加味六味地黄汤治疗肿瘤化疗所致的血小板减少症的临床疗效观察

发布时间：2018-03-01 09:34

本文关键词： 加味六味地黄汤恶性肿瘤化疗血小板减少症临床疗效　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的：临床中肿瘤化疗所致的血小板减少症(CIT)是癌症患者常见的问题。目前尚未有相关的指南指导这部分患者的治疗。血小板减少除了出血风险,也会限制肿瘤患者治疗的化疗剂量和化疗频率。故本研究在导师李世杰教授治疗CIT的临床经验基础上,以肿瘤化疗后血小板计数100x 109／L为研究对象,观察“加味六味地黄汤”治疗CIT的临床疗效及安全性,为临床应用提供一定的依据。研究方法：将来源于成都中医药大学附属医院肿瘤科住院的90例符合本试验纳入标准的患者,按就诊先后顺序,随机分入治疗组和对照组,每组各45例,两组基线无显著差异,具有可比性。治疗组采用加味六味地黄汤免煎颗粒,对照组采用利可君片,疗程均为21天,观察患者用药后第4天、第7天、第10天、第14天、第21天的血小板计数变化,对比两组患者治疗前后KPS评分、中医证候积分改变情况,评估治疗后心、肝、肾功能和不良反应,以评价“加味六味地黄汤”的疗效及安全性。研究结果：(1)治疗后在提高血小板计数水平、缩短血小板减少的持续时间、加快血小板的恢复、预防CIT的复发、减少血小板的输注、增加KPS评分和改善中医证候等方面治疗组均优于对照组,差别具有统计学意义(P均0.05)。(2)治疗组出现6例不良反应,均为Ⅰ级,可自行缓解,对试验结果无直接影响；两组患者均未见明显心、肝、肾功能方面的毒副作用。研究结论：加味六味地黄汤可提高CIT患者的血小板计数水平,缩短血小板减少的持续时间、加快血小板的恢复,减少出血及出血风险、预防CIT的复发。同时可改善患者的中医证候和增加KPS评分,以减轻患者的痛苦,提高患者的生活质量。且价格适宜,能减少化疗患者的经济负担,具有安全性,可广泛应用于临床。但本研究观察时间较短,需延长观察时间和排除干扰因素,以期对加味六味地黄汤的远期疗效及安全性做出更精准的评价。
[Abstract]:Objective: To study the clinical chemotherapy induced thrombocytopenia (CIT) is a common problem in cancer patients. There have been no guidelines to guide the treatment of these patients. In addition to thrombocytopenia and bleeding risk, will also limit the treatment of patients with cancer chemotherapy and chemotherapy dose frequency. So this study the clinic experience of Professor Li Shijie the treatment of CIT, the platelet count after chemotherapy 100x 109 / L as the research object, observe the clinical effect and safety of modified six Dihuang Decoction "in the treatment of CIT, and provide a basis for clinical application. Methods: the future research in oncology Affiliated Hospital of Chengdu University of Traditional Chinese Medicine hospital 90 patients met the inclusion criteria of this patients, according to the visiting sequence, were randomly divided into treatment group and control group, 45 cases in each group, there was no significant difference between the two groups at baseline and comparable treatment group with modified. Six Ingredient Rehmannia Decoction granules, the control group using Leucogen Tablets, lasted for 21 days, fourth days, observe patients after seventh days, tenth days, fourteenth days, twenty-first days, the changes of the platelet count, KPS score before and after treatment were compared between two groups, TCM syndrome score changes after treatment, assessment of heart, liver the renal function, and adverse reactions, to evaluate the efficacy and safety of modified Rehmanniae Decoction of six ingredients ". Results: (1) after treatment in improving the level of platelet count, shorten the duration of thrombocytopenia, accelerate the platelet recovery, prevent the recurrence of CIT, reduce platelet transfusion, increase KPS score and improve TCM syndrome and other aspects of the treatment group were better than the control group, the difference was statistically significant (P < 0.05). (2) 6 cases had adverse reactions in treatment group, were grade I, relieve itself, has no direct impact on the test results; two groups of patients were no obvious heart, liver, kidney The function of the side effects. Conclusion: modified Rehmanniae Decoction of six ingredients can improve the level of platelet count in patients with CIT, reduce the duration of thrombocytopenia, accelerate platelet recovery, reduce bleeding and bleeding risk, prevention of recurrence of CIT. At the same time can improve the TCM syndrome and the KPS score increased, in order to reduce patient the pain, improve the quality of life of patients. And the price is appropriate, can reduce the economic burden of the patients with chemotherapy, safety, can be widely used in clinic. But the shorter observation time, longer observation time and eliminate interference factors, make the evaluation more accurate long-term efficacy and safety of modified Rehmanniae Decoction of six ingredients in order.

【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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