加味参芪地黄汤联合多西他赛治疗去势抵抗性前列腺癌骨转移的临床疗效观察  

Clinical observation of Modified Shenqi Dihuang Decoction combined with docetaxel in the treatment of bone metastasis of castration resistant prostate cancer

作　　者：华山 蒋君涛[1] 贾高臻 万众 Hua Shan;Jiang Juntao;Jia Gaozhen;Wan Zhong(Department of Urology,the First People′s Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200080,China;Urological Center,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021,China)

机构地区：[1]上海交通大学附属第一人民医院泌尿外科,上海200080 [2]上海中医药大学附属曙光医院泌尿中心,上海200021

出　　处：《国际泌尿系统杂志》2023年第3期439-444,共6页International Journal of Urology and Nephrology

摘　　要：目的评估加味参芪地黄汤采用多西他赛化疗方案治疗的去势抵抗性前列腺癌骨转移患者的临床疗效。方法将2014年11月至2020年11月上海交通大学附属第一人民医院及上海中医药大学附属曙光医院收治的68例CRPC骨转移患者随机分为试验组与对照组,每组各34例。对照组采用DP方案,试验组在对照组用药的基础上给予加味参芪地黄汤。观察并比较两组的临床疗效、生化指标、骨转移程度、临床症状评分、终点及不良事件等情况。结果试验组患者的临床总有效率显著高于对照组(P=0.015)。治疗后,试验组的血清前列腺特异性抗原(PSA)、睾酮及血清碱性磷酸酶(AKP)浓度低于对照组(P<0.05),白细胞减少、贫血、数字评估法(NRS)评分、残余尿量(PVR)及新发骨转移病灶发生率低于对照组(P<0.05),最大尿流率(Qmax)及卡式生活质量(KPS)评分高于对照组(P<0.05),中医症状自我评价中食欲不振、神疲乏力、腰酸背痛及体重降低等事件改善程度优于对照组(P<0.05)。结论加味参芪地黄汤可有效提高多西他赛对CRPC骨转移患者的治疗疗效,降低其带来的毒副作用,改善中医症候,提高患者的生活质量。Objective To evaluate the clinical effect of Modified Shenqi Dihuang Decoction on castration resistant prostate cancer(CRPC)patients with bone metastasis treated with docetaxel.Methods A total of 68 patients with CRPC with bone metastasis from November 2014 to November 2020 in the Shanghai Jiaotong University Affiliated First People's Hospital and Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were randomly divided into experimental group and control group,with 34 cases in each group.The control group was treated with DP regimen,that is,75 mg/m2 docetaxel intravenous drip for 3 weeks,combined with 5 mg prednisone oral,once a day.The experimental group took 150 mL of Modified Shenqi Dihuang Decoction half an hour after breakfast and dinner on the basis of the control group.The clinical efficacy,biochemical indexes,degree of bone metastasis,clinical symptom scores,end points and adverse events were observed and compared between the two groups.Results The total clinical effective rate of the experimental group was significantly higher than that of the control group(P=0.015).The serum concentrations of prostate specific antigen(PSA),testosterone and alkaline phosphatase(AKP)in the experimental group were lower than those in the control group(P<0.05).The incidence of leucopenia,anemia and new bone metastasis in the experimental group was lower than that in the control group(P<0.05).The maximum flow rate(Qmax),residual urine volume(PVR),numerical rating scale(NRS)score and karnofsky quality of life(KPS)score in the observation group were higher than those in the control group(P<0.05),and the improvement of appetite loss,fatigue,backache and weight loss in the self-evaluation of TCM symptoms was better than that in the control group(P<0.05).Conclusions Modified Shengqi Dihuang Decoction can effectively improve the efficacy of docetaxel in the treatment of CRPC patients with bone metastasis,reduce its toxic and side effects,improve the Chinese medicine syndromes and symptoms,and impro

关 键 词：前列腺肿瘤 多西他赛 加味参芪地黄汤 骨转移 

分 类 号：R737.25[医药卫生—肿瘤]