芪凌方联合中医针灸治疗前列腺癌骨转移的临床研究

Clinical efficiency of herb preparation oiling combined with traditional Chinese medicine acupuncture and moxibustion in the treatment of bone metastasis of prostate cancer

目的观察芪凌方联合中医针灸治疗晚期前列腺癌骨转移的临床效果。方法将70例晚期前列腺癌骨转移患者随机分为治疗组(35例)和对照组(35例)。所有患者均给予全雄激素阻断治疗,即手术或药物去势加用类固醇类抗雄激素药物治疗,治疗组在上述基础治疗的同时给予中药组方芪凌方口服联合传统中医针灸治疗,对照组采用现代化学止痛药物治疗。治疗周期为3个月。根据患者血清前列腺特异性抗原(PSA)水平,评价两组患者的临床疗效;检测并比较两组患者的血清碱性磷酸酶(ALP)水平;采用疼痛数字评分法(NRS)评定患者的骨转移疼痛情况;采用欧洲癌症治疗研究组织(EORTC)制定的生存质量调查表(EORTC-QLQ)中C30和PR25子量表评定患者的生存质量。结果 (1)临床疗效:治疗组和对照组的总有效率分别为31.4%和25.7%,两组临床疗效比较,其差异无统计学意义(P>0.05)。(2)ALP水平:治疗后,对照组患者的血清ALP水平明显升高(P<0.05),且显著高于治疗组(P<0.05)。(3)疼痛NRS评分:治疗后,两组患者的疼痛NRS评分较治疗前均显著降低(P<0.05),但两组患者的疼痛NRS评分比较,差异则无统计学意义(P>0.05);(4)EORTC-QLQ C30子量表评分:治疗后,治疗组患者的疲乏、疼痛维度评分较治疗前显著降低(P<0.05),经济困难、躯体功能、情绪功能、总体健康状况维度评分显著升高(P<0.05);对照组患者的疼痛维度评分显著降低(P<0.05),经济困难、情绪功能、总体健康状况维度评分显著升高(P<0.05);治疗组患者的疲乏、恶心呕吐、失眠维度评分显著低于对照组(P <0.05),躯体功能、总体健康状况维度评分高于对照组(P <0.05);(5)EORTC-QLQ PR25子量表评分:治疗后,两组患者的排尿症状维度评分均显著降低(P <0.05),治疗相关症状维度评分显著升高(P<0.05),且治疗组患者的排尿症状维度评分低于对照组(P<0.05)。结论芪凌方联合中医针灸辅助治疗晚期前列腺癌骨转移患者,可以改善患者血清指标(PSA、ALP)并减轻骨转移相关的疼痛,提高患者的生存质量,改善其临床症状。

Objective Observation on the clinical effect of Chinese Herba Preparation Qiling combined with traditional Chinese medicine acupuncture and moxibustion on bone metastasis of advanced prostate cancer.Methods Sixty- five patients with advanced prostate cancer were randomly divided into treatment group (35cases)and control group (35 cases).All patients were given full androgen block therapy,that is,surgery or drug castration plus steroid anti-androgen therapy,the treatment group in the above-mentioned basic treatment at the same time to give Chinese Herba Preparation Qiling combined with traditional Chinese medicine acupuncture treatment,the control group Modern chemical pain medication.The treatment period is 3months.The clinical efficacy of the two groups was evaluated according to the serum prostate specific antigen (PSA)level;to detect and compare the serum alkaline phosphatase (ALP)levels in both groups;to assess the bone metastatic pain in patients using the Numeric Rating Scale (NRS);the European Cancer Treatment Research Organization (EORTC)The quality of life of the patients was assessed by the C30 and PR25 subscales in the Quality of Life Inventory (EORTC-QLQ).Results (1)The clinical efficacy:the total effective rate of the treatment group and the control group were 31.4%and 25.7%,the two groups of clinical efficacy,the difference was not statistically significant (P>0.05). (2)ALP level:After treatment,serum ALP levels in the control group were significantly higher (P<0.05),and significantly higher than the treatment group (P<0.05).(3)NRS pain score:After treatment,the two groups of patients with NRS pain score were significantly lower than before treatment (P<0.05),but the two groups of patients with NRS pain score,the difference was not statistically significant (P>0.05).(4)EORTC-QLQ C30subscale scale:After treatment,the fatigue and pain dimensions of the treatment group were significantly lower than those before treatment (P<0.05).The scores of economic difficulties,physical function,emotional function and overall health status were significantly increased (P<0.05). The scores of dyspnea,nausea and vomiting were significantly higher in the treatment group than in the control group (P<0.05) (P<0.05).The scores of somatic function and overall health status were significantly higher than those of the control group (P<0.05).(5)EORTC-QLQ PR25Subscale Score:After treatment,the scores of dysuria in both groups were significantly decreased (P<0.05),the treatment-related symptom score was significantly increased (P<0.05),and the treatment group of patients with urinary symptoms The score was lower than that of the control group (P<0.05).Conclusion Chinese Herba Preparation Qiling combination of traditional Chinese medicine acupuncture and moxibustion treatment of advanced prostate cancer patients with bone metastases,can significantly lower the prostate-specific antigen and alkaline phosphates level, relieve the bone metastatic pain,improve the quality of life of patients to improve their clinical symptoms.