华蟾素联合卡介菌多糖核酸或顺铂腔内注射治疗恶性胸腹腔积液

Intracavitary infusion of Huachansu injection combined with polysaccharide nucleic acid fraction of Bacillus Calmette Guérin(BCG-PSN) or cisplatin in the treatment of malignant pleural and peritoneal effusions

目的：探讨华蟾素联合卡介菌多糖核酸（polysaccharide nucleic acid fraction of Bacillus Calmette Gu6rin for injection，BCG-PSN）或顺铂行腔内注射治疗恶性胸腹腔积液的疗效。方法：将70例恶性胸腹腔积液患者随机分为2组，试验组35例抽取胸腹腔积液后腔内灌注华蟾素20mL和卡介菌多糖核酸18mL；对照组35例采用华蟾素20mL和顺铂60mg腔内灌注。每周1次，连续2～4周后，进行疗效对比研究。结果：试验组24例恶性胸腔积液有效率为83．3％，11例恶性腹腔积液有效率为63.6％，试验组治疗恶性胸腹腔积液总有效率为77．1％；KPS评分提高26例，稳定7例，降低2例。对照组22例恶性胸腔积液有效率为86．4％，13例恶性腹腔积液有效率为69．2％，对照组治疗恶性胸腹腔积液总有效率80．0％；KPS评分提高16例，稳定11例，降低8例。2组疗效比较差异无统计学意义（P〉0．05），但试验组不良反应更小，生活质量改善更显著（P〈0．05）。结论：华蟾素联合卡介菌多糖核酸或顺铂腔内注射治疗恶性胸腹腔积液均有效，而华蟾素联合卡介菌多糖核酸不良反应更小，尤其适合治疗晚期不能耐受腔内化疗的患者。

Objective：To study the effect of intracavitary infusion of Huachansu injection combined with polysaccharide nucleic acid fraction of Bacillus Calmette Guérin （BCG-PSN） or cisplatin in the treatment of the malignant pleural and peritoneal effusions. Methods. Seventy patients were randomly divided into two groups. Patients in the treatment group （ n = 35） were intracavitarily infused with 20 mL of Huachansu injection and 18 mL of BCG-PSN; patients in the control group （ n = 35 ） were intracavitafily infused with 20 mL of Huachansu injection and 60 mg of cisplatin once a week and the treatment lasted for 2- 4 weeks. Results ： For the treatment group, the response rate （ complete response ＋ partial response） was 83.3% in 24 cases with malignant pleural effusion and 63.6% in 11 cases with malignant peritoneal effusion. The total response rate was 77.1% （27/35） in the treatment group. The KPS score was elevated in 26 cases, stable in 7 cases, and decreased in 2 cases. For the control group, the response rate （complete response ＋ partial response） was 86.4% in 22 cases with malignant pleural effusion and 69.2% in 13 cases with malignant peritoneal effusion. The total response rate was 80.0 % （28/35）. The KPS score was increased in 16 cases, stable in 11 cases, and decreased in 8 cases. There was no significant difference in clinical efficacy between the two groups （ P 〉 0.05 ）. Patients in the treatment group had less adverse reaction and a more improved living quality than those in the control group （ P 〈 0.05 ）. Conclusion： Intracavitary infusion of Huachansu injection com- bined with BCG-PSN or cisplatin was effective in the treatment of malignant pleural and peritoneal effusions, but Huachansu injection plus BCG-PSN had less toxicity especially for the advanced patients who can not tolerate the intracavitary chemotherapy.