatment (P 0.05), the adverse reaction in the control group was lower than that in the control group. Conclusion: Huisheng oral liquid combined with concurrent radiotherapy and chemotherapy can improve the short-term curative effect of tumor, improve the coagulation function of patients, reduce the incidence of adverse reactions of radiotherapy and chemotherapy, and improve the quality of life of the patients. Increase patient compliance in treatment to ensure timely and quantitative completion of clinical treatment plans.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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