芪蓝胶囊对去势后气虚血瘀型前列腺癌患者临床增效作用研究

发布时间：2018-06-04 08:04

本文选题：芪蓝胶囊 + 气虚血瘀　；参考：《中华男科学杂志》2017年07期

【摘要】：目的:观察中药芪蓝胶囊对去势后行内分泌治疗的前列腺癌患者(气虚血瘀型)的临床增效作用。方法:采用随机、对照、双盲的方法,分别从成都中医药大学附属医院、四川大学华西医院和四川省人民医院3家医疗中心各取82例去势后前列腺癌患者(气虚血瘀型),共246例。随机分为试验组(芪蓝胶囊联合去势及雄激素拮抗剂)和对照组(安慰剂联合去势及雄激素拮抗剂)各123例。芪蓝胶囊每日3次,每次4粒,去势治疗为手术去势或戈舍瑞林3.6 mg,每4周1次,皮下注射,雄激素拮抗剂比卡鲁胺50 mg,每日1次,口服。安慰剂为外观和芪蓝胶囊一致的淀粉制剂。观察比较两组患者治疗前以及治疗6个月后国际前列腺症状评分(IPSS)、中医症侯评分、最大尿流率(Qmax)及血清PSA水平。结果:试验组和对照组治疗后在分级证候疗效(87.7%vs 67.9%,P0.05)、总有效率上(86.0%vs 71.6%,P0.05)比较,两组间差异有统计学意义。试验组在中医症侯评分[治疗前(17.1±5.1)分,治疗后(8.3±4.0)分]、IPSS[(治疗前(17.7±7.5)分,治疗后(11.4±4.6)分]及Qmax[治疗前(10.9±4.3)ml/s,治疗后(14.7±3.7)ml/s]等方面疗效优于对照组[治疗前(16.8±5.2)分,治疗后(11.5±5.2)分;治疗前(17.8±6.7)分,治疗后(14.6±5.8)分;治疗前(11.0±4.3)ml/s,治疗后(12.0±4.1)ml/s],差异有统计学意义(P0.05);试验组在PSA改善例数上与对照组相比不具有统计学意义(P0.05)。结论:芪蓝胶囊对去势术后气虚血瘀型前列腺癌患者治疗安全有效,对去势后抗雄激素治疗有增效作用,但对血清PSA值的干预作用不明显。
[Abstract]:Aim: to observe the clinical synergistic effect of Qilan capsule on prostate cancer (qi deficiency and blood stasis type) treated by endocrine therapy after castration. Methods: a randomized, controlled and double-blind method was used from the affiliated Hospital of Chengdu University of traditional Chinese Medicine. 82 patients with prostate cancer (Qi deficiency and blood stasis type) were collected from 3 medical centers of Sichuan University Huaxi Hospital and Sichuan Provincial people's Hospital respectively. They were randomly divided into experimental group (Qilan capsule combined castration and androgen antagonist) and control group (placebo combined castration and androgen antagonist). Qilan capsule was treated with ovariectomized or goserelin 3.6 mg every 4 weeks, subcutaneously injected androgen antagonist than Carous 50 mg, once a day, oral. The placebo is a starch preparation that looks the same as the Qilan capsule. To observe and compare the international prostatic symptom score (IPSS), TCM symptom score, maximum urinary flow rate (Qmax) and serum PSA level before treatment and 6 months after treatment between the two groups. Results: after treatment, the curative effect of the treatment group and the control group was 87.7 vs 67.9%, and the total effective rate was 86.0 vs 71.6% P0.05. The difference between the two groups was statistically significant. The scores of TCM symptom score [17.1 卤5.1 before treatment, 8.3 卤4.0 after treatment] IPSS [(17.7 卤7.5 before treatment, 11.4 卤4.6) after treatment] and Qmax [10.9 卤4.3 ml / s before treatment, 14.7 卤3.7)ml/s after treatment] were better than those in control group [16.8 卤5.2 before treatment, 11.5 卤5.2 after treatment, 17.8 卤6.7 before treatment]. After treatment, the scores were 14.6 卤5.8, 11.0 卤4.3 ml / s and 12.0 卤4.1)ml/s, respectively. The difference was statistically significant (P 0.05). There was no significant difference in the improvement of PSA between the experimental group and the control group (P 0.05). Conclusion: Qilan capsule is safe and effective in treating patients with prostate cancer of qi deficiency and blood stasis type after castration, and has synergistic effect on anti androgen treatment after castration, but the intervention effect on serum PSA value is not obvious.
【作者单位】：成都中医药大学;四川大学华西医院泌尿外科;四川省人民医院泌尿外科;成都中医药大学附属医院男科;
【基金】：四川省中医药管理局重大疑难疾病防治研究项目(2012-A-095) 四川省教育厅重大培育项目(14CZ0010)~~
【分类号】：R273

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