参芪扶正注射液联合甲地孕酮改善晚期恶性肿瘤患者癌因性疲乏的临床研究  

Clinical study on the effect of Shenqifuzheng injection combined with megestrol acetate in improving cancer- related fatigue in patients with advanced cancer

作　　者：刘志勇[1] 周建伟[1] 潘龙赐[1] 葛婷[1] 

机构地区：[1]复旦大学附属中山医院青浦分院中医科,上海201700

出　　处：《临床和实验医学杂志》2016年第3期216-219,共4页Journal of Clinical and Experimental Medicine

基　　金：上海市青浦区卫生局支持项目;编号:W2013-05

摘　　要：目的探讨参芪扶正注射液联合甲地孕酮改善晚期恶性肿瘤患者癌因性疲乏的临床效果。方法选择恶性肿瘤患者60例为研究对象,随机分作两组,一组为中西药联合组(30例),另一组为西药组(30例),前者使用参芪扶正注射液联合甲地孕酮加对症支持治疗,后者予甲地孕酮加对症支持治疗,比较两组治疗后Piper评分、血红蛋白(Hb)、总T细胞(CD3^+)、Th细胞(CD3^+CD4^+)比例、TNF-α和TGF-β1的水平。结果治疗后两组在Pipper评分各项中得分相比,中西医联合组显著低于西药组(t=2.412-3.723,P=0.008-0.040)。治疗后中西医药联合组Hb、总T细胞(CD3^+)、Th细胞(CD3^+CD4^+)比率显著高于治疗后的西药组(t=2.543-3.812,p=0.011-0.039)。治疗后中西医药联合组静脉血TNF-α、TGF-β1的水平显著低于西药组(t=2.913,4.223,P=0.002,0.034)。结论参芪扶正注射液联合甲地孕酮改善晚期恶性肿瘤患者癌因性疲乏具有较好的治疗效果,其机制可能与提高总T细胞、Th细胞比例,降低TGF-β1、TNF-α等细胞因子水平有关。Objective To explore the effect of Shenqifuzheng injection combined with megestrol acetate in improving the effect of cancer-related fatigue in patients with advanced cancer.Methods A total of 60 cases of cancer were collected and randomly divided into Chinese combined western medicine group and western medicine group,each with 30 cases.In Chinese combined western medicine group,patients were administrated with Shenqifuzheng injection combined with megestrol acetate plus symptomatic and supportive treatment.In western medicine group,patients were given with megestrol acetate plus symptomatic and supportive treatment.Piper scoring,level of hemoglobin（Hb）,total number of T cells（CD3~＋）,ratio of Th cells（CD3~＋ and CD4~＋） and levels of TNF- α and TGF-β1 were compared between these two groups after treatment.Results The Pipper scores in patients of Chinese and western medicine group were significantly lower than those of patients in western medicine group（t =2.412 ~3.723,P =0.008 ~0.040）.In patients of Chinese and western medicine group after treatment,the level of Hb,total number of T cells（CD3~＋） and ratio of Th cells（CD3~＋ CD4~＋） were significantly higher than those of patients in western medicine group（t =2.543 ~3.812,P =0.011 ~0.039）.The blood levels of TNF- α and TGF- β1 in patients of Chinese and western medicine group were significantly lower than those of patients in western medicine group（t =2.913,4.223,P =0.002 ~0.034）.Conclusion The application of Shenqifuzheng injection combined with megestrol acetate can relieve the cancer- related fatigue in patients with advanced cancer,and its mechanism may be related to the increase of total number of T cells and proportion of Th cells and decrease the levels of TGF- β1 and TNF- α,the joint treatment have a better therapeutic effect,hence it is worthy to be clinically applied.

关 键 词：恶性肿瘤 癌因性疲乏 参芪扶正 甲地孕酮 

分 类 号：R730.5[医药卫生—肿瘤]