葶苈大枣泻肺汤合苓桂术甘汤加减治疗晚期肺癌合并恶性胸腔积液的疗效观察  

Efficacy observation of modified Tingli Dazao Xiefei Decoction and Linggui Zhugan Decoction in the treatment of advanced lung cancer with malignant pleural effusion

作　　者：阎慧君[1] YAN Hui-jun(Fourth Department of Internal Medicine,Dalian Traditional Chinese Medicine Hospital,Dalian 116000,China)

机构地区：[1]大连市中医医院内四科,116000

出　　处：《中国实用医药》2023年第5期130-133,共4页China Practical Medicine

基　　金：大连市科技局高层次人才创新支持计划项目(项目编号:2017B0078);大连市卫生健康委员会医学重点专科登峰计划专项(项目编号:大卫发[2021]203号)。

摘　　要：目的探讨葶苈大枣泻肺汤合苓桂术甘汤加减治疗晚期肺癌合并恶性胸腔积液的临床效果。方法80例晚期肺癌合并恶性胸腔积液患者,按随机数字表法分为对照组和研究组,各40例。对照组给予化疗及胸腔闭式引流治疗,研究组在对照组基础上给予葶苈大枣泻肺汤合苓桂术甘汤加减治疗。比较两组疗效、肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰值流速(PEF)、FEV1/FVC],治疗后不同时间的D-二聚体水平,治疗前后的血清CD4^(+)/CD8^(+)、CD4^(+)、CD8^(+),生活质量评分。结果研究组治疗总有效率为85.00%,高于对照组的65.00%,差异有统计学意义(P<0.05)。治疗后,研究组FEV1(2.28±0.03)L、FEV1/FVC(67.73±5.63)%、FVC(2.71±0.04)L、PEF(4.28±0.65)L/s均高于对照组的(1.65±0.21)L、(56.45±4.26)%、(2.25±0.05)L、(3.45±0.12)L/s,差异有统计学意义(P<0.05)。治疗1、3、5、9周,两组D-二聚体水平逐渐降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗后,研究组CD4^(+)/CD8^(+)、CD4^(+)高于本组治疗前,对照组CD4^(+)低于本组治疗前,且研究组CD4^(+)/CD8^(+)、CD4^(+)高于对照组,差异有统计学意义(P<0.05)。治疗后,对照组CD8^(+)高于本组治疗前,研究组CD8^(+)低于本组治疗前,且研究组CD8^(+)低于对照组,差异有统计学意义(P<0.05)。研究组躯体功能评分(67.35±3.48)分、认知功能评分(77.75±3.15)分均高于对照组的(54.34±3.24)、(60.77±3.13)分,差异有统计学意义(P<0.05)。结论葶苈大枣泻肺汤合苓桂术甘汤加减治疗晚期肺癌伴恶性胸腔积液可增强患者肺功能,改善免疫相关功能、血液高凝状态,提升患者生活质量。Objective To discuss the clinical effect of modified Tingli Dazao Xiefei Decoction and Linggui Zhugan Decoction in the treatment of advanced lung cancer with malignant pleural effusion.Methods A total of 40 patients with advanced lung cancer and malignant pleural effusion were divided into control group and research group according to the random numerical table,with 40 cases in each group.The control group was treated with chemotherapy and closed thoracic drainage,while the research group was treated with modified Tingli Dazao Xiefei Decoction and Linggui Zhugan Decoction.Both groups were compared in terms of efficacy,lung function indexes[forced vital capacity(FVC),forced expiratory volume in one second(FEV1),peak expiratory flow rate(PEF),FEV1/FVC],D-dimer levels at different time points after treatment,serum CD4^(+)/CD8^(+),CD4^(+),CD8^(+)and quality of life scores before and after treatment.Results The total effective rate of the research group was 85.00%,which was higher than 65.00%of the control group,and the difference was statistically significant(P<0.05).After treatment,FEV1(2.28±0.03)L,FEV1/FVC(67.73±5.63)%,FVC(2.71±0.04)L,PEF(4.28±0.65)L/s in the research group were higher than(1.65±0.21)L,(56.45±4.26)%,(2.25±0.05)L,(3.45±0.12)L/s in the control group,and the differences were statistically significant(P<0.05).At 1,3,5 and 9 weeks of treatment,the level of D-dimer in two groups gradually decreased,and the research group was lower than the control group,and the difference was statistically significant(P<0.05).After treatment,CD4^(+)/CD8^(+)and CD4^(+)in the research group was higher than those before treatment in this group,the CD4^(+)in the control group was lower than that before treatment in this group,and CD4^(+)/CD8^(+)and CD4^(+)in the research group were higher than those in the control group,and the differences were statistically significant(P<0.05).After treatment,the CD8^(+)of the control group was higher than that before treatment in this group,the CD8^(+)of the research group was lowe

关 键 词：肺癌 胸腔积液 葶苈大枣泻肺汤 苓桂术甘汤 肺功能 

分 类 号：R273[医药卫生—中西医结合]