消瘤方加减治疗化疗后正虚痰凝型弥漫大B细胞淋巴瘤60例临床观察  

Modified Xiaoliu Formula (消瘤方) for Treatment of 60 Cases of Diffuse Large B-cell Lymphoma after Chemotherapy with Healthy Qi Deficiency and Phlegm Coagulation Pattern

作　　者：李捷凯 鲍计章 朱文伟[1] 张福鹏[1] 周永明[1] LI Jiekai;BAO Jizhang;ZHU Wenwei;ZHANG Fupeng;ZHOU Yongming(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437;Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中医药大学附属市中医医院

出　　处：《中医杂志》2022年第4期349-355,共7页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(81774258);上海市名老中医学术经验研究工作室建设项目(SHGZS-2017019);上海中医药大学名老中医药专家学术经验研究工作室建设项目(SZYMZYGZS4018)。

摘　　要：目的观察消瘤方加减对化疗后正虚痰凝型弥漫大B细胞淋巴瘤(DLBCL)患者生活质量、肿瘤负荷情况及机体免疫的影响。方法收集化疗4~6个疗程结束临床评估为完全缓解或不确定的完全缓解的DLBCL患者60例,随机分为对照组与治疗组各30例。两组患者均遵医嘱随访观察定期复查,入组后每个月进行1次随访。治疗组在此基础上予消瘤方加减口服,2周为1个疗程,共治疗6个疗程。对比两组患者治疗前后中医症状积分、生活质量(EORTC-QLQ-C30)评分、KPS评分、肿瘤负荷指标[包括乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)]、免疫球蛋白[包括免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]水平,并判定中医证候疗效、生活质量疗效,计算复发率。结果治疗组中医证候疗效总有效率为96.67%,明显优于对照组的33.3%,差异有统计学意义(P<0.05)。治疗组无复发,对照组复发率为16.67%,差异有统计学意义(P<0.05)。治疗组生活质量疗效中好转率(80.00%)高于对照组(13.33%),治疗组恶化率(0)低于对照组(6.67%,P<0.01)。与本组治疗前比较,治疗后治疗组疲倦、恶心呕吐、气促、失眠、食欲不振、便秘评分,中医症状积分,LDH、β2-MG水平均明显降低,社会功能、情绪功能、躯体功能、角色功能、总体健康状况评分,IgA、IgG、IgM水平均明显升高(P<0.05);对照组中医症状积分明显降低(P<0.05),其余指标差异均无统计学意义(P>0.05),两组各指标差值比较差异均有统计学意义(P<0.05)。结论消瘤方加减可以有效改善化疗后正虚痰凝型DLBCL患者中医证候,提高生活质量及机体免疫力,有效降低肿瘤负荷指标,并可减少复发。Objective To observe the effect of Modified Xiaoliu Formula(消瘤方)on quality of life,tumor burden and body immunity of diffuse large B-cell lymphoma(DLBCL)patients with healthy qi deficiency and phlegm coagulation pattern after chemotherapy.Methods Sixty DLBCL patients who have been evaluated as complete remission(CR)or uncertain complete remission(CRU)after chemotherapy(4 to 6 treatment courses)were randomly divided into control group and MXF group,with 30 cases in each group.All the patients were required to take follow-up appointment once a month after enrollment.In addition,the patients in the treatment group were given Xiaoliu Formula orally,for six courses with two weeks as a course.The traditional Chinese medicine(TCM)symptoms scores,European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC-QLQ-C30)scores,Karnofsky performance status(KPS)scores,tumor burden indicators including lactate dehydrogenase(LDH),β2-microglobulin(β2-MG),and immunoglobulin levels including immunoglobulin M(IgM),immunoglobulin G(IgG),immunoglobulin A(IgA)were measured before and after the treatment and compared between groups;the effective rates regarding TCM symptoms and quality of life,as well as the recurrence rate were assessed.Results The effective rate regarding TCM symptoms in the MXF group was 96.67%,significantly better than 33.3%in the control group,with significant differences(P<0.05).No patient relaps in the treatment group,while the recurrence rate was16.67%in the control group(P<0.05).The improvement rate regarding quality of life was 80.00%in the treatment group,higher than 13.33%in the control group;and the deterioration rate was 0.00%,lower than 6.67%of the control group(P<0.01).After treatment,scores of fatigue,nausea,vomiting,shortness of breath,insomnia,loss of appetite and constipation,level of LDH andβ2-MG decreased significantly,while scores of social function,emotional funtion,physical function,role function and overall health status,as well as level of IgA,I

关 键 词：弥漫大B细胞淋巴瘤 消瘤方 正虚痰凝 生活质量 免疫球蛋白 肿瘤负荷 

分 类 号：R733.1[医药卫生—肿瘤]