三棱消瘤合剂联合化疗治疗痰瘀互结型进展期胃癌的临床观察  

Clinical observation on Sanleng Xiaoliu Mixture combined with chemotherapy in treatment of advanced gastric cancer of intermingled phlegm and stasis syndrome

作　　者：王立玉[1] 陈舲[1] 王芹 苏羚子 龚亚斌[1] 谢国群 WANG Liyu;CHEN Ling;WANG Qin;SU Lingzi;GONG Yabin;XIE Guoqun(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

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,上海201203

出　　处：《上海中医药杂志》2023年第4期36-40,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81803888);上海市卫健委科研项目(20224Y0059);上海中医药大学附属岳阳中西医结合医院院级基金项目(2019YYQ2019-2021)。

摘　　要：目的观察三棱消瘤合剂联合化疗治疗痰瘀互结型进展期胃癌的临床疗效及安全性。方法将92例痰瘀互结型进展期胃癌患者根据意愿分为治疗组(n=44)和对照组(n=48),对照组给予化疗(以氟尿嘧啶为基础方案),治疗组在对照组治疗措施基础上加用三棱消瘤合剂。21 d为1个化疗周期,两组基本疗程均为4个周期,可视情况继续随访治疗至6~8个周期。基本疗程结束后,观察两组中医证候疗效、实体瘤疗效,比较卡氏功能状态(KPS)评分的变化情况;记录化疗周期,比较两组治疗前及治疗第22天、85天时中医证候积分的变化情况,以及基本疗程中的毒性反应发生情况。结果(1)治疗组、对照组中医证候总有效率分别为77.3%、50.0%;治疗组中医证候疗效优于对照组(P<0.05)。(2)两组实体瘤疗效比较,差异无统计学意义(P>0.05)。(3)治疗组治疗第22天时,胃脘痛、恶心呕吐、纳差、肢体困重积分及中医证候总积分减少(P<0.05),对照组仅中医证候总积分减少(P<0.05)。治疗第85天时组间比较,胃脘痛、恶心呕吐、纳差、肢体困重积分及中医证候总积分差异有统计学意义(P<0.05)。(4)治疗前后组内比较,治疗组KPS评分升高(P<0.05);组间治疗后比较,治疗组KPS评分高于对照组(P<0.05)。(5)两组完成化疗周期情况比较,差异无统计学意义(P>0.05)。(6)治疗组周围神经毒性反应发生率低于对照组(P<0.05),但两组血液毒性、胃肠道毒性反应发生率比较,差异无统计学意义(P>0.05)。结论三棱消瘤合剂联合化疗治疗痰瘀互结型进展期胃癌疗效满意,能有效改善患者的中医证候及生活质量,减轻化疗毒性反应。Objective To observe the clinical efficacy and safety of combining chemotherapy with Sanleng Xiaoliu Mixture in the treatment of advanced gastric cancer of intermingled phlegm and stasis syndrome.Methods Ninety-two patients with advanced gastric cancer of intermingled phlegm and stasis syndrome were divided into treatment group(n=44)and control group(n=48)according to their wishes.The control group was given chemotherapy(fluorouracil as the basic regimen),while the treatment group was treated with Sanleng Xiaoliu Mixture in addition to the treatment measures of the control group.A cycle of chemotherapy is 21 days.The basic course of chemotherapy was 4 cycles in both groups,and the follow-up treatment could be continued to 6-8 cycles as appropriate.At the end of the basic course of treatment,syndrome therapeutic evaluation and solid tumor evaluation were conducted,and the changes in Karnofsky Performance Status(KPS)score were compared.The chemotherapy cycles were recorded,and the changes in TCM syndrome scores before treatment and at the 22nd and 85th days of treatment were compared between the two groups,as well as the incidence of toxic reactions during the basic course of treatment.Results①The total effective rate according to the TCM syndrome therapeutic evaluation was 77.3%in the treatment group and 50.0%in control group;the TCM syndrome therapeutic evaluation in the treatment group was better than that in the control group(P<0.05).②The difference in the efficacy for solid tumors between the two groups was not statistically significant(P>0.05).③In the treatment group,the scores of epigastralgia,nausea and vomiting,poor appetite,heavy sensation in the body and limbs and the total TCM syndrome score decreased on day 22 of treatment(P<0.05),while the total TCM syndrome score decreased in the control group(P<0.05).And the differences in the scores of epigastralgia,nausea and vomiting,poor appetite,heavy sensation in the body and limbs and total TCM syndrome score were statistically significant on day 85 of

关 键 词：胃癌 三棱消瘤合剂 痰瘀互结证 中西医结合疗法 中医证候 临床试验 

分 类 号：R735.2[医药卫生—肿瘤]