扶正逐水汤联合胸腔灌注治疗肺脾气虚型肺癌胸水的临床观察

发布时间：2017-12-26 22:25

本文关键词：扶正逐水汤联合胸腔灌注治疗肺脾气虚型肺癌胸水的临床观察　出处：《成都中医药大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：通过临床应用,观察扶正逐水汤联合胸腔灌注治疗肺脾气虚型肺癌胸水的疗效及安全性。方法：收集2012年10月—2013年12月成都中医药大学附属医院肿瘤科住院的符合纳入标准的65例患者,将其随机平分为治疗组33例和对照组32例。对照组给予单纯胸腔灌注(顺铂注射液60mg/m2+0.9%氯化钠注射液20ml)治疗,一周一次,根据情况可于7天后重复,最多使用4次,末次化疗后5周评价疗效。治疗组在此基础上服用扶正逐水汤免煎中药,每次一格,一天三次,开水冲服,一日一剂,直到末次化疗结束后5周。观察记录两组病例化疗前后的胸水变化、KPS评分、中医症候疗效、胃肠道反应、血象变化等。结果：(1)经统计学分析后,两组患者在性别、年龄、胸水量、胸腔积液位置、肿瘤病理类型和治疗前KPS评分上无统计学差异(P0.05),具有可比性；(2)两组病例治疗后胸水变化比较,治疗组的总有效率高于对照组(P0.05)；(3)两组病例治疗后KPS评分比较,临床获益率治疗组优于对照组(P0.05)； (4)两组病例中医证候疗效比较,两组患者症状均有改善,但治疗组优于对照组(P0.05)；(5)两组病例化疗后胃肠道反应和骨髓抑制比较,治疗组较对照组少,具有统计学意义(P0.05),而肝(ALT/AST)肾(尿素氮和肌酐)功方面无明显差异(P0.05)。结论：扶正逐水汤联合胸腔灌注化疗能有效治疗肺癌胸腔积液。提高患者生存质量,改善患者临床症状,减轻胃肠道反应以及骨髓抑制,但不增加副作用。临床运用安全有效。因此可将其作为临床上治疗肺癌胸腔积液的手段之一,为以后进一步研究积累经验,为增加中医治疗肺癌胸腔积液开辟新的思路。
[Abstract]:Objective: To observe the efficacy and safety of Fuzheng Zhu Shui decoction combined with pleural perfusion in the treatment of lung and spleen qi deficiency lung cancer by clinical application. Methods: a total of 65 patients who met the inclusion criteria in the oncology department of Chengdu University of Traditional Chinese Medicine Affiliated Hospital from October 2012 to December 2013 were randomly divided into treatment group (33 cases) and control group (32 cases). The control group received simple thoracic perfusion (Cisplatin Injection 60mg/m2+0.9% Sodium Chloride Injection 20ml), once a week, according to the situation, can be repeated after 7 days, the most used 4 times, 5 weeks after the last chemotherapy, to evaluate the curative effect. The treatment group based on the use of water decoction of traditional Chinese medicine decoction of Fuzheng one by one, each style, three times a day, boiling water, one dose daily, 5 weeks after the last chemotherapy until the end. The changes of hydrothorax, KPS, TCM syndrome, gastrointestinal reaction and Hemogram were observed before and after chemotherapy in the two groups. Results: (1) after the statistical analysis, no significant difference between the two groups in gender, age, chest water, pleural effusion, pathological type and tumor location before treatment KPS score (P0.05), comparable; (2) the two groups were compared after the treatment of water change, the total efficiency of the treatment group higher than that of the control group (P0.05); (3) the two groups were compared after treatment KPS score, clinical benefit rate of the treatment group than the control group (P0.05); (4) the two groups were compared the efficacy of TCM syndrome, two patients symptoms were improved, but the treatment group than the control group (P0.05); (5) comparison inhibition of gastrointestinal reaction and bone marrow of two groups of patients after chemotherapy, the treatment group than in the control group, with statistical significance (P0.05), (ALT/AST) and liver kidney (urea and creatinine) no significant difference function (P0.05). Conclusion: Fuzheng Zhu Shui decoction combined with pleural perfusion chemotherapy can effectively treat the pleural effusion of lung cancer. Improve the patient's quality of life, improve the patient's clinical symptoms, reduce the gastrointestinal reaction and bone marrow suppression, but do not increase side effects. The clinical application is safe and effective. Therefore, it can be used as a way to treat pleural effusion of lung cancer in clinical practice. It will accumulate experience for further research and open up a new train of thought for increasing TCM treatment of lung cancer pleural effusion.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R734.2

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