扶正和胃合剂治疗化疗所致迟发性恶心呕吐的疗效及分析  

Efficacy and Analysis of Fuzheng Hewei Mixture on Chemotherapy-Induced Delayed Nausea and Vomiting

作　　者：孙云芸 张卫东[1] 张军[1] 王敦英[1] 侍晓辰[1] SUN Yunyun;ZHANG Weidong;ZHANG Jun;WANG Dunying;SHI Xiaochen(Department of Thyroid and Breast,Wuxi Hospital of Traditional Chinese Medicine,Wuxi 214000,China)

机构地区：[1]无锡市中医医院甲乳科,江苏无锡214000

出　　处：《中医药学报》2024年第1期64-69,共6页Acta Chinese Medicine and Pharmacology

基　　金：2021年度无锡市中医医院院内课题(ZYYYB21011)。

摘　　要：目的:观察扶正和胃合剂三联法预防及治疗乳腺癌化疗所致迟发性恶心呕吐的疗效,及其对血清五羟色胺(5-HT)浓度的影响。方法:选取2021年5月—2022年10月收入无锡市中医医院并给予高致吐化疗方案治疗的女性乳腺癌患者60例,采用随机数字表法分为试验组30例,对照组30例,其中试验组口服昂丹司琼、地塞米松及扶正和胃合剂三联法干预止吐治疗,对照组口服昂丹司琼、地塞米松干预止吐治疗。观察两组恶心呕吐情况、填写中医症候积分量表,并采用ELISA法检测化疗前、化疗24 h后、化疗120 h后血清5-HT浓度。结果:试验组治疗迟发性恶心呕吐有效率高于对照组(P<0.05)。化疗后24 h、化疗后120 h,试验组中医症候评分均小于对照组,差异有统计学差异(P<0.01)。提示试验组获得了更好的止吐效果。急性呕吐期试验组血清5-HT浓度差大于对照组,差异有统计学意义(P<0.01),提示试验组可增强急性呕吐期5-HT受体拮抗剂的阻断作用。化疗后试验组及对照组血清白蛋白水平均较化疗前有所下降(P<0.05),但化疗后试验组血清白蛋白高于对照组,差异有统计学意义(P<0.05)。两组化疗前后血清丙氨酸氨基转移酶及谷草转氨酶变化无显著性差异(P>0.05),提示扶正和胃合剂三联法治疗化疗后恶心呕吐,减少了呕吐及化疗引起的营养流失,且无明显肝损害的副反应。结论:中药扶正和胃合剂三联法治疗乳腺癌高致吐方案化疗所致迟发性恶心呕吐安全、有效、方便,在急性期增强了5-HT受体拮抗剂的阻断作用,协同昂丹司琼可达到更好的止吐效果。Objective:To observe the efficacy of three drug combination therapy containing Fuzheng Hewei mixture(FHM)in preventing and treating delayed nausea and vomiting caused by chemotherapy for breast cancer,and its effect on serum serotonin(5-HT)concentration.Methods:Sixty female patients with breast cancer who were admitted to Wuxi Traditional Chinese Medicine Hospital from May 2021 to October 2022 and were treated with hyperemetic chemotherapy scheme were selected.The patients were randomly divided into an experimental group(n=30)and a control group(n=30).The experimental group received oral intervention with ondansetron,dexamethasone,and FHM as three drug combination therapy,while the control group received oral intervention with ondansetron and dexamethasone.Nausea and vomiting were observed in the two groups,Traditional Chinese Medicine Syndrome Score Scale were filled up,and serum 5-HT concentration was measured by ELISA before chemotherapy,24 hours after chemotherapy,and 120 hours after chemotherapy.Results:The effective rate of treating delayed nausea and vomiting in the experimental group is higher than that in the control group(P<0.05).After 24 hours of and 120 hours of chemotherapy,the TCM symptom scores of the experimental group were lower than those of the control group,with statistical differences(P<0.05).This indicated that the experimental group had better treatment effects.The difference in serum 5-HT concentration between the experimental group and the control group during the acute vomiting period was statistically significant(P<0.05),indicating that the experimental group can enhance the blocking effect of 5-HT receptor antagonists during the acute vomiting period.After chemotherapy,the serum albumin levels in both the experimental and control groups decreased compared to before chemotherapy(P<0.05),but after chemotherapy,the serum albumin levels in the experimental group were higher than those in the control group,with a statistically significant difference(P<0.05).There was no significant differen

关 键 词：扶正和胃合剂 乳腺癌 化疗 恶心 呕吐 5-HT 

分 类 号：R256.31[医药卫生—中医内科学]