消瘀散结抑癌灌肠剂治疗晚期前列腺癌的临床研究

Therapeutic Effect of Xiaoyu Sanjie Yi'ai Enema on Advanced Prostate Cancer

【目的】观察中药消瘀散结抑癌灌肠剂治疗晚期前列腺癌的临床疗效。【方法】根据自愿原则,将22例患者分为治疗组(15例)和对照组(7例)。对照组仅给予最大限度雄激素阻断治疗(MAB),治疗组在MAB治疗基础上给予消瘀散结抑癌灌肠剂(由山慈菇、夏枯草、莪术、虎杖、吴茱萸等组成)灌肠,隔天1次,2组疗程均为2个月。观察2组治疗前后前列腺体积、前列腺特异性抗原(PSA)、最大尿流率(MFR)等指标的变化。【结果】(1)在依从性方面,治疗组中有2例因不能耐受灌肠而退出研究,其他20例均获得随访2个月。(2)治疗后2组患者血清PSA水平均明显降低(与治疗前比较,P<0.01),但治疗组的降低作用明显优于对照组(P<0.05)。(3)治疗后2组患者前列腺的体积均有所缩小(与治疗前比较,P<0.05),分别缩小达到26.1%和26.2%。2组治疗后比较,差异无显著性意义(P>0.05),表明2组在缩小前列腺体积方面作用相似。(4)治疗后2组患者的MFR均明显改善(与治疗前比较,P<0.01)。2组治疗后比较,差异有显著性意义(P<0.05),表明治疗组在改善患者最大尿流率方面优于对照组。【结论】中药协同MAB治疗晚期前列腺癌作用优于单用MAB;灌肠给药是个很好的给药途径,可直达病所且副作用少、起效快。

Objective To observe the therapeutic effect of Xiaoyu Sanjie Yi＇ai Enema （XSYE） on advanced prostate cancer. Methods Twenty-two advanced prostate cancer were divided into the treatment group （N = 15） and the control group （N = 7） according to their willing. The control group was given maximal androgen blockade （MAB） , and the treatment group was given eoloclysis with XSYE （mainly composed of Pseudobulbus Cremastrae sen Pleiones, Spiea Prunellae, Rhizoma Curcumae, Rhizoma Polygoni Cuspidati, Fructus Evodiae, etc. ） once on alternate days. The treatment of the two groups lasted 2 months. The changes of prostate size, prostate specific antigen （PSA） level and maximum urine flow rate were observed in the two groups before and after treatment. Results （1） The results of compliance evaluation showed that 2 patients in the treatment group dropped out for intolerance of enema, and the rest 20 patients had a 2-month follow-up. （2） Serum PSA level was decreased in the two groups （P 〈0.01 compared with that before treatment） , and the decrease in the treatment group was obvious （P 〈0. 05 compared with that in the control group）. （3） The prostate size was shrinked in the two groups （P 〈0.05 compared with that before treatment） , and the shrinkage rate was 26. 1% in the treatment group and 26.2% in the control group, the difference being insignificant （P 〉 0. 05 ）. （4） Maximum urine flow rate was improved in the two groups （P 〈0.01 compared with that before treatment）, and the improvement in the treatment group was obvious （P 〈 0. 05 compared with that in the control group）. Conclusion The combination of XSYE and MAB exerts a better effect on advanced prostate cancer than MAB alone, indicating that coloclysis is a good medication way, with less side effects while effect starting quickly.