王克穷运用大半夏汤本源剂量化裁治疗食管癌48例回顾性研究  

A Retrospective Study of 48 Cases of Esophageal Cancer Treated by Wang Ke-qiong with the Original Dose Modification of Major Pinellia Decoction

作　　者：朱小燕 王克穷 张春红[1] 杨春荣 周勇 李晨 ZHU Xiao-yan;WANG Ke-qiong;ZHANG Chun-hong;YANG Chun-rong;ZHOU Yong;LI Chen(Shaanxi University of Chinese Medicine,Xianyang,Shaanxi,China,712046;Affiliated Hospital of Shaanxi University of traditional Chinese Medicine,Xianyang,Shaanxi,China,712000)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《河南中医》2021年第10期1508-1512,共5页Henan Traditional Chinese Medicine

摘　　要：目的:观察王克穷运用大半夏汤本源剂量化裁治疗食管癌的临床疗效。方法:对48例运用大半夏汤本源剂量化裁治疗的食管癌患者进行回顾性分析,判定中医证候疗效,评价呕吐症状缓解程度及QLQ-OES18食管癌特异模块量表疗效,进行生存周期分析,观察实验室指标。结果:48例患者中,临床痊愈1例,显效8例,有效33例,无效6例,有效率为87.5%;平均生存期16.95个月,中位总生存期14个月,生存周期与服药剂数成正相关;大半夏汤本源剂量化裁对呕吐、吞咽困难、进食、反流、疼痛、梗阻、口干、食欲减退症状的改善与治疗前比较,差异有统计学意义(P<0.05),对咽口水、咳嗽、言语功能的改善与治疗前比较无统计学意义(P>0.05);治疗前后,患者血常规,肿瘤标志物比较有统计学意义(P<0.05),肝肾功能比较差异无统计学意义(P>0.05);基于多元线性回归所建立的食管癌生存时间的预报仪方程为:Y=1.706X1-1.446X2-0.424X3+0.737X4+0.265X5-0.424X6,R^(2)=0.559。结论:大半夏汤本源剂量化裁治疗食管癌可改善患者的临床症状,有效提高生活质量,且无明显肝肾毒性。Objective:To explore the clinical efficacy of the original dose Modification of Major Pinellia Decoction used by Wang Ke-qiong on esophageal cancer.Methods:A total of 48 patients with esophageal cancer treated with the original dose Modification of Major Pinellia Decoction were analyzed retrospectively.The curative effect of TCM syndrome was determined.The remission degree of vomiting symptoms and the curative effect of QLQ-OES18 esophageal cancer specific module scale were evaluated.The survival cycle was analyzed,and the laboratory indexes were observed.Results:Among the 48 patients,1 case was clinically cured,8 cases were markedly effective,33 cases were effective and 6 cases were ineffective.The effective rate was 87.5%.The average survival time was 16.95 months,the median overall survival time was 14 months,and the survival cycle was positively correlated with the dose of decoction.After treatment,original dose Modification of Major Pinellia Decoction had statistical significance in improving the symptoms of vomiting,dysphagia,eating,reflux,pain,obstruction,dry mouth and anorexia compared with those before treatment(P<0.05),but there was no significant difference in the improvement of swallowing slavor,cough and speech compared with those before treatment(P>0.05).Blood cell analysis and tumor markers were statistically significant before and after Treatment(P<0.05),but there was no significant difference in liver and kidney functions(P>0.05).The predictor equation of survival time of esophageal cancer based on multiple linear regression was:Y=1.706X1-1.446X2-0.424X3+0.737X4+0.265X5-0.424X6,R^(2)=0.559.Conclusion:The original dose Modification of Major Pinellia Decoction in the treatment of esophageal cancer can improve the clinical symptoms,effectively enhance the quality of life,and has no obvious hepatorenal toxicity.

关 键 词：食管癌 大半夏汤 本源剂量 《金匮要略》 张仲景 

分 类 号：R273.351[医药卫生—中西医结合]