葶苈甘遂逐水饮联合化疗治疗晚期胃癌合并恶性腹水临床观察

Clillical Observation of Tingli Gansui Zhushui Yin Combined with Chemotherapy on Advanced Gastric Cancer with Malignant Ascites

目的:观察葶苈甘遂逐水饮联合化疗治疗晚期胃癌合并恶性腹水临床疗效及安全性。方法:应用随机平行对照方法,将62例晚期胃癌合并恶性腹水的住院患者,随机分为两组。对照组31例患者应用化疗,治疗组31例患者在化疗基础上,应用葶苈甘遂逐水饮口服。观察比较两组患者的临床疗效、卡式评分、中医证候评分、免疫功能、不良反应。结果:两组临床疗效差异无统计学意义(P>0.05),但治疗周期内,腹水总引流量,治疗组为(5226±1585)m L,显著少于对照组(4128±1238)m L,差异具有统计学意义(P<0.01);治疗组中位生存时间较对照组延长(P<0.01);生活质量比较,与对照组相比,治疗组(60.9%)改善率高于对照组(39.1%),差异显著(P<0.01);两组患者中医证候临床疗效比较治疗组总有效率为67.7%,对照组总有效率为41.9%,差异均具有统计学意义(P<0.01);免疫功能比较,治疗后,治疗组的CD3+、CD4+及CD4+/CD8+值明显高于对照组,差异显著(P<0.01);不良反应比较,治疗后,治疗组恶心呕吐及乏力的发生率明显低于对照组(P<0.05)。结论:葶苈甘遂逐水饮联合化疗治疗晚期胃癌合并恶性腹水方面疗效可靠,减轻患者化疗副作用,改善中医证候,提高患者免疫功能,提升生活质量。

Objective：To investigate the efficacy and safety of Tingli Gansui Zhushui Yin combined with chemotherapy for advanced gastric cancer with malignant ascites. Methods：62 cases of advanced gastric cancer with malignant ascites patients were divided into treatment group and control group. The control group（n=31）was treated with chemotherapy. The treatment group（n=31）received Tingli Gansui Zhushui Yin based oncontrol group treatment. Compared with the recent curative effect of pleural effusion in two groups,Karnofsky score（KPS score）,the TCM syndrome,T cell subgroup distribution（CD3＋ CD4＋ CD4＋/CD8＋）and adverse reactions were observed before and after treatment. Results：Compared with the curative effect of two groups,the difference was not statistically significant clinical effect（P0.05）. Within the treatment period,the total drainage of ascites,the treatment group（5226±1585）m L,significantly less than the control group（4128±1238）m L,the difference statistically significant（P0.01）. Longer median OS（P0.01）. The quality of life improving rate in obsen,ation group was 60.9%,which was better than that 39.1% in the control group（P0.01）.In the TCM syndrome,the treatment group（67.7%）was superior to those in the contorl group（41.9%）,there were significant differences（P0.01）,the levels of T cell subgroup distribution（CD3＋,CD4＋及CD4＋/CD8＋）after treatment in observation group were significantly higher than those in control group（P0.05）. The nausea,vomiting and fatigue of treatment group was significantly lower than the control group（P0.05）. Conclusion：Tingli Gansui Zhushui Yin combined with chemotherapy in advanced gastric cancer with malignant ascites reduce side effects of chemotherapy patients,improving traditional Chinese medicine syndrome,improve immune function in patients,improve quality of life.