益气解毒祛瘀方联合间歇内分泌疗法治疗晚期前列腺癌的临床观察

Clinical Efficacy Analysis on Advanced Prostate Cancer By Yiqi Jiedu Quyu Prescription(益气解毒祛瘀方,YQJDQYP) Combined Intermittent Hormone Therapy

目的:观察益气解毒祛瘀方联合间歇内分泌治疗晚期前列腺癌的临床疗效。方法:选择前列腺癌患者49例,根据治疗方式分为治疗组29例和对照组20例,对照组行间歇内分泌治疗(全雄激素阻断),治疗组在对照组基础上加用益气解毒祛瘀方治疗。比较两组发展为去势抵抗性前列腺癌的时间、平均间歇时间、间歇期最低PSA值、生活质量、不良反应(疲乏、潮热、贫血)发生率。结果:截至观察终点,发展为去势抵抗性前列腺癌的患者22例,其中治疗组8例,对照组14例,两组平均转化时间比较,差异有统计学意义(P<0.05)。两组间歇期平均时间比较,差异有统计学意义(P<0.05)。两组第1周期、第2周期间歇期最低PSA值比较,差异无统计学意义(P>0.05),治疗组第三周期、第四周期间歇期间最低PSA值优于对照组,差异有统计学意义(P<0.05)。治疗结束后治疗组情绪功能、总健康水平、中医临床症状评分明显改善,差异有统计学意义(P<0.05)。对照组治疗前后情绪功能下降明显,差异有统计学意义(P<0.05)。两组潮热、贫血发生率比较,差异均有统计学意义(P<0.05),两组疲乏发生率比较,差异无统计学意义(P>0.05)。结论:益气解毒祛瘀方联合间歇内分泌治疗晚期前列腺癌能延长治疗间歇时间、延长发展为去势抵抗性前列腺癌的时间,并且能减轻内分泌治疗的不良反应,起到减毒增效的作用,明显提高患者的生活质量。

Objective： To observe the clinical efficacy of YQJDQYP combined Intermittent Hormone Therapy（IHT） in treating advanced prostate cancer（APC）. Methods： The 49 cases of inpatient or outpatient APC patients were assigned to the treatment group（29 cases） and the control group（20 cases）. All the patients received IHT（Total Androgen Deprivation）, and the treatment group received YQJDQYP on the basis of the control group.The time transferring to castration resistant prostate cancer（CRPC）, the average intermittent time, the lowest PSA value of the interim period, QLQ-C30 scale, Chinese medical symptoms score, as well as the incidence of tidel fever, anemia, and fatigue were observed. Results： By the end of the study, 22 patients transferred into CRPC, in which there were 8 cases from the treatment group and 14 cases from control group; the average transposition time and the conversation rate showed statistical difference between the two groups（P〈0.05）. In the treatment group, the average intermittent time from the first cycle to the forth cycle were improved. Besides,better effects were obtained in the treatment group（P〈0.05）. In the treatment group, the lowest PSA value in the first cycle and second cycle showed no statistical difference between the two groups（P〉0.05）. However, in the third and forth cycle, the lowest PSA value were improved in the treatment group, showing statistical difference between the two groups（P〈0.05）. In terms of quality of life, after the treatment, the emotional function, total health level together with Chinese medical symptoms score were improved in the treatment group, showing statistical difference between the two groups（P〈0.05）. In terms of advise reactions, the incidence of tidel fever,anemia in the treatment group obtained better effects, showing statistical difference between the two groups（P〈0.05）. However the the difference on incidence of fatigue was not statistically significant（P〉0.05）. Conclusion：YQJDQYP combined IHT could obviously prolong the intermittent time of Endocrine Therapy and the transferring time of CRPC, mitigate the advise reactions of Endocrine Therapy, and obviously improve the APC patients＇ QOL.