不同治则组方治疗化疗白细胞减少临床疗效差异性研究

Differential Study on Different Therapeutic Principles and Formulas in Treating Chemotherapy Leukopenia

目的 :探讨益气养血、补肾益精及健脾补肾三种治则组方在防治化疗白细胞减少中的差异及合理应用。方法 :160例肿瘤患者随机分为4组,根据患者病情给予规律化疗,空白组、补肾益精组、益气养血组及健脾补肾组在化疗同期分别口服不同中药汤剂;各组患者在化疗第1天及第7天检查血细胞分析患者白细胞变化情况;各组患者在第1周期化疗第1天及第2周期化疗第7天检测血清G-CSF及IL-3水平。结果:在维持白细胞计数水平、刺激G-CSF分泌、IL-3分泌方面,空白组与补肾益精组、益气养血组、健脾补肾组比较,差异有统计学意义(P<0.05),补肾益精组与益气养血组比较(P<0.05),补肾益精组与健脾补肾组比较(P>0.05),益气养血组与健脾补肾组比较(P>0.05),补肾益精组效果较好,健脾补肾组次之,益气养血组最次,三组与空白组比较均具有明显的升高白细胞,刺激G-CSF、IL-3分泌作用。结论:不同治疗原则组方均可减轻化疗白细胞减少,以补肾益精为原则组方疗效更好。

Objective：To discusses the difference and reasonable application of three therapeutic principles in the treatment of chemotherapy leukopenia which were enriching Qi and blood,nourishing kidney essence,invigorating the spleen and kidney. Methods：Total 160 patients with tumors were randomly divided into four groups：blank group,group of nourishing kidney essence,group of enriching Qi and blood and group of invigorating the spleen and kidney,given different oral Chinese prescriptions during the same period of regular chemotherapy,checked blood cell analysis on the 1st and 7th day of chemotherapy and recorded the value of patients＇ white blood cells,checked and recorded the value of serum G-CSF and IL-3 on the 1st day of the 1st chemotherapy cycle and the 7th day of the 2nd chemotherapy cycle. Results：In terms of maintaining the white blood cell count,stimulating the secretion of G-CSF and IL-3 secretion,there were statistical significances between the three treatment groups and the blank group（P〈 0.05）. The three groups could obviously elevate white blood cell count,stimulate the secretion of G-CSF and IL-3 secretion,compared between the group of nourishing kidney essence and the group of enriching Qi and blood（P〈0.05）,between the group of nourishing kidney essence and the group of invigorating the spleen and kidney（P〉 0.05）,between the group of enriching Qi and blood and the group of invigorating the spleen and kidney（P 〉0.05）.The group of nourishing kidney essence had the best effect,followed by the group of invigorating the spleen and kidney and the group of enriching Qi and blood. Conclusion：All the three different therapeutic principles and ratios of Chinese formulas could alleviate chemotherapy leukopenia,restore hematopoietic function of marrow,the group of nourishing kidney essence might have better curative effect in terms of treatment of chemotherapy leukopenia.