增髓升白汤联合常规西药治疗原发性肝癌化疗后骨髓抑制脾肾阳虚证疗效观察  

Efficacy of Zengsui Shengbai Decoction combined with conventional Western medicine on post-chemotherapy myelosuppression in patients with primary hepatic carcinoma of spleen-kidney yang deficiency syndrome

作　　者：侯建强 王玉涛 HOU Jianqiang;WANG Yutao(Department of Traditional Chinese Medicine,the Third People's Hospital of Yangquan,Yangquan,Shanxi 045000;Department of Hematology and Oncology,the Third People's Hospital of Yangquan,Yangquan,Shanxi 045000)

机构地区：[1]山西省阳泉市第三人民医院中医科,山西阳泉045000 [2]山西省阳泉市第三人民医院血液肿瘤科,山西阳泉045000

出　　处：《河北中医》2024年第5期717-721,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察增髓升白汤联合常规西药治疗原发性肝癌(PHC)化疗后骨髓抑制脾肾阳虚证的疗效。方法将86例肝动脉化疗栓塞术(TACE)化疗后发生骨髓抑制的PHC脾肾阳虚证患者按照随机数字表法分为2组,对照组43例予常规西药治疗,治疗组43例在对照组基础上予增髓升白汤治疗。2组均治疗至血细胞恢复至正常范围。比较2组白细胞计数(WBC)、血小板计数(PLT)恢复正常时间,治疗前和治疗7天血常规情况[WBC、PLT、血红蛋白(Hgb)、中性粒细胞(N)]、卡氏功能状态评分(KPS)、中医证候评分,并统计中医疗效及临床疗效。结果治疗组中医证候总有效率86.05%(37/43),对照组总有效率67.44%(29/43),治疗组中医证候疗效优于对照组(P<0.05)。治疗组临床总有效率97.67%(42/43),对照组总有效率83.72%(36/43),治疗组临床疗效优于对照组(P<0.05)。治疗组WBC和PLT恢复至正常范围的时间均短于对照组(P<0.05)。2组治疗3、7天WBC、PLT、Hgb、N水平均较本组治疗前及治疗1天升高(P<0.05),治疗7天均较本组治疗3天升高(P<0.05);且治疗组治疗3、7天WBC、PLT、Hgb、N水平均高于对照组同期(P<0.05)。2组治疗7天KPS评分均较本组治疗前升高(P<0.05),且治疗组治疗7天KPS评分高于对照组(P<0.05)。2组治疗7天中医证候各项评分及总分均较本组治疗前降低(P<0.05),且治疗组治疗7天中医证候各项评分及总分均低于对照组(P<0.05)。结论增髓升白汤联合常规西药治疗PHC化疗后骨髓抑制脾肾阳虚证,可有效缩短血细胞恢复正常的时间,改善患者血常规、功能状态以及中医证候,提升临床治疗效果。Objective To investigate the efficacy of Zengsui Shengbai Decoction combined with conventional Western medicine(CWM)on post-chemotherapy myelosuppression in patients with primary hepatic carcinoma(PHC)of spleen-kidney yang deficiency syndrome.Methods Totally 86 patients with PHC(spleen-kidney yang deficiency syndrome)underwent transcatheter arterial chemoembolization(TACE)in our hispital,they had myelosuppression after chemotherapy.The patients were randomly assigned to receive CWM(the treatment group,n=43)or CWM combined with Zengsui Shengbai Decoction(the control group,n=43).The treatment lasted until that the blood cells(white blood cell count[WBC],platelet count[PLT])returned to normal range.The recovery time of blood cells and the blood routine examination including WBC,PLT,hemoglobin(Hgb),neutrophils(N)were compared between the two groups.Karnofsky Performance Status(KPS)and traditional Chinese medicine(TCM)syndrome score were compared,and TCM curative effect and clinical efficacy were assessed.Results The curative effect in the treatment group was significantly better than that in the control group(total effective rate of TCM syndromes:86.05%[37/43]vs 67.44%[29/43],clinical efficacy rate:97.67%[42/43]vs 83.72%[36/43],both P<0.05).The recovery time of WBC and PLT in the treatment group was significantly shorter than that in the control group(P<0.05).The levels of WBC,PLT,Hgb,N in the both groups on days 3 and 7 were significantly higher than those on day 0 and on day 1(P<0.05),and which on day 7 were significantly higher than those on day 3(P<0.05).The levels of WBC,PLT,Hgb,N in the treatment group on days 3 and 7 were significantly higher than those in the control group(P<0.05).On day 7,significantly increased KPS scores and significantly decreased TCM syndrome scores were found in the both groups than those on day 0(all P<0.05),and the treatment group was superior to the control group for KPS and TCM syndrome scores(all P<0.05).Conclusion Zengsui Shengbai Decoction combined with CWM can effectively shorte

关 键 词：原发性肝癌 骨髓抑制 脾肾阳虚证 中药疗法 

分 类 号：R735.7[医药卫生—肿瘤]