基于癌毒-态靶理论消癌解毒类靶方治疗老年弥漫大B细胞淋巴瘤疗效观察  

Efficacy of target decoctions for resolving cancer and removing toxin on diffuse large B-cell lymphoma in elderly based on the theory of cancer toxin-state target

作　　者：孙剑声 白洁 凌冰莹 巩明霞 孔祥图[1] 倪海雯[1] 于慧[1] SUN Jiansheng;BAI Jie;LING Bingying;GONG Mingxia;KONG Xiangtu;NI Haiwen;YU Hui(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China;The First School of Clinical Medicine of Nanjing University of Chinese Medicine,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学第一临床医学院,江苏南京210029

出　　处：《现代中西医结合杂志》2024年第16期2233-2237,2243,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家中医药管理局第四批全国中医优秀人才研修项目(国中医药办人教函[2017]24号);江苏省中医药管理局课题(YB2017014);江苏省卫生健康委重点项目(ZD 2021040)。

摘　　要：目的基于癌毒-态靶理论探讨消癌解毒类靶方和淋巴瘤中医证候量表在初诊老年弥漫大B细胞淋巴瘤免疫化疗期的临床应用价值。方法选取2022年8月—2023年8月在南京中医药大学附属医院及江苏省人民医院初诊的老年弥漫大B细胞淋巴瘤患者60例作为研究对象,采用简单随机化法将患者分为治疗组和对照组,每组30例。对照组采用R-CHOP方案化疗,治疗组采用R-CHOP方案化疗联合消癌解毒类靶方口服,2组均以21 d为1个化疗周期,治疗4个化疗周期。观察比较2组治疗前后淋巴瘤中医证候量表中单项症状评分及证候总积分、中文版欧洲癌症研究与治疗协会生活质量调查问卷(EORTC-QLQ-C30)评分及治疗4个化疗周期后的临床疗效、中医证候疗效和治疗期间不良反应发生情况。结果治疗组28例、对照组29例完成研究。治疗后,治疗组皮下肿块、神疲乏力、痛有定处、盗汗、纳差、便秘评分及证候总积分均明显低于对照组(P均<0.05);治疗后2组EORTC-QLQ-C30量表中躯体功能、角色功能、社会功能、情绪功能、认知功能评分均较治疗前明显升高(P均<0.05),且治疗组躯体功能、角色功能、情绪功能评分均明显高于对照组(P均<0.05)。治疗组客观缓解率为85.7%(24/28),对照组为72.4%(21/29),2组比较差异无统计学意义(P>0.05);治疗组中医证候总有效率明显高于对照组[92.9%(26/28)比27.6%(8/29),P<0.05]。治疗组胃肠道反应发生率明显低于对照组[10.7%(3/28)比34.5%(10/29),P<0.05]。结论消癌解毒类靶方联合免疫化疗可明显改善初诊老年弥漫大B细胞淋巴瘤能患者的中医证候,提高患者生活质量,减轻化疗胃肠道反应,基于癌毒理论的中医证候量表应用于老年弥漫大B细胞淋巴瘤中医药干预的疗效评价具有临床实际意义。Objective It is to explore the clinical application value of lymphoma traditional Chinese medicine(TCM)syndrome scale and target decoctions for resolving cancer and removing toxin in the immunochemotherapy period of newly diagnosed elderly diffuse large B-cell lymphoma based on the theory of cancer toxin-state target.Methods Sixty newly diagnosed elderly diffuse large B-cell lymphoma patients at Affiliated Hospital of Nanjing University of Chinese Medicine and Jiangsu Province Hospital from August 2022 to August 2023 were selected as the study subjects.The patients were randomized into treatment group and control group,with 30 cases in each group.The control group was treated with R-CHOP regimen chemotherapy only,while the treatment group was treated with R-CHOP regimen combined with target decoctions for resolving cancer and removing toxin.21d as 1 chemotherapy cycle,and both groups were treated for 4 chemotherapy cycles.The scores of single symptom and total syndrome scores of lymphoma TCM syndrome scale,the scores of EORTC-QLQ-C30 before and after treatment,the clinical efficacy and TCM syndrome efficacy after 4 chemotherapy cycles and the occurrence of adverse reactions during the treatment period in the two groups were observed and compared.Results Twenty-eight cases in the treatment group and 29 cases in the control group completed the study.After treatment,the scores of subcutaneous mass,fatigue,pain in a fixed place,night sweating,poor appetite,constipation,and total syndrome scores of of the treatment group were significantly lower than those of the control group(all P<0.05);the scores of somatic function,role function,social function,emotional function,and cognitive function in the EORTC-QLQ-C30 scale of the two groups after treatment were significantly higher than those before treatment(all P<0.05),and the scores of somatic function,role function,and emotional function of the treatment group were significantly higher than those of the control group(all P<0.05).The objective remission rate was 85.7%(24/

关 键 词：老年弥漫大B细胞淋巴瘤 癌毒-态靶理论 消癌解毒类靶方 

分 类 号：R733.4[医药卫生—肿瘤]