补阳还五汤对气虚血瘀型肺癌患者血液高凝状态的影响

Effects of Buyanghuanwu decoction on blood hypercoagulability in lung cancer patients with Qi deficiency and blood stasis

目的:探讨补阳还五汤对气虚血瘀型肺癌患者血液高凝状态的影响。方法:将60例气虚血瘀型肺癌患者分为观察组和对照组。对照组采用常规营养支持治疗。观察组在对照组基础上,给予补阳还五汤治疗。采用卡式评分(KPS评分)评估患者的生存质量的变化;采用中医症状评分评估患者的中医症状疗效;检测两组患者治疗前后血液流变学指标(全血黏度、血浆黏度、红细胞压积、纤维蛋白原、血小板)的水平;检测两组患者治疗前及治疗后7、14、28 d的血清组织型纤溶酶原激活物(tissue plasminogen activator,t PA)、纤溶酶原激活物抑制物-1(plasminogen activatinhibitor 1,PAI-1)的水平。记录两组患者治疗过程中肺栓塞的发生情况。结果:观察组的卡氏评分的疗效明显高于对照组,差异具有统计学意义(P<0.05);观察组的中医症状评分的疗效明显高于对照组,差异有统计学意义(P<0.05);观察组治疗后的全血黏度、血浆黏度、红细胞压积、纤维蛋白原、血小板明显降低,且上述指标明显低于对照组,差异均有统计学意义(P<0.05);治疗28 d后,观察组的t PA明显升高,且明显高于对照组,PAI-1明显降低,且明显低于对照组,差异有统计学意义(P<0.05);观察组肺栓塞发生率低于对照组,但差异无统计学意义(P>0.05)。结论:补阳还五汤能显著改善气虚血瘀型肺癌患者的血液高凝状态,改善患者的生存质量。

AIM： To investigate the effects of Buyanghuanwu decoction on blood hypercoagulability in lung cancer patients with Qi deficiency and blood stasis type. METHODS： Sixty cases of lung cancer patients with Qi deficiency and blood stasis were divided into observation group and control group. The control group was treated with routine nutritional support. The observation group was given Buyanghuanwu decoction on the basis of the control group.The KPS score was recorded to assess the quality of life of the patients. Symptoms of Chinese medicine were evaluated by TCM symptom score. Blood rheology indexes（ whole blood viscosity,plasma viscosity,hematocrit,fibrinogen and platelet） were detected before and after treatment of the two groups. The levels of serum t PA and PAI-1 were detected before and after treatment 7,14,28 d in two groups. The incidence of pulmonary embolism in the two groups was recorded during the treatment. RESULTS： The curative effect of the observation group was significantly higher than that of the control group. The difference was statistically significant（ P〈0. 05）.The curative effect of TCM symptom score in the observation group was significantly higher than that in the control group. The difference was statistically significant（ P〈0. 05）. The whole blood viscosity,plasma viscosity,hematocrit,fibrinogen and platelets were significantly decreased after treatment in the observation group. And the above indexes were significantly lower than that of the control group.The difference was statistically significant（ P〈0. 05）. After 28 d of treatment,the t PA in the observation group was significantly higher than that of the control group. PAI-1 was significantly lower than that of the control group. The difference was statistically significant（ P〈0. 05）. The incidence of pulmonary embolism in the observation group was lower than that in the control group. But the difference was not statistically significant（ P〈0. 05）. CONCLUSION： Buyanghuanwu decoction can significantly improve the hypercoagulable state of patients with Qi deficiency and blood stasis type lung cancer,and improve the quality of life of patients.