温阳补肾汤加减联合穴位刺激辅助治疗前列腺癌骨转移临床研究  

Clinical Study on Modified Wenyang Bushen Tang Combined with Point Stimulation in Adjuvant Therapy of Bone Metastases from Prostate Cancer

作　　者：刘德果 陈其华[2] 李博 LIU Deguo;CHEN Qihua;LI Bo

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410008

出　　处：《新中医》2021年第4期137-142,共6页New Chinese Medicine

基　　金：湖南省科技厅湖南省临床医学研究中心及临床医疗技术示范基地组建计划—湖南省男性疾病中医临床医学研究中心项目(2018SK4012);湖南省自然科学基金面上项目(2020JJ4068);湖南省卫生计生委科研基金项目(20180567)。

摘　　要：目的:观察温阳补肾汤联合穴位刺激辅助治疗前列腺癌骨转移的临床疗效,并探讨其可能的作用机制。方法:选取54例前列腺癌骨转移患者,按随机数字表法分为观察组及对照组,每组27例。因病情进展及失访,最终2组均有25例患者完成研究。2组均于术后给予药物去势及抗雄激素药物治疗,观察组在此基础上口服温阳补肾汤联合穴位刺激治疗,对照组则给予止痛药物治疗。2组均连续干预12周并进行6个月随访。比较2组临床疗效及治疗前后前列腺癌骨转移相关指标、炎症相关指标、疼痛程度及生活质量,记录不良反应。结果:观察组总有效率为40.00%,对照组总有效率为28.00%,2组比较,差异无统计学意义(P>0.05)。治疗后,2组血清碱性磷酸酶(ALP)水平均较治疗前升高(P<0.05),观察组血清ALP水平低于对照组(P<0.05);2组血清前列腺特异性抗原(PSA)水平、疼痛口述分级评分法(VRS)评分均较治疗前降低(P<0.05),观察组血清PSA水平、VRS评分均低于对照组(P<0.05)。治疗后,2组排尿症状、精神状态、疼痛、胃肠道反应评分均较治疗前降低(P<0.05),观察组上述4项细则评分均较对照组降低更明显(P<0.05);2组活动受限、心理波动、整体健康、睡眠评分均较治疗前升高(P<0.05),观察组上述4项细则评分较对照组升高更明显(P<0.05)。治疗后随访6个月,观察组症状加重率为30.00%,低于对照组的57.14%(P<0.05)。观察组症状加重患者VRS评分为(5.64±1.86)分,低于对照组的(6.71±2.25)分(P<0.05)。治疗后,2组血清白细胞介素(IL)-1、IL-17、肿瘤坏死因子-α(TNF-α)及基质金属蛋白酶-3(MMP-3)水平均较治疗前降低(P<0.01),观察组血清TNF-α、IL-1、IL-17及MMP-3水平均较对照组降低更明显(P<0.05)。结论:温阳补肾汤联合穴位刺激辅助治疗前列腺癌骨转移,可明显缓解骨转移造成的疼痛,提升近期疗效及生活质量,同时可延缓前列腺癌骨转移进展,�Objective:To observe the clinical effect of modified Wenyang Bushen tang combined with point stimulation in adjuvant therapy of bone metastases from prostate cancer,and to discuss its possible mechanism.Methods:A total of 54 cases of patients with bone metastases from prostate cancer were selected and divided into the observation group and the control group according to the random number table method,27 cases in each group.Due to disease progression and the loss to follow-up,there were 25 cases left in each group and completed the study.Both groups were given medical castration and antiandrogen medicine after surgery;the observation group was additionally treated with oral administration of Wenyang Bushen tang combined with point stimulation,and the control group was treated with analgesic medicine.Both groups were intervened for continuous 12 weeks and were followed up for 6 months.The clinical effect was compared between the two groups.The related indexes of bone metastases from prostate cancer,inflammation,pain degree,quality of life were compared between the two groups before and after treatment,and recorded adverse reactions.Results:The total effective rate was 40.00%in the observation group,and 28.00%in the control group,there was no significant difference between the two groups(P>0.05).After treatment,the levels of alkaline phosphatase(ALP)in serum in both groups were increased when compared with those before treatment(P<0.05),and the ALP level in the observation group was lower than that in the control group(P<0.05).After treatment,the levels of prostate-specific antigen(PSA)in serum and the scores of Verbal Rating Scale of pain(VRS)in the two groups were decreased when compared with those before treatment(P<0.05);the PSA level and VRS score in the observation group were lower than those of the control group(P<0.05).After treatment,the scores of urination symptom,mental state,pain and gastrointestinal reactions in the two groups were decreased when compared with those before treatment(P<0.05),and the decr

关 键 词：前列腺癌 骨转移 温阳补肾汤 穴位刺激 前列腺特异性抗原 疼痛 炎症因子 生活质量 

分 类 号：R737.25[医药卫生—肿瘤]