健脾解毒化滞方联合腹腔热灌注化疗治疗腹膜转移癌的疗效观察  

Observation on the Curative Effect of Jianpi Jiedu Huazhi Decoction(健脾解毒化滞方)Combined with Hyperthermic Intraperitoneal Chemotherapy in the Treatment of Peritoneal Metastatic Carcinoma

作　　者：王莹雪 李宁[1] 刘赳 袁晗颖 马璐文 梁慧[2] WANG Yingxue;LI Ning;LIU Jiu;YUAN Hanying;MA Luwen;LIANG Hui(Hunan University of Chinese Medicine,Changsha Hunan 410208,China;Hunan Cancer Hospital,Changsha Hunan 410031,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南省肿瘤医院,湖南长沙410031

出　　处：《中医药导报》2023年第3期88-93,共6页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：湖南省中医药管理局重点项目(2021035),项目名称:基于Zeb2-肠道菌群-上皮间质转化轴探讨肠复方抑制大肠癌肝转移的机制研究。

摘　　要：目的:观察健脾解毒化滞方联合腹腔热灌注化疗治疗腹膜转移癌患者的临床疗效。方法:将60例腹盆腔恶性肿瘤腹膜转移患者随机分为对照组与联合组,各30例,对照组使用单纯腹腔热灌注化疗,联合组在对照组的基础上服用健脾解毒化滞方,治疗后评价两组患者瘤体疗效、疾病进展时间(TTP)、腹水临床疗效、血清肿瘤标志物(CA125、CA19-9和CEA)水平、Karnofsky(KPS)评分、中医证候积分,并进行安全性评价。结果:两组瘤体疗效比较,差异无统计学意义(P>0.05);两组患者TTP比较,差异无统计学意义(P>0.05),亚组分析提示腹水患者中联合组患者TTP为4.55个月[95%CI(3.44,5.65)],明显高于对照组的2.93个月[95%CI(1.69,4.18)](P<0.05);联合组患者腹水客观缓解率为70.00%(14/20),显著高于对照组的33.33%(6/18)(P<0.05);治疗后联合组患者血清肿瘤标志物CA125水平降低,且明显低于对照组(P<0.05),两组患者血清CA19-9、CEA水平治疗前后及组间比较,差异均无统计学意义(P>0.05);治疗后两组患者KPS评分均升高,且联合组高于对照组(P<0.05);治疗后两组患者中医证候积分均降低,且联合组明显低于对照组(P<0.05);联合组患者胃肠道反应、骨髓抑制、肝肾功能损伤等不良反应发生率明显低于对照组(P<0.05),而神经毒性比较,差异无统计学意义(P>0.05)。结论:健脾解毒化滞方联合腹腔热灌注化疗能够延长腹膜转移癌伴腹水患者的TTP,提高腹水的临床疗效,降低肿瘤标志物CA125水平,提高患者的生活质量,改善临床症状,降低不良反应发生率,显示了良好的应用前景。Objective:To observe the clinical efficacy of combined treatment of Jianpi Jiedu Huazhi Decoction and hyperthermic intraperitoneal chemotherapy in patients with peritoneal metastatic carcinoma.Methods:A total of 60 patients with peritoneal metastasis of malignant tumors in the abdominal and pelvic cavities were randomly divided into a control group and a combined treatment group,with 30 cases in each group.The control group was treated with intraperitoneal hyperthermic perfusion chemotherapy alone,and the combined group was treated with Jianpi Jiedu Huazhi Decoction on the basis of the control group.After treatment,the therapeutic effect of the tumor,time to progression(TTP),clinical efficacy of ascites,serum tumor markers(CA125,CA19-9,and CEA)levels,Karnofsky performance status,traditional Chinese medicine(TCM)syndrome score,and safety evaluation were evaluated in both groups.Results:There was no statistically significant difference in the therapeutic effect of the tumor between the two groups(P>0.05).There was also no statistically significant difference in TTP between the two groups (P>0.05). However, subgroup analysis suggested that the TTP of patients in the combined treatment group with ascites was 4.55 months [95%CI (3.44, 5.65)], significantly higher than the control group's 2.93 months [95%CI (1.69, 4.18)] (P<0.05). The objective remission rate of ascites in the combined treatment group was 70.00% (14/20), significantly higher than the control group's 33.33% (6/18) (P<0.05). After treatment, the serum tumor marker CA125 level in the combined treatment group decreased significantly and was significantly lower than that in the control group (P<0.05). There was no statistically significant difference in serum CA19-9 and CEA levels between the two groups before and after treatment (P>0.05). The Karnofsky performance status of both groups increased after treatment, with the combined treatment group showing a significantly higher increase than the control group (P<0.05). The TCM syndrome score of both groups d

关 键 词：腹盆腔恶性肿瘤 腹膜转移癌 健脾解毒化滞方 腹腔热灌注化疗 临床疗效 

分 类 号：R273[医药卫生—中西医结合]