扶正消水汤治疗脾肾阳虚型恶性腹腔积液的临床研究  

Clinical Research on Fuzheng Xiaoshui Decoction in the Treatment of Malignant Peritoneal Effusion of Spleen-Kidney Yang Deficiency Syndrome

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作  者:邹善思 张亚玲[1] 万姜维[1] 郑玉玲[1] ZOU Shansi;ZHANG Yaling;WAN Jiangwei;ZHENG Yuling(Department of Oncology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450099 Henan,China)

机构地区:[1]河南中医药大学第一附属医院肿瘤科,河南郑州450099

出  处:《中医肿瘤学杂志》2025年第2期9-16,共8页Journal of Oncology in Chinese Medicine

基  金:河南省中医药科学研究基地专项项目(编号:2019JDZX2073);国家中医药管理局中医药传承与创新“百千万”人才工程项目(岐黄工程)(国中医药人教函〔2018〕284号);河南省第二批中医药青苗人才培养项目(豫卫中医函〔2021〕16号)。

摘  要:目的评价扶正消水汤治疗脾肾阳虚型恶性腹腔积液(malignant peritoneal effusion,MPE)的临床疗效。方法纳入120例患者,随机分为治疗A组、治疗B组、对照组各40例。治疗A组给予扶正消水方联合腹腔热灌注化疗;治疗B组给予扶正消水方;对照组给予腹腔热灌注化疗,疗程42天。比较三组患者治疗后临床疗效、卡氏功能状态(Karnofsky performance status,KPS)评分、中医证候疗效,并进行安全性评价。结果最终纳入治疗A组患者32例,治疗B组患者33例,对照组患者32例。治疗后腹腔积液总有效率为治疗A组59.38%,治疗B组42.42%,对照组34.38%(P>0.05),两两比较,治疗A组疗效优于对照组(P<0.05)。KPS评分方面,治疗A组和治疗B组患者治疗后较本组治疗前均提高(P<0.05);与治疗A组相比,治疗B组、对照组KPS评分降低,差异有统计学意义(P<0.05)。中医证候疗效方面,治疗A组优于对照组(P<0.05)。治疗前后各症状比较,治疗A组除腹部包块、发热症状外,其余症状评分治疗后均降低,优于治疗B组、对照组。治疗后三组均未见严重并发症。结论扶正消水方单用或联合腹腔热灌注治疗恶性腹腔积液在减少腹腔积液、改善患者功能状态、降低中医证候积分方面均有一定疗效,且安全性良好。Objective To evaluate the clinical efficacy of Fuzheng Xiaoshui Decoction in the treatment of malignant peritoneal effusion(MPE)of spleen-kidney yang deficiency syndrome.Methods A total of 120 patients were included and randomly allocated into treatment group A,treatment group B,and control group,each comprising 40 patients.Treatment group A was administered Fuzheng Xiaoshui Decoction alongside hyperthermic intraperitoneal chemotherapy(HIPEC),treatment group B received solely Fuzheng Xiaoshui Decoction,and the control group was treated with HIPEC alone over a 42-day period.The clinical outcomes,Karnofsky performance status(KPS)scores,and efficacy in alleviating traditional Chinese medicine(TCM)syndromes across the groups were compared,alongside a safety assessment.Results The efficacy rates of ascites management after treatment were 59.38%in treatment group A,42.42%in treatment group B,and 34.38%in the control group(P>0.05).Pairwise comparison showed that treatment group A exhibited a significantly higher efficacy rate than the control group(P<0.05).KPS scores improved post-treatment in both treatment group A and B(P<0.05),whereas treatment group B and the control group experienced declines in KPS scores compared with treatment group A,with significant statistical differences(P<0.05).Treatment group A also demonstrated superior TCM syndrome efficacy over the control group.After treatment,treatment group A showed reductions in all symptoms except for abdominal mass and fever,outperforming both treatment group B and the control group.After treatment,no serious complications were observed in three groups.Conclusion Fuzheng Xiaoshui Decoction,either as a standalone treatment or in conjunction with HIPEC,exhibits notable efficacy in reducing peritoneal effusion,improving patients’functional status,and diminishing TCM syndrome scores among patients suffering from MPE,and has good safety.

关 键 词:中医药 恶性腹腔积液 脾肾阳虚 扶正消水汤 临床研究 

分 类 号:R273[医药卫生—中西医结合] R730.6[医药卫生—中医肿瘤科]

 

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