疏肝和胃法联合化疗治疗肝胃不和型晚期胃癌的临床观察

发布时间：2018-06-22 08:15

本文选题：疏肝和胃法 + OLF方案　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:肝胃不和型晚期胃癌患者以“肝气郁结,气逆犯胃,脾气亏虚,淤毒互结”为主要病机特点,本研究旨在观察以“疏肝解郁,理气和胃”为主要功效的疏肝和胃方联合OLF方案化疗治疗肝胃不和型晚期胃癌的疗效。方法:将60例术后复发或不能手术,且中医辩证分型为肝胃不和型的胃癌住院患者,随机分两组,其中治疗组30例,对照组30例,两组均给予OLF方案化疗,治疗组加服疏肝和胃方并随证加减,连续观察2个化疗周期后,比较两组患者治疗前后的肿瘤病灶大小、中医临床症状、KPS评分、体重、血常规、肝肾功能指标、免疫功能指标、肿瘤标志物CEA、CA199等的变化和毒副反应的出现情况。结果:疏肝和胃方联合OLF方案化疗可更好地改善患者的中医临床症状,提高生活质量,稳定或增加体重,提高免疫功能,减轻化疗的消化道反应和周围神经毒性,但在降低肿瘤标志物CEA、CA199,减小或稳定病灶,减轻化疗的骨髓毒性和肝肾毒性方面较单纯化疗组无明显差异。结论:疏肝和胃法联合化疗在肝胃不和型晚期胃癌的临床治疗中,可明显改善患者中医症状,提高患者生活质量和免疫功能,增加体重,减轻化疗引发的消化道和周围神经毒副反应。是中西医结合治疗晚期肝胃不和型晚期胃癌的有效方法之一。
[Abstract]:Objective: the main pathogenesis of advanced gastric cancer with disharmony between liver and stomach was "stagnation of liver-qi, invasion of stomach by inverses of qi, deficiency of temper and deficiency of qi, mutual formation of toxin and stasis". The purpose of this study was to observe "soothing the liver and relieving depression". The effect of Shugan Hewei recipe combined with OLF regimen on advanced gastric cancer with disharmony of liver and stomach. Methods: sixty patients with recurrent or inoperable gastric cancer were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). After two consecutive cycles of chemotherapy, the size of tumor focus, KPS score, body weight, blood routine, liver and kidney function, immune function were compared between the two groups before and after treatment. The changes of tumor marker CEA CA199 and the occurrence of side effects. Results: the combination of Shugan and Wei Fang and OLF regimen could improve the clinical symptoms of TCM, improve the quality of life, stabilize or increase body weight, improve immune function, reduce the digestive tract reaction and peripheral neurotoxicity of chemotherapy. But there was no significant difference in reducing tumor marker CEA CA199, decreasing or stabilizing the focus, alleviating the toxicity of bone marrow and liver and kidney in chemotherapy group. Conclusion: the combination of soothing liver and stomach therapy in the clinical treatment of advanced gastric cancer with hepatogastric disharmony can obviously improve the symptoms of TCM, improve the quality of life and immune function of the patients, and increase the weight of the patients. The toxicity of digestive tract and peripheral nerve induced by chemotherapy was alleviated. It is one of the effective methods for the treatment of advanced gastric cancer with advanced hepatogastric disharmony.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.2

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