养正合剂联合滋脾益胃汤对结肠癌放化疗后脾虚痰湿型厌食症患者营养状态及预后的影响  

Effects of Yangzheng mixture combined with Zipi Yiwei Decoction on nutritional status and prognosis of colon cancer patients withpost-(chemo)radiotherapy anorexia of spleen-deficiency and phlegm-dampness type

作　　者：朱淑云 谭远忠 ZHU Shuyun;TAN Yuanzhong(Department of Spleen and Stomach Diseases,the Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi,Hubei 445000)

机构地区：[1]湖北省恩施土家族苗族自治州中心医院脾胃病科,湖北恩施445000

出　　处：《河北中医》2023年第10期1670-1674,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察养正合剂联合滋脾益胃汤对结肠癌放化疗后脾虚痰湿型厌食症患者营养状态及预后的影响。方法将98例结肠癌放化疗后脾虚痰湿型厌食症患者按照随机数字表法分为2组,对照组49例予醋酸甲羟孕酮片治疗,治疗组49例予养正合剂联合滋脾益胃汤治疗,2组均治疗2周。比较2组食欲改善疗效、中医症状改善疗效、卡氏评分疗效;比较2组治疗前后营养状态指标血红蛋白(Hb)、血浆白蛋白(ALB)、转铁蛋白(TRF)、总蛋白(TP)变化;比较2组治疗前后免疫功能指标免疫球蛋白A(IgA)、IgG、IgM变化;比较2组治疗前后胃蛋白酶原Ⅰ(PGⅠ)、PGⅡ、PGⅠ/PGⅡ变化。结果治疗组食欲改善率85.71%(42/49),对照组食欲改善率55.10%(27/49),治疗组食欲改善疗效优于对照组(P<0.05)。治疗组中医症状改善率95.92%(47/49),对照组中医症状改善率75.51%(37/49),治疗组中医症状改善疗效优于对照组(P<0.05)。治疗组卡氏评分改善率77.55%(38/49),对照组卡氏评分改善率44.90%(22/49),治疗组卡氏评分疗效优于对照组(P<0.05)。2组治疗后Hb、ALB、TRF、TP均较本组治疗前升高(P<0.05),治疗后治疗组Hb、ALB、TRF、TP均高于对照组(P<0.05)。2组治疗后IgA、IgG、IgM均较本组治疗前升高(P<0.05),治疗后治疗组IgA、IgG、IgM均高于对照组(P<0.05)。2组治疗后PGⅠ、PGⅠ/PGⅡ均较本组治疗前升高(P<0.05),治疗后治疗组PGⅠ、PGⅠ/PGⅡ均高于对照组(P<0.05)。结论养正合剂联合滋脾益胃汤治疗结肠癌放化疗后脾虚痰湿型厌食症,能改善患者厌食症状,保护胃黏膜,改善营养状态,提高免疫力。Objective To analyze the effect of Yangzheng mixture combined with Zipi Yiwei Decoction on nutritional status and prognosis of colon cancer(CC)patients withpost-(chemo)radiotherapy anorexia of spleen-deficiency and phlegm-dampness type.Methods Totally 98 CC patients with post-(chemo)radiotherapy anorexia(spleen-deficiency and phlegm-dampness type)were randomized 1∶1 to receivemedroxyprogesterone(control group)or Yangzheng mixture combined with Zipi Yiwei Decoction(treatment group)for 2 weeks.The improvement rates of appetite,traditional Chinese medicine(TCM)symptoms,and karnofsky score(KS),nutritional status indicators(hemoglobin[Hb],plasma albumin[ALB],transferrin[TRF],total protein TP]),immune function-related indicators(immunoglobulin A[IgA],immunoglobulin G[IgG],immunoglobulin M[IgM)])and pepsinogens(pepsinogenⅠ[PGⅠ],pepsinogenⅡ[PGⅡ],PGⅠ/PGⅡ)were included as comparisons between groups.Results After treatment,the improvement rate of appetite,TCM symptoms,and KSintreatment group was superior to the control group(85.71%[42/49]vs 55.10%[27/49];95.92%[47/49]vs 75.51%[37/49];77.55%[38/49]vs 44.90%[22/49],all P<0.05,respectively).The levels of Hb,ALB,TRF and TP in the two groups were all improved compared with those before treatment,and the improvementwasmore pronounced in thetreatment group than in the control group(P<0.05).The levels of IgA,IgG and IgM were significantly increased in the both groups compared to before treatment,and the levels intreatment group were significantly higher than those inthe control group(P<0.05).The PGⅠand PGⅠ/PGⅡin both groups were significantlyhigher than those before treatment,and which in the treatmentgroup were more common(P<0.05).Conclusion For CC patients withpost-(chemo)radiotherapy anorexia of spleen-deficiency and phlegm-dampness type,the application of Yangzheng mixture combined with Zipi Yiwei Decoction can improve anorexia symptoms,protect the gastric mucosa,improve the nutritional status,and enhance the immunity.

关 键 词：结肠肿瘤 放化疗 辨证 厌食 中医疗法 

分 类 号：R735.35[医药卫生—肿瘤] R289.6[医药卫生—临床医学]