益气化瘀解毒法联合化疗治疗晚期胃癌的临床疗效观察

发布时间：2018-06-11 23:09

本文选题：益气化瘀解毒方 + 晚期胃癌　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:本研究旨在探讨益气化瘀解毒方联合TS方案化疗治疗晚期胃癌,以期体现其在肿瘤客观疗效、症状改善及安全性等方面的作用,为晚期胃癌的进一步规范化治疗及深入研究提供依据。方法:将60例晚期胃癌患者,用随机数字表法分成2组,每组各30例。治疗组采用益气化瘀解毒方联合TS(紫杉醇脂质体+替吉奥)化疗方案;对照组仅采用TS方案化疗。分别记录两组治疗前后的中医证候、实体瘤大小、肿瘤标志物(CEA、CA125、CA199)值、凝血功能(D-二聚体、FDP)、KPS评分、生活质量量表评分及化疗毒副反应的情况,换算成积分,整理信息录入数据库,并运用SPSS20.0、EXCEL 2007等软件,将益气化瘀解毒方联合TS方案治疗前后的数据分析结果分析对比,同时与单纯TS方案进行疗效对比。结果:在中医证候的方面,治疗组显效+有效率为66%,与对照组相比(P0.01),提示治疗组能有效改善患者的不适症状;在凝血功能方面,治疗组治疗后的D-二聚体和FDP值均较前明显下降(P0.05),且在D-二聚体下降方面治疗组优于对照组(P0.05);在KPS评分方面,治疗组治疗后KPS评分较显著升高(P0.01),对照组治疗后KPS评分较前有所下降,提示治疗组在改善体力状况方面的疗效明显高于对照组;在生活质量方面,治疗组治疗后生活质量较前有明显改善(P0.05),而对照组的在这方面的改善不够突出;在安全性方面,两组均未出现恶性不良事件,主要毒副作用为白细胞减少和腹泻,且治疗组能有效减少白细胞减少和腹泻方面的发生,差异有统计学意义(P0.05);两组患者治疗后肿瘤指标均较前降低,但在实体瘤疗效、肿瘤标志物(CEA、CA199、CA125)值变化方面,两组未显示出明显差异。结论:晚期胃癌患者临床不适症状较多,体力状况和生活质量均不高,而益气化瘀解毒方联合TS化疗方案,在保证临床疗效的同时能够明显减轻患者的不适症状、提高体力状况、改善生活质量,同时能够缓解肿瘤患者普遍出现的血液高凝状态,并减轻化疗出现的毒副反应。
[Abstract]:Objective: to explore the effect of Yiqi Huayu jiedu recipe combined with TS regimen in the treatment of advanced gastric cancer in order to reflect its effect on the objective curative effect, symptom improvement and safety of cancer. To provide the basis for further standardized treatment and further study of advanced gastric cancer. Methods: 60 patients with advanced gastric cancer were randomly divided into two groups, 30 cases in each group. The treatment group was treated with Yiqi Huayu jiedu recipe combined with TS1 (paclitaxel liposome tiguor), while the control group was treated with TS regimen only. Before and after treatment, the TCM syndromes, solid tumor size, tumor marker CEA CA125 / CA199, coagulation function D- D- dimer KPS score, quality of life scale and chemotherapy toxicity were recorded before and after treatment. The results of data analysis before and after treatment of Yiqi Huayu jiedu prescription combined with TS regimen were analyzed and compared with those of simple TS regimen by using SPSS 20.0 + excel 2007 and other softwares. Results: in the aspect of TCM syndrome, the effective rate of the treatment group was 66g. Compared with the control group, the treatment group could effectively improve the uncomfortable symptoms of the patients and the coagulation function. After treatment, the values of D- dimer and FDP in the treatment group were significantly lower than those in the previous treatment group (P 0.05), and the treatment group was superior to the control group in terms of D- dimer decline (P 0.05), and the KPS score was higher in the treatment group than in the control group. The KPS score of the treatment group was significantly higher than that of the control group, and the KPS score of the control group was lower than that of the control group, indicating that the therapeutic effect of the treatment group on improving physical condition was significantly higher than that of the control group, and the quality of life in the treatment group was significantly higher than that in the control group. The quality of life in the treatment group was significantly improved than that in the previous treatment group, but the improvement in the control group was not obvious. In terms of safety, there were no malignant adverse events in both groups, and the main side effects were leukopenia and diarrhea. The treatment group could effectively reduce leukopenia and diarrhea, the difference was statistically significant (P 0.05), the tumor indexes of the two groups were lower than those before treatment, but in the effect of solid tumor, the tumor marker CEA CA199CA125 was changed. There was no significant difference between the two groups. Conclusion: the patients with advanced gastric cancer have more clinical symptoms, lower physical condition and lower quality of life. The combination of Yiqi Huayu jiedu recipe and TS chemotherapy regimen can significantly reduce the discomfort symptoms of patients with advanced gastric cancer while ensuring the clinical efficacy. Improve physical condition, improve quality of life, at the same time can alleviate the hypercoagulability of patients with cancer, and reduce the toxic side effects of chemotherapy.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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