归脾汤对非小细胞肺癌化疗后骨髓抑制影响的临床观察

发布时间：2018-05-06 15:27

本文选题：非小细胞肺癌 + 化疗后骨髓抑制　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的观察归脾汤对气血亏虚型非小细胞肺癌患者化疗后骨髓抑制的改善情况。从归脾汤临床应用方面研究其对保护骨髓造血功能的应用价值,意在改善患者化疗后骨髓抑制,提高患者生存质量,以使患者顺利完成化疗从而可能一定程度延长生存期。方法临床观察收集的病例资料来自2015年3月至2016年10月在武汉中医医院肿瘤科,因NSCLC拟行第3周期AP方案化疗,且中医辨证为气血亏虚为主证的患者的56例,按就诊号随机分为对照组和治疗组,对照组28例行常规AP方案化疗,治疗组28例在行常规化疗同时,加服归脾汤,日1剂,每日2次,每次200毫升,连用21天。记录两组患者在治疗期间中不同时间血液各组分水平、重组人粒细胞刺激因子使用情况、KPS评分、中医证候积分,同时记录不良反应,并进行安全性评价。本试验数据均采用统计学软件SPSS 19.0软件系统对上述所得数据进行分析,并设定P0.05为具有统计学意义,同时结合临床,得出结论。结果(1)白细胞变化情况:观察期间第7天、第14天、第21天白细胞计数治疗组高于对照组,差异有统计学意义,(P0.05);(2)在补救使用重组人粒细胞刺激因子例数方面,对照组高于治疗组,差异有统计学意义,(P0.05);(3)血小板变化情况:观察期间第7天、第14天、第21天血小板计数治疗组高于对照组,差异有统计学意义,(P0.05);(4)血红蛋白变化情况:对照组与治疗组第21天血红蛋白值均有下降,比较差异无统计学意义,(P0.05);(5)KPS评分变化情况:第21天对照组KPS评分较治疗前比较差异有统计学意义,(P0.05);治疗组较治疗前比较差异无统计学意义,(P0.05);(6)其中头昏眼花、神疲、乏力、懒言、自汗症状等改善方面差异有统计学意义,(P0.05)。结论归脾汤可以一定程度减轻非小细胞肺癌化疗后骨髓抑制的发生,使粒细胞集落刺激因子使用量减少,有效地缓解神疲乏力等症状,从而使肿瘤患者生存质量提高。对于临床上防治恶性肿瘤患者化疗时出现的骨髓抑制,中医证属气血亏虚证者采用归脾汤辅助治疗,患者恢复情况好。
[Abstract]:Objective to observe the improvement of Guipi decoction on bone marrow suppression in patients with non-small cell lung cancer with deficiency of qi and blood after chemotherapy. To study the value of Guipi decoction in protecting the hematopoietic function of bone marrow in order to improve the suppression of bone marrow after chemotherapy and improve the quality of life of patients so as to make the patients finish chemotherapy successfully and prolong the survival time to some extent. Methods the clinical data collected from March 2015 to October 2016 in Department of Oncology, Wuhan traditional Chinese Medicine Hospital, were 56 patients with AP regimen chemotherapy in the third cycle of NSCLC, and the main syndrome was deficiency of qi and blood. The control group (28 cases) received routine AP regimen chemotherapy, and the treatment group (28 cases) received routine chemotherapy plus Guipi decoction once a day, 200 ml per day for 21 days. The levels of blood components, KPS score, TCM syndrome score and adverse reactions were recorded in the two groups at different time during the treatment period, and the safety evaluation was carried out. The data of this experiment were analyzed by SPSS 19.0 software system, and P05 was set as statistical significance. At the same time, combined with clinical data, the conclusion was reached. Results 1) changes of leukocyte: the white blood cell count in the treatment group was higher than that in the control group on the 7th, 14th and 21st day during the observation period, and the difference was statistically significant (P 0.05). The platelet count in the control group was higher than that in the control group on the 7th day, the 14th day and the 21st day, and the platelet count in the treatment group was higher than that in the control group. The change of hemoglobin in control group and treatment group decreased on the 21st day. There was no significant difference between the two groups. There was no significant difference in KPS score between the control group and the control group on the 21st day after treatment. There was no significant difference between the treatment group and the pre-treatment group (P 0.05), and there was no significant difference between the treatment group and the pre-treatment group (P < 0.05), and the scores of dizziness, fatigue, fatigue and laziness were found in the treatment group, and there was no significant difference between the treatment group and the pre-treatment group (P < 0.05). There was significant difference in the improvement of self-sweating symptoms (P 0.05). Conclusion Guipi decoction can alleviate the occurrence of bone marrow suppression after chemotherapy in non-small cell lung cancer, reduce the use of granulocyte colony stimulating factor, relieve fatigue and other symptoms, and improve the quality of life of tumor patients. For the clinical prevention and treatment of malignant tumor patients with bone marrow suppression, TCM syndrome of deficiency of qi and blood use Guipi decoction adjuvant treatment, the patient recovered well.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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