三阳血傣合剂辅助放化疗对头颈鳞癌患者骨髓抑制的影响  

Effect of Neoadjuvant Radio-chemotherapy of Sanyang Xuedai Mixture on Myelosuppression in Patients with Squamous Carcinoma

作　　者：周华[1] 孙红文[1] 赵培珠[1] 张瑞[1] 邓雯[1] 

机构地区：[1]昆明医科大学第一附属医院,昆明650032

出　　处：《中国实验方剂学杂志》2015年第21期173-176,共4页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：云南省教育厅中青年基金项目(2013Y300)

摘　　要：目的：评价三阳血傣合剂辅助放化疗对头颈鳞癌患者骨髓抑制的防治作用。方法：将132例符合研究条件的患者随机按数字表法分为观察组67例和对照组65例。两组均采用调强放疗＋紫杉醇与顺铂联合化疗（TP）方案。对照组同期口服利可君片,2片/次,3次/d。观察组在对照组治疗的基础上加用三阳血傣合剂,20 m L/次,3次/d。放化疗结束时仍然存在骨髓抑制者,可再使用4~8周。放化疗过程中若出现Ⅲ度骨髓抑制,均采用重组人粒细胞刺激因子注射液（rh G-CSF）2~5μg·kg-1·d-1,皮下注射。放化疗开始后,每周进行1次血常规检查,记录出现骨髓抑制时间和骨髓抑制恢复时间,评价骨髓抑制程度;评价治疗前后生活质量（KPS）和实体肿瘤大小的评价;记录两组rh G-CSF的使用量。结果：观察组骨髓抑制发生率为88.06%,对照组为96.92%,观察组低于对照组,但差异无统计学意义,观察组骨髓抑制程度轻于对照组,差异有统计学意义（P〈0.05）;观察组平均出现骨髓抑制反应时间晚于对照组（P〈0.05）;放化疗结束后,观察组骨髓抑制反应平均恢复时间短于对照组（P〈0.05）;观察组平均rh G-CSF使用量少于对照组（P〈0.01）;放化疗结束时观察组白细胞、中性粒细胞、血红蛋白水平均高于对照组（P〈0.01）;放化疗结束时观察组KPS评分高于对照组（P〈0.05）;观察组实体瘤疗效总有效率为88.06%,对照组为76.92%,观察组高于对照组,组间比较差异无统计学意义。结论：三阳血傣合剂辅助用于头颈鳞癌同期放化疗患者,能减轻骨髓抑制程度,推迟骨髓抑制出现时间,促进骨髓抑制的恢复,稳定患者的生活质量。Objective： To evaluate the preventive and therapeutic effect of neoadjuvant radiochemotherapy of Sanyang Xuedai mixture on myelosuppression in patients with squamous carcinoma. Method： One hundred and thirty-two eligible patients were randomly divided into control group（ 65 cases） and observation group（ 67 cases） by random number table. Patients in both groups received treatment of radiotherapy and chemotherapy（ TP scheme）. At the same time,patients in control group also received leucogen tablets,2 tablets/time,3 times/day. Based on the treatment of control group,patients in observation group also received Sanyang Xuedai mixture,20 m L / time,3 times / day. At the end of radiotherapy and chemotherapy,patients still with myelosuppression used Sanyang Xuedai mixture for another 4 to 8 weeks. During radiotherapy and chemotherapy,patients with Ⅲ degree myelosuppression received recombinant human granulocyte colony stimulating factor injections（ rh G-CSF） by subcutaneous injection,2-5 μg·kg- 1·d- 1. At the beginning of radiotherapy and chemotherapy,blood routine examination was made once a week,emerging and recovering time of myelosuppression was recorded to evaluate the degree of myelosuppression. Karnofsky performance status（ KPS） and size of solid tumor were also evaluated. And application amount of rh G-CSF was recorded. Result： Rate of myelosuppression in observation group was88. 06%,lower than 96. 92% in control group,but there was no statistical difference between two groups. The degree of myelosuppression in observation group was lighter than that in control group（ P〈0. 05）. Average response time of myelosuppression in observation group was later than that in control group（ P〈0. 05）. After radiotherapy and chemotherapy,average recovery time of myelosuppression in observation group was shorter than that in control group（ P〈0. 05）. And the application amount of rh G-CSF was also less than that in control group（ P〈0. 01）. At the end of radiotherapy and chemot

关 键 词：头颈鳞癌 放疗 化疗 骨髓抑制 三阳血傣合剂 

分 类 号：R287[医药卫生—中药学]