摘要
目的观察自拟生血方治疗脾肾两虚型晚期胃癌行奥沙利铂联合替吉奥方案化学治疗致骨髓抑制的疗效和安全性。方法将60例中医辨证为脾肾两虚型晚期胃癌患者随机分成对照组和观察组,每组30例。对照组予以奥沙利铂联合替吉奥方案化学治疗,观察组在对照组基础上加用自拟生血方汤剂口服及粉剂加工后外敷穴位联合治疗。观察两组患者首次骨髓抑制发生时间、骨髓抑制持续时间、0~3周骨髓抑制等级变化,采用卡氏功能状态量表(Karnofsky's performance scale,KPS)、中医证候积分评价患者生活质量,观察两组患者的无进展生存期(progression-free survival,PFS)。结果与对照组比较,观察组患者首次出现白细胞、血红蛋白、血小板下降的时间明显延长(P<0.05),白细胞、血红蛋白、血小板抑制持续时间明显缩短(P<0.05)。两组患者不同时点白细胞、血红蛋白、血小板抑制等级比较,差异有统计学意义(P<0.05),两组患者化学治疗第21天与化学治疗第1天白细胞抑制等级变化比较,差异有统计学意义(P<0.05)。与治疗前比较,对照组患者治疗后KPS评分显著降低(P<0.05)。两组患者治疗前后KPS评分差值比较,差异有统计学意义(P<0.05)。与治疗前比较,观察组患者中医证候积分显著下降(P<0.05),观察组中医证候积分下降程度明显大于对照组(P<0.05)。观察组患者PFS为10个月,较对照组PFS(6个月)明显延长。结论自拟生血方治疗晚期脾肾两虚型胃癌奥沙利铂联合替吉奥方案化学治疗所致骨髓抑制,能延迟首次骨髓抑制发生时间并缩短持续时间,降低白细胞骨髓抑制等级,在一定程度上改善晚期胃癌患者临床症状及生活质量。
Objective Toinvestigate the clinical effect and safety of a self-made blood-promoting prescription in the treatment of bone marrow suppression induced by the chemotherapeutic regimen of oxaliplatin combined with tegafur,gimeracil,and oteracil potassium for advanced gastric cancer with deficiency of spleen and kidney.Methods A total of 60 patients with advanced gastric cancer with deficiency of spleen and kidney based on traditional Chinese medicine(TCM)syndrome differentiation were randomly divided into control group and observation group,with 30 patients in each group.The patients in the control group were given chemotherapy with the regimen of oxaliplatin combined with tegafur,gimeracil,and oteracil potassium,and those in the observation group were given oral administration of the decoction of a self-made blood-promoting prescription combined with external acupoint application of its powder after processing in addition to the treatment in the control group.The two groups were observed in terms of the time to the first episode of bone marrow suppression,duration of bone marrow suppression,and change in the grade of bone marrow suppression within 0-3 weeks;Karnofsky's performance scale(KPS)and TCM syndrome score were used to evaluate quality of life,and progression-free survival(PFS)was observed.Results Compared with the control group,the observation group had significantly longer time to the first episodes of reductions in leukocytes,hemoglobin,and platelets(P<0.05)and significantly shorter duration of the inhibition of leukocytes,hemoglobin,and platelets(P<0.05).There were significant differences in the grades of inhibition of leukocytes,hemoglobin,and platelets between the two groups at different time points(P<0.05),and both groups had a significant change in the grade of inhibition of leukocytes from day 1 to day 21 of chemotherapy(P<0.05).The control group had a significant reduction in KPS score after treatment(P<0.05),and there was a significant difference between the two groups in the change of KPS score
作者
陈国庆
喻怀斌
丁美钱
CHEN Guo-qing;YU Huai-bin;DING Mei-qian(Cancer Center,Lu an Hospital of Traditional Chinese Medicine,Anhui Lu an 237006,China)
出处
《安徽中医药大学学报》
CAS
2021年第3期30-35,共6页
Journal of Anhui University of Chinese Medicine
基金
安徽省卫生计生委中医药科研项目(2016zy43)。
关键词
胃癌
脾肾两虚
骨髓抑制
生血方
化学治疗
Gastric cancer
Deficiency of spleen and kidney
Bone marrow suppression
Blood-promoting prescription
Chemotherapy
