独活补骨方联合唑来膦酸治疗恶性肿瘤骨转移的临床观察

Clinical Observation of Duhuo Bugu Decoction Combined with Zoledronic Acid in the Treatment of Malignant Bone Metastasis

目的观察中药独活补骨方联合唑来膦酸治疗恶性肿瘤骨转移的临床疗效。方法选择2014年9月-2016年2月重庆市中医院肿瘤科收治的恶性肿瘤骨转移患者50例,随机分为观察组和对照组,2组均采用唑来膦酸治疗,观察组加用中药独活补骨方口服。观察2组止痛效果、止痛药用量及治疗前后生活质量评分(KPS)变化情况,用ELISA法测定治疗前后尿Ⅰ型胶原氨基末端肽(NTX)、血骨碱性磷酸酶(BALP)。结果观察组治疗后止痛药用量较对照组明显减少(P<0.05),KPS较对照组明显提高(P<0.05),2组治疗后疼痛评分(NRS)变化无显著差异(P>0.05),治疗组治疗后尿NTX、血BALP水平较治疗前降低(P<0.01),但与对照组比较,差异无统计学意义(P>0.05)。结论中药联合唑来膦酸是恶性肿瘤骨转移的有效治疗方式,中药能有效提高止痛效果,减少止痛药用量,提高患者生活质量,对改善肿瘤骨破坏具有协同作用的趋势。

OBJECTIVE To observe the clinical effects of the combination of Duhuo Bugu decoction and zoledronie acid in the treatment of malignant bone metastasis. METHODS Fifty patients with bone metastases of malignant tumor were selected from the Department of oncology, Chongqing Hospital of traditional Chinese medicine from September 2014 to February 2016, and were randomly divided into the observation group and the control group. Two groups were both treated by zoledronic acid, and the observation group was also treated by adding Duhuo Bugu Decoction. Changes of the analgesic effects, analgesic dosages and life quality scores（KPS） of two groups were observed before and after treatment. Urinary type I collagen amino terminal peptide （uNTX） and bone alkaline phosphatase（BALP） were measured via ELISA method before and after treatment. RESULTS Compared with the control group, the analgesic medicinal amount of the observation group reduced significantly（P〈 0.05）, and KPS improved significantly（P 〈0.05）. After the treatment, numerical pain scores（NRS） of two groups had no significant changes（P〉0.05）. After the treatment, uNTX and sBALP level of the treatment group decreased compared with that before treatment （P〈0.01）. While compared with the control group, the difference was not significant（P〉0.05）. CONCLUSION The combination of Chinese herbs and zoledronic acid is an effective therapy for bone metastasis malignant tumors. Chinese herbs can effectively improve the analgesic effect, reduce the analgesic medicinal amount, improve the patients＇ life quality, and have a tendency of synergy in improving the bone destruction caused by tumor.