沙利度胺联合健脾养阴活血方治疗晚期结直肠癌合并重度营养不良疗效观察  

Observation of the curative effect of thalidomide combined with Jianpi Yangyin Huoxue decoction on advanced colorectal carcinoma complicated with severe malnutrition

作　　者：张兰会 刘瑜 黄汝芹 张辉 吴昊 党媛媛 耿碧竹 郑瑾 ZHANG Lanhui;LIU Yu;HUANG Ruqin;ZHANG Hui;WU Hao;DANG Yuanyuan;GENG Bizhu;ZHENG Jin(Tangdu Hospital, The Second Affiliated Hospital of Air Force Military Medical University, Xi’an 710038, Shaanxi, China;Shaanxi Provincial Cancer Hospital, Xi’an 710061, China;Shaanxi University of Traditional Chinese Medicine, Xianyang 712046, Shaanxi, China)

机构地区：[1]空军军医大学第二附属医院唐都医院,陕西西安710038 [2]陕西省肿瘤医院,陕西西安710061 [3]陕西中医药大学,陕西咸阳712046

出　　处：《现代中西医结合杂志》2020年第21期2285-2288,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：陕西中医药管理局资助项目(2016KTCL03-16)。

摘　　要：目的观察沙利度胺联合健脾养阴活血方治疗晚期结直肠癌合并重度营养不良患者的临床效果。方法将2017年4月—2018年9月空军军医大学第二附属医院唐都医院收治的180例晚期结直肠癌合并重度营养不良患者随机分为3组各60例,对照组仅接受化疗治疗,沙利度胺组在对照组治疗基础上联合使用沙利度胺,中药组在沙利度胺组治疗基础上加用健脾养阴活血方。评估3组的近期疗效、不良反应,采用患者主观整体评估(PG-SGA)评估患者的营养状态。结果沙利度胺组总有效率为95.0%(57/60),中药组为93.3%(56/60),对照组为80.0%(48/60),沙利度胺组与中药组均明显高于对照组(P均<0.05),沙利度胺组与中药组间比较差异无统计学意义(P>0.05)。中药组胃肠道反应、骨髓抑制和肝肾功能损伤严重程度均明显轻于对照组和沙利度胺组(P均<0.05)。治疗后对照组PG-SGA评分无明显变化(P>0.05),沙利度胺组与中药组PG-SGA评分均明显低于治疗前及对照组(P均<0.05),且中药组明显低于沙利度胺组(P<0.05)。结论沙利度胺能显著提高晚期结直肠癌合并重度营养不良患者化疗的近期疗效,联合健脾养阴活血方虽不能进一步提升疗效,但能有效减轻不良反应,改善患者的营养状况。Objective It is to observe the clinical effect of thalidomide combined with Jianpi Yangyin Huoxue decoction on patients with advanced colorectal carcinoma complicated with severe malnutrition.Methods 180 patients with advanced colorectal cancer complicated with severe malnutrition admitted to Tangdu Hospital,the Second Affiliated Hospital of Air Force Military Medical University from April 2017 to September 2018 were randomly divided into 3 groups,60 patients in each group.The control group only was treated with chemotherapy,and the thalidomide group was treated with thalidomide on the basis of the control group,and the Traditional Chinese Medicine(TCM)group was treated with Jianpi Yangyin Huoxue decoction on the baisis of the thalidomide group.The short-term efficacy and adverse reactions of the three groups were evaluated,and the patient’s nutritional status was evaluated by Patient-Generated Subjective Global Assessment(PG-SGA).Results The total effective rates of thalidomide group and TCM group were 95.0%(57/60)and 93.3%(56/60)respectively,that in the control group was 80.0%(48/60),both thalidomide group and TCM group were significantly higher than that in the control group(all P<0.05).There was no significant difference in the rate between the thalidomide group and the TCM group(P>0.05).The severity of gastrointestinal reaction and bone marrow suppression of the TCM group were significantly lower than those of the control group and the thalidomide group(P<0.05).No significant change of PG-SGA scores was found in the control group after treatment(P>0.05),while the PG-SGA scores of the thalidomide group and the TCM group were significantly lower than that before treatment and in the control group(P<0.05),and the TCM group was significantly lower than the thalidomide group(P>0.05).Conclusion Thalidomide can significantly improve the short-term efficacy of chemotherapy for advanced colorectal carcinoma complicated with severe malnutrition.Although the combination of TCM can not further improve the efficacy,but

关 键 词：沙利度胺 健脾养阴活血方 晚期结直肠癌 重度营养不良 

分 类 号：R735.37[医药卫生—肿瘤]