加味十枣膏外敷联合西医治疗癌性腹水随机平行对照研究

A Random Parallel Control Study on the Treatment of Malignant Ascites by Flavored Ten Dates Plaster for External Application Combining With Western Medicine

[目的]观察加味十枣膏外敷联合西医治疗癌性腹水疗效。[方法]使用随机平行对照方法,将61例住院患者按就诊顺序随机分两组。对照组30例腹腔穿刺抽取腹水;呋塞米20mg,qd;螺内酯20mg,bid。治疗组31例加味十枣膏(芫花、甘遂、大戟、生大黄、甘草、姜黄、槟榔、大枣等),以脐为中心外敷,外用腹带固定,每天换药;西医治疗同对照组。连续治疗2周为1疗程。观测临床症状、KPS评分、腹水最大液平直径、腹围、腹胀、呕吐、不良反应。治疗1疗程,随访4周,判定疗效。[结果]治疗组CR11例,PR18例,SD1例,PD1例,总有效率93.54%;对照组CR4例,PR17例,SD4例,PD5例,总有效率70.00%;治疗组疗效优于对照组(P<0.05)。腹水最大液平直径、腹围、KPS评分两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]加味十枣膏外敷联合西医治疗癌性腹水,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the curative effect of treating malignant ascites by flavored ten dates plaster for external application combining with western medicine. [Methods] 61 patients in hospital were randomly divided into two groups in the order of seeing doctors by random parallel control method. 30 patients in control group made the extraction of ascites by conventional puncture, taking furosemide 20mg qd （once a day） and spirolaetone 20mg bid （twice a day）. 31 patients in treatment group had external application of flavored ten dates plaster （Daphne genkwa, Euphorbia kansui, Euphorbia pekinensis, Raw rhubarb, Liquorice, Turmeric, Areea catechu, Chinese Dates, etc.） being centered on umbilicus, fixed by external bellyband and changed daily; the treatment of western medicine in treatment group was the same as the treatment in control group. Two weeks of continuous treatment was as a course of treatment. Clinical symptoms, KPS score, the max diameter of ascites plane, abdominal girth, bloating degree, vomiting degree and adverse reaction were observed. The curative effect was determined after a course of treatment. [Results] In treatment group, there were 11 patients of complete response （CR）, 18 patients of partial response （PR） and 1 patient of stable disease （SD）, and the total effective rate was 93.54%. In control group, there were 4 patients of complete response （CR）, 17 patients of partial response （PR）, 4 patients of stable disease （SD） and 5 patients of progressive disease （PD）, and the total effective rate was 70.00%. The curative effect in treatment group was better than that in control group （P〈0.05）. The improvement in the max diameter of aseites plane, abdominal girth and KPS score in treatment group was better than that in control group （P〈0.01）. [Conclusion] The treatment of malignant aseites by flavored ten dates plaster for external application combining with western medicine has satisfactory curative effect, has no serious adverse reaction and is worth promoting.