温阳消水方治疗癌性腹水的临床观察及机制研究

Clinical observation and mechanism research of Wenyang Xiaoshui Formula on malignant ascites

目的:探讨温阳消水方对癌性腹水的治疗效果及作用机制。方法:选择北京中医药大学第三附属医院肿瘤科符合纳入标准的60例癌性腹水患者,按照随机数字表法分为空白组、对照组、治疗组。治疗组每日外敷温阳消水方4-6h,对照组给予托拉塞米入壶20mg/d,空白组不利尿且不外用中药。3组于治疗前、第2周治疗结束后,分别测定平脐腹围、临床症状评分、KPS评分、不良反应评价、血癌胚抗原(CEA)、γ-干扰素(IFN-γ)、白介素-4(IL-4)及血管内皮生长因子(VEGF)。结果:与空白组比较,治疗组及对照组治疗前后的IFN-γ、IL-4表达水平有统计学意义(P<0.05)。而VEGF及CEA治疗前后无差异。与空白组比较,治疗组和对照组平脐腹围、临床症状评分、KPS评分差异有统计学意义(P<0.05),且不良反应评价相对安全。结论:温阳消水方外敷后在缓解癌性腹水方面,与西药利尿剂临床疗效相当,同时可以减少因反复利尿造成患者耐药情况及电解质紊乱的风险,提高癌性腹水患者的生活质量。

Objective： To explore the effects and mechanism of Wenyang Xiaoshui Formula（WXF） on malignant ascites. Methods： Sixty malignant ascites patients in accordance with the inclusion criteria standard from the Oncology Department of Beijing University of Chinese Medicine Third Affiliated Hospital, who were divided into a blank group, a control group and a treatment group by the random number table method. The treatment group was treated with external application of WXF for 4 to 6h a day, and the control group was treated with 20mg/d of Torasemide into the pot, while there was no treatment for the blank group. The abdominal circumference, clinical symptom scores, KPS score, evaluation of adverse reaction, blood CEA, IFN-γ, IL-4 and VEGF were detected before the treatment and two weeks after the treatment, respectively. Results： Compared with blank group, the levels of the IFN-γ and IL-4 before and after treatment in the treatment group and the control group were statistically significant（P〈0.05）, while the levels of VEGF and CEA had no significant difference. Compared with blank group, the abdominal circumference, clinical symptom scores and KPS score in the control group and treatment group were statistically significant（P〈0.05）, and adverse reactions were relatively safety. Conclusion： The external application of WXF has a quite clinical effect on relieving malignant ascites with diuretic, meanwhile it could reduce the adverse reaction caused by repeated diuretic resistance condition and the risk of electrolyte disorder, as well as improve the quality of life of patients with malignant ascites.