中西医结合扶正抑瘤法治疗前列腺癌142例临床观察

发布时间：2018-10-19 12:13

【摘要】：目的:观察中西医结合扶正抑瘤治疗前列腺癌的临床疗效,探讨该法治疗前列腺癌的可能机理。方法:对142例患者在西医治疗的基础上加用中药(基本方:生黄芪、西洋参、龟板、全蝎、白花蛇舌草、王不留行、白术、茯苓、甘草)治疗,统计分析总生存率、总体中位生存期、总体无进展生存期、骨转移灶数目、前列腺特异性抗原(PSA)、血细胞分析、QLQ-C30量表、并发症发生率等,观察扶正抑瘤法对前列腺癌的实际临床疗效。结果:142例患者随访时间1～50月,观察期间死亡16例,总生存率88.73%;总体中位生存期27.7月;总体无进展中位时间25.2月。其中T3～4NxM1c期患者21例总体无进展生存期24.3月;去势后PSA最低值0,PSA复发时间(23.9±19.2)月,PSA倍增时间(24.1±20.4)月。T3～4NxM1b期110例患者总体无进展生存期24.3月;去势后PSA最低值0,PSA复发时间(20.1±15.2)月,PSA倍增时间(22.3±17.4)月。142例患者ECT转移灶数目治疗前为(7.6±4.7)个,治疗12月后为(3.4±1.7)个,24月后为(2.6±1.4)个,36月后为(4.8±2.1)个。其中T3～4NxM1b期110例,骨转移灶消失4例,缩小、变淡79例,无扩散、无增多18例,出现新的转移灶9例。治疗第24、36月,白细胞(WBC)明显升高,与治疗前比较,差异有非常显著性意义(P0.01);治疗后第12、24、36月血红蛋白(Hb)、血小板(BPC)均明显升高,与治疗前比较,差异有非常显著性意义(P0.01)。按QLQ-C30量表标准分统计,治疗12月,症状改善有效率81.0%,潮热症状发生率22.4%,骨质疏松发生率13.8%,乳房肿痛发生率11.7%。结论:扶正抑瘤法能延缓前列腺癌的进展,减少骨转移灶数目,提高患者生存质量。
[Abstract]:Objective: to observe the clinical effect of traditional Chinese and western medicine (TCM) combined with western medicine (WM) in the treatment of prostate cancer and to explore the possible mechanism of this method. Methods: 142 patients were treated with traditional Chinese medicine (basic prescription: Astragalus membranaceus, Panax quinquefolium, tortoise plate, scorpion, Atractylodes macrocephala, Poria cocos, Glycyrrhiza uralensis) on the basis of western medicine, and the overall survival rate was analyzed statistically. The median survival time, total progressive survival period, bone metastasis, (PSA), hematocyte analysis, QLQ-C30 scale, complication rate and so on were observed. Results: 142 patients were followed up for 1 ~ 50 months, 16 patients died during the observation period, the overall survival rate was 88.73, the overall median survival time was 27.7 months, and the overall median time of no progress was 25.2 months. The overall progression-free survival time was 24.3 months in 21 patients with T3~4NxM1c, 23.9 卤19.2 months after castration, 24.1 卤20.4 months in PSA doubling time, 24.3 months in T3~4NxM1b patients, 23.9 卤19.2 months after castration, 24.1 卤20.4 months after castration, and 24.1 卤20.4 months after castration. The recurrence time of PSA was (20.1 卤15.2) months, the doubling time of PSA was (22.3 卤17.4) months. The number of ECT metastasis was (7.6 卤4.7) before treatment, (3.4 卤1.7) after 12 months, (2.6 卤1.4) after 24 months, and (4.8 卤2.1) after 36 months. There were 110 cases of T3~4NxM1b, 4 cases of bone metastasis disappeared, 79 cases of shrinking, 79 cases of light, 18 cases of no diffusion, no increase, 9 cases of new metastasis. WBC (WBC) increased significantly at 24,36 months after treatment (P0.01), and hemoglobin (Hb), platelet (BPC) increased significantly at 1224 and 36 months after treatment (P0.01). According to the standard score of QLQ-C30 scale, the effective rate of symptom improvement was 81.0%, the incidence of hot flashes was 22.4%, the incidence of osteoporosis was 13.8%, and the incidence of breast swelling and pain was 11.7%. Conclusion: Fuzheng Anti-tumor method can delay the progression of prostate cancer, reduce the number of bone metastases and improve the quality of life of the patients.
【作者单位】：广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科广东省中医院泌尿外科
【分类号】：R737.25

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