消痰利水凝胶敷脐联合顺铂腹腔灌注治疗胃癌腹水临床观察

Clinical Observation for Combination of Umbilical Compress Therapy with Xiaotan Lishui Gel and Intraperitoneal Chemotherapy with Cisplatin for Gastric Cancer Ascites

目的观察消痰利水凝胶敷脐联合顺铂腹腔灌注治疗胃癌腹水的临床疗效。方法将78例胃癌腹水患者随机分为治疗组39例和对照组38例。对照组予单纯顺铂腹腔灌注,治疗组加用消痰利水凝胶敷脐,疗程均为2周,随访180 d。观察2组总有效率、无穿刺存活期、穿刺间隔时间、中位生存期、生存质量、症状改善情况和安全性。结果最终73例患者完成观察。治疗组总有效率为56.76%(21/37),对照组为33.33%(12/36),差异有统计学意义(P=0.044)。治疗组无穿刺存活期和穿刺间隔期分别为59、62 d,对照组分别为49、54 d,治疗组明显长于对照组(P<0.05)。2组中位生存期比较未见明显差异。治疗后卡氏评分治疗组明显高于对照组(P=0.012),治疗组对活动性下降、腹痛、腹胀、饱腹感和尿频症状的改善作用优于对照组(P<0.05)。结论消痰利水凝胶敷脐联合顺铂腹腔灌注可延缓胃癌腹水患者腹水增长速度,提高生存质量。

Objective To investigate the clinical efficacy of combination of umbilical compress therapy with Xiaotan Lishui Gel and intraperitoneal chemotherapy with cisplatin in patients with gastric cancer ascites. Methods A total of 78 patients were included and divided randomly into treatment group（39 patients） and control group（38 patients）. Patients of both groups received intraperitoneal chemotherapy with cisplatin, and the treatment group received additionally umbilical compress therapy of Xiaotan Lishui Gel. Two weeks were regarded as a course of treatment. All patients were followed up for 180 days. The total effective rate, puncture-free survival, interval time of puncture, median survival time, life quality, improvement of symptoms and safety of the two groups were observed. Results Finally 73 patients completed the observation. The total effective rate was 56.76%（21/37） in the treatment group and 33.33%（12/36） in the control group, with statistical significance（P=0.044）. The puncture-free survival and interval time of puncture were 59 d and 62 d, respectively, and 49 d and 54 d in the control group, respectively（P〈0.05）. There was no difference in median survival time between the two groups. Karnofsky performance status in the treatment group was significantly higher than the control group（P=0.012）, and decreased mobility, abdominal pain, abdominal distension, early satiety and urinary frequency in the treatment group were better improved than the control group（P〈0.05）. Conclusion Combination of umbilical compress therapy with Xiaotan Lishui Gel and intraperitoneal chemotherapy with cisplatin can postpone the ascites increasing speed of patients with gastric cancer ascites, and improve patients’ life quality.