加味八珍汤对化疗后骨髓抑制影响的临床研究

发布时间：2018-05-24 18:58

本文选题：加味八珍汤 + 化疗　；参考：《安徽中医药大学》2016年硕士论文

【摘要】：1研究目的以加味八珍汤防治化疗所引起的骨髓抑制为切入点,为传统中医学在防治化疗后骨髓抑制方面提供临床研究数据,为中医防治骨髓抑制提供切实可靠的方法和思路。从减轻化疗后骨髓抑制的角度,为中医药减轻化疗所致毒副反应提供新的内涵。2研究方法将60例恶性肿瘤患者随机分为两组,治疗组和对照组各30例。对照组:常规一线化疗同时加服地榆升白片,治疗组:在化疗基础上加用加味八珍汤颗粒。通过观察记录外周血细胞变化及骨髓抑制情况,以及化疗后中医临床症候改善情况,生活质量变化、体重变化,免疫状态变化及其毒副反应,来研究加味八珍汤在防治化疗后骨髓抑制的临床疗效。3研究结果血象变化分析:(1)治疗前后外周血象变化情况分析比较:经化疗后第7天的血常规观察,对照组、治疗组WBC、NE、HGB、PLT均较治疗前明显下降(P0.05),下降幅度治疗组明显低于对照组(P0.05);经第14天观察WBC、NE、HGB呈上升趋势,治疗组优于对照组(P0.05),而PLT计数水平下降到最低谷;经第21天观察WBC、NE、HGB、PLT,对照组较治疗前明显下降(P0.05),治疗组较治疗前无明显差异(P0.05),但治疗组较对照组有明显差异(P0.05)。(2)治疗后骨髓抑制发生率比较:对化疗后1周患者血象观察,化疗后对于WBC、NE、HGB骨髓抑制发生率治疗组明显低于对照组(P0.05),且骨髓抑制程度治疗组明显轻于对照组(P0.05),对于PLT骨髓抑制率及骨髓抑制程度,对照组与治疗组无明显差异(P0.05)。(3)治疗后升高WBC疗效比较:经观察化疗后2周血象,对照组有效率53.3%,治疗组有效率83.3%,治疗组明显优于对照组(P0.05)。中医症候改善方面:经治疗后治疗组能明显改善中医临床症候,其优于对照组(P0.05)。生活质量改善方面:化疗后治疗组的KPS评分改善情况及体重稳定情况均明显优于对照组(P0.05)。免疫功能改善方面:两组患者化疗前后CD3+、CD4+、CD4+/CD8+、NK细胞水平比较,均较前有明显升高(P0.05),而CD8+较前明显下降(P0.05);两组患者化疗后比较,治疗组明显优于对照组(P0.05)。安全性比较分析:治疗组消化道反应明显小于对照组(P0.05);两组肝肾功损害对比无明显性差异(P0.05)。4研究结论加味八珍汤能有效防治肿瘤患者化疗后骨髓抑制,改善患者骨髓抑制后中医临床症状,提高患者生活质量,增强患者免疫力,且安全可靠,无明显毒副作用。
[Abstract]:Objective to provide clinical data for the prevention and treatment of bone marrow suppression caused by chemotherapy in traditional Chinese medicine, and to provide practical and reliable methods and ideas for the prevention and treatment of bone marrow suppression in traditional Chinese medicine. From the perspective of alleviating bone marrow suppression after chemotherapy, 60 patients with malignant tumor were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Control group: routine first-line chemotherapy plus Diyu Shengbai tablet, treatment group: on the basis of chemotherapy plus Jiawei Bazhen decoction granule. The changes of peripheral blood cells and bone marrow suppression, the improvement of TCM clinical symptoms, the changes of quality of life, weight, immune state and side effects after chemotherapy were observed and recorded. To study the clinical efficacy of Jiawei Bazhen decoction in the prevention and treatment of bone marrow suppression after chemotherapy .Results Hematological changes Analysis of Peripheral Blood before and after treatment: blood routine observation on the 7th day after chemotherapy, control group, In the treatment group, the levels of PLT in the treatment group were significantly lower than those in the control group (P 0.05), and on the 14th day, the PLT count in the treatment group was higher than that in the control group (P 0.05), but the PLT count level had decreased to the lowest point. On the 21st day, the incidence of bone marrow suppression in the control group was significantly lower than that before treatment, but there was no significant difference between the treatment group and the control group, but the incidence of bone marrow suppression in the treatment group was significantly higher than that in the control group. After chemotherapy, the incidence of bone marrow suppression in the treatment group was significantly lower than that in the control group (P 0.05), and the degree of bone marrow suppression in the treatment group was significantly lower than that in the control group (P 0.05). The rate of bone marrow suppression and the degree of bone marrow suppression in the treatment group were significantly lower than those in the control group. There was no significant difference between the control group and the treatment group (P0.05U. 3) after the treatment, the effect of WBC was increased: after 2 weeks of chemotherapy, the effective rate of the control group was 53.3%, and the effective rate of the treatment group was 83.3%. The treatment group was obviously superior to the control group (P0.05). The improvement of TCM symptoms: the treatment group can obviously improve the clinical symptoms of TCM after treatment, which is superior to the control group (P 0.05). The improvement of quality of life in the treatment group was better than that in the control group (P 0.05). The improvement of immune function: before and after chemotherapy, the level of CD4 / CD8 / CD8 NK cell of CD3 was significantly higher in both groups than that of the former, while the level of CD8 was significantly lower than that of the former, and the treatment group was significantly better than the control group after chemotherapy. Safety comparison analysis: the digestive tract reaction in the treatment group was significantly lower than that in the control group (P 0.05), and there was no significant difference between the two groups in liver and kidney function damage. Conclusion Jiawei Bazhen decoction can effectively prevent and treat the bone marrow depression of tumor patients after chemotherapy. Improve the clinical symptoms of TCM after bone marrow suppression, improve the quality of life of patients, enhance the immunity of patients, and safe and reliable, no obvious side effects.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R730.5

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