启膈散联合食管支架置入术治疗晚期食管癌并食管狭窄的临床研究

发布时间：2018-07-10 11:36

本文选题：启膈散 + 电子胃镜　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:本研究旨在:运用启膈散联合食管支架置入术治疗晚期食管癌并食管狭窄。通过本临床研究,对该方式治疗食管癌并食管狭窄的临床疗效做出评估,为今后中西医结合治疗食管癌并狭窄的研究提供更多的临床依据。方法:采用随机数字表分组方法,将符合入组标准病例65例分为两组,其中治疗组32例,对照组33例。经统计学检验,两组治疗前在年龄、性别、疾病分期、饮食情况上无统计学差异(P0.05)。两组均在电子胃镜下行食管支架置入术,术后予常规抗感染、抑酸、营养支持等1-3天。其中治疗组在支架置入术后第7天起予口服启膈散,药物组成主要由沙参、丹参、茯苓、砂仁壳等组成;日服2次,每次100ml,30天为1疗程,共6个疗程;对照组予单纯食管支架置入术治疗。疗程结束后,通过分别临床随访观察每位入组患者,对比两种治疗方式下患者在中医证候、生存质量、饮食、体重、并发症的差异,以探讨其改进的方法。结果:通过统计软件分析治疗结果表明:(1)在中医证候疗效方面:治疗组治疗后总有效率为87.09%,对照组为62.5%,经统计学检验后,差异具有统计学意义(P0.05);(2)治疗前后KPS评分的比较:两组治疗前KPS积分,经统计学检验,差异无统计学意义(P0.05),治疗后治疗组KPS积分与对照组相比较,差异有统计学意义(P0.05);(3)治疗组与对照组在饮食变化上的比较,差异具有统计学意义(P0.05);(4)治疗组可增加患者体重,治疗前后有统计学差异(P0.05);(5)并发症方面:两组治疗后在反流性食管炎、再狭窄方面的比较,差异有统计学意义(P0.05);两组在治疗后的并发症:疼痛、移位方面的比较,差异无统计学意义(P0.05)。结论:启膈散加减联合支架置入术治疗食管癌并食管狭窄,近期疗效确切,可改善临床症状,减少术后并发症,改善进食状况,提高生活质量,从而改善预后,发挥了中医药优势,为中西医结合治疗食管癌并食管狭窄提供了一定的依据。
[Abstract]:Objective: to treat advanced esophageal carcinoma with esophageal stricture by Qige Powder combined with esophageal stent implantation. Through this clinical study, to evaluate the clinical effect of the treatment of esophageal cancer with esophageal stenosis, and to provide more clinical basis for the treatment of esophageal cancer with stricture by the combination of traditional Chinese and western medicine. Methods: 65 cases were divided into two groups, 32 cases in the treatment group and 33 cases in the control group. After statistical test, the two groups before treatment in age, sex, disease stages, diet no statistical difference (P0.05). The two groups were treated with esophageal stents under electronic gastroscopy for 1-3 days, including routine anti-infection, acid suppression and nutritional support. In the treatment group, Qigi powder was given orally on the 7th day after stent implantation, and the drug composition was mainly composed of Salvia miltiorrhiza, Salvia miltiorrhiza, Poria cocos, Amomum kernel shell, etc. The control group was treated with simple esophageal stent implantation. After the course of treatment, each patient was followed up and compared the difference of TCM syndrome, quality of life, diet, body weight and complications. Results: the results showed that: (1) the total effective rate after treatment was 87.09 in the treatment group and 62.5 in the control group. The difference was statistically significant (P0.05) before and after treatment. Before and after treatment, there was no significant difference between the two groups before and after treatment (P0.05). After treatment, the KPS score of the treatment group was higher than that of the control group. The difference was statistically significant (P0.05); (3) the difference between the treatment group and the control group in diet changes was statistically significant (P0.05); (4) the treatment group could increase the weight of the patients before and after treatment (P0.05); (5) complications: the two groups after treatment in reflux esophagitis, Restenosis comparison, the difference was statistically significant (P0.05); the two groups in the treatment of complications: pain, displacement comparison, the difference was not statistically significant (P0.05). Conclusion: Qige Powder plus or minus plus stent implantation is effective in the treatment of esophageal carcinoma with esophageal stricture. It can improve clinical symptoms, reduce postoperative complications, improve food intake, improve quality of life, and improve prognosis. The advantages of traditional Chinese medicine are brought into play, which provides a basis for the treatment of esophageal cancer with esophageal stricture by combining traditional Chinese and western medicine.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.1

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