调胃醒脾方加减改善晚期癌症患者恶病质症状的临床疗效观察

Clinical Observation on Tiaowei Xinpi Decoctionto in Improving the Symptoms of Cachexia in Patients With Advanced Cancer

目的:评价调胃醒脾方改善晚期癌症恶病质症状的临床疗效。方法:采用随机对照的临床试验方法,将符合入组标准的63例患者随机分为治疗组(32例)与对照组(31例)。治疗组予调胃醒脾方治疗。对照组予醋酸甲地孕酮分散片治疗。2组病例以1周为1个治疗周期。共治疗2个周期。观察2组患者治疗前、结束治疗后第1天及结束治疗后第15天的中医症状积分变化。结果:治疗后第1天与治疗后第15天分别与治疗前2组间中医各症状得分的差值相比较,经秩和检验,消瘦、气短、乏力P>0.05,无统计学意义,说明治疗组与对照组对此3项的改善均有积极效果。而纳差、腹胀方面均有P<0.05,具有统计学意义,治疗组症状积分的下降比对照组更明显,可以认为治疗组在改善患者的纳差、腹胀方面均优于对照组。结论:在改善患者中医证候积分方面,无论是短期疗效还是长期疗效,调胃醒脾方均优于醋酸甲地孕酮;无论在短期疗效还是长期疗效中,调胃醒脾方在改善患者中医症状积分方面,对纳差、腹胀症状的改善均优于醋酸甲地孕酮。

Objective： To evaluate the clinical efficacy of Tiaowei Xinpi decoction in improving the symptoms of advanced cancer cachexia. Methods： A randomized controlled clinical trial was conducted. Sixty-three patients meet the entry criteria were randomly divided into treatment group（ 32 cases） and control group（ 31 cases）. The treatment group received Tiaowei Xinpi decoction and the control group received megestrol acetate tablet. Each group takes one week as a treatment session and was treated for 2 sessions. Observe the TCM symptom score in the day before treatment,the first day and fifteenth day after treatment. Results： After 1day and 15 day of treatment,the difference between the two groups in TCM symptom score in weight loss,shortness of breath,and weakness before and after treatment have no statistically significant difference（ P〉0. 05）,which indicated that both the drugs in the treatment group and the control group have a positive effect on improving these symptoms. However,there are significant difference in the improvement of anorexia and abdominal distension（ P〉0. 05）,and the TCM symptom score in treatment group decreased more significantly than that of the control group,indicating that the treatment group drug can achieve more obvious effect in improving anorexia and abdominal distention. Conclusion： In the improvement of TCM syndrome,and as regard to either short-term efficacy or long-term efficacy,Tiaowei Xinpi decoction was better than megestrol acetate. Also,both in the short-term efficacy or long-term efficacy,Tiaowei Xinpi Decoction achieve more obvious effect in improving TCM symptoms of anorexia,abdominal distension than megestrol acetate.