中药退热贴治疗肝癌发热（阴虚内热型）的临床研究

发布时间：2018-08-03 11:40

【摘要】：目的:本课题系统观察退热贴治疗肝癌发热的有效性和安全性,并通过与柴胡口服液做对比,观察退热贴治疗肝癌发热的临床疗效,对其安全性作出客观的评价。为退热贴在治疗肝癌发热中的推广作初步的临床研究,为中医药在肝癌发热治疗中的运用提供一种安全有效的方法。方法:所有资料均来自河南中医药大学附属开封市中医院(肝胆脾胃科、肿瘤科)、开封市第二中医院(肝病科)及开封市传染病医院(肝病科)2014年2月—2016年2月住院病人。将84例符合纳入标准的肝癌发热患者,随机分为两组,治疗组、对照组各42例。在常规治疗(两组病人均给予肝癌基础知识宣教,制定合理的饮食及药物治疗处方)基础上,治疗组:予退热贴贴于神阙穴,每日1次,一次4小时(中药退热贴开封市中医院制剂室提供,药物组成:地黄、丹皮、水牛角、冰片等药物。)对照组:予柴胡口服液,一日3次,一次10ml((国药准字Z41021539),河南省百泉制药有限公司。);观察退热贴对肝癌发热患者的退热疗效、中医证候积分、卡氏评分、不良反应等相关指标等的影响。结果:(1)一般情况比较:两组患者在年龄、性别、治疗前一天发热程度、中医证候积分、KPS评分等方面,经统计学分析,差异无统计学意义(P0.05),两者具有均衡可比性;(2)退热疗效比较:经秩和检验,治疗组总有效率为92.86%;对照组总有效率为71.43%(P0.05),差异有统计学意义,提示这两种方法都能降低体温,但治疗组效果优于对照组。(3)中医症状积分比较:组内比较,两组治疗后较治疗前中医症状积分均下降,差异均有统计学意义(P0.05);组间比较,治疗组较对照组下降更明显,差异有统计学意义(P0.05)。(4)KPS比较:经秩和检验,治疗组治疗后评分水平较治疗前改善,差异有统计学意义(P0.05),对照组治疗后与治疗前评分水平比较,差异无统计学意义(P0.05);KPS积分差,经秩和检验,治疗组治疗后积分差改善程度较对照组更明显(P0.05),差异有统计学意义。(5)安全性分析:治疗组与对照组在治疗前后均未出不良反应及毒副作用,其临床实验室检查等未见与药物治疗相关的变化。结论:1.退热贴可降低肝癌发热患者的体温,退热疗效显著。2.退热贴可缓解肝癌发热患者的中医症状及降低中医证候积分。3.退热贴可改善肝癌发热患者KPS评分,提高患者生活质量。
[Abstract]:Objective: to observe the efficacy and safety of antipyretic plaster in the treatment of liver cancer fever, and to evaluate its safety objectively by comparing it with Chaihu oral liquid in the treatment of liver cancer fever. To make a preliminary clinical study on the application of antipyretic paste in the treatment of liver cancer fever, and to provide a safe and effective method for the application of traditional Chinese medicine in the treatment of liver cancer fever. Methods: all the data were collected from Kaifeng Hospital of traditional Chinese Medicine (Department of liver, gallbladder, spleen and stomach, Department of Oncology), Kaifeng second Hospital of traditional Chinese Medicine (Department of liver Diseases) and Kaifeng City Hospital of Infectious Diseases (Department of liver Diseases) from February 2014 to February 2016. 84 patients with liver cancer fever were randomly divided into two groups: treatment group (n = 42) and control group (n = 42). On the basis of routine treatment (two groups of patients were given basic knowledge of liver cancer education, formulation of reasonable diet and drug treatment prescriptions), the treatment group: antipyretic sticking to Shenque point, once a day, 4 hours a time (traditional Chinese medicine antipyretic paste Kaifeng City traditional Chinese Medicine Hospital preparation room, drug composition: Rehmannia, pastry, buffalo horn, borneol and other drugs.) Control group: Chaihu oral liquid, 3 times a day, once 10ml (Z41021539), Henan Baiquan Pharmaceutical Co., Ltd.); to observe the antipyretic effect on patients with liver cancer fever, TCM syndrome score, card score, Effects of adverse reactions and other related indicators. Results: (1) comparison of general conditions: two groups of patients in age, sex, fever before treatment, TCM syndrome score and KPS score were statistically analyzed. The difference was not statistically significant (P0.05), the two were balanced and comparable; (2) comparison of antipyretic efficacy: the total effective rate of the treatment group was 92.86 by rank sum test, the total effective rate of the control group was 71.43% (P0.05), the difference was statistically significant, indicating that both methods can reduce body temperature. But the effect of the treatment group was better than that of the control group. (3) the scores of TCM symptoms in the treatment group were significantly lower than those before the treatment (P0.05), and the scores in the treatment group were significantly lower than those in the control group (P0.05). The difference was statistically significant (P0.05). (4) KPS comparison: by rank sum test, the score level of treatment group was improved compared with that before treatment, the difference was statistically significant (P0.05), the difference between control group and pre-treatment score level was not statistically significant (P0.05). By rank sum test, the improvement of integral difference after treatment in the treatment group was more obvious than that in the control group (P0.05), the difference was statistically significant. (5) Safety analysis: there were no adverse reactions and side effects before and after treatment in the treatment group and the control group. No changes related to drug therapy were found in clinical laboratory examination. Conclusion 1. Antipyretic plaster can reduce the temperature of patients with liver cancer fever, the antipyretic effect is significant. 2. Antipyretic plaster can alleviate the TCM symptoms of patients with liver cancer fever and reduce TCM syndrome integral. 3. Antipyretic plaster can improve KPS score and quality of life of patients with liver cancer fever.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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