华蟾素注射液胸腔灌注治疗“湿热毒证”恶性胸腔积液的临床效果

Clinical effect of Cinobufacin Injection in the treatment of malignant pleural effusion with“damp heat toxin syndrome”

目的探讨华蟾素注射液胸腔灌注治疗“湿热毒证”恶性胸腔积液的临床效果。方法选取北京中医药大学东方医院2017年9月~2019年3月收治的“湿热毒证”恶性胸腔积液患者30例,采用随机数字表法将其分为治疗组和对照组,每组15例。所有患者均采用闭式胸腔穿刺引流术引尽胸腔积液,治疗组予华蟾素注射液,对照组予白介素-2胸腔灌注,每周3次,2周为1个疗程。比较两组治疗前后胸腔积液量、胸腔积液质[红细胞(RBC)、乳酸脱氢酶(LDH)、肿瘤标志物(TM)]、中医症状积分、卡氏功能状态评分(KPS)及血管内皮生长因子(VEGF)水平。结果两组治疗后胸腔积液量情况比较差异无统计学意义(P>0.05)。两组治疗后RBC、TM水平比较,差异有统计学意义(P<0.05);两组治疗后LDH水平比较,差异无统计学意义(P>0.05)。两组治疗后中医症状积分均低于治疗前,差异有统计学意义(P<0.05)。两组治疗前后KPS评分组内、组间比较,差异无统计学意义(P>0.05)。两组治疗前后VEGF水平组内、组间比较,差异均无统计学意义(P>0.05)。结论华蟾素注射液胸腔灌注治疗“湿热毒证”恶性胸腔积液与降低胸腔积液RBC及TM的水平有关,其可能的作用机制是降低胸腔积液中VEGF表达。

Objective To explore clinical effect of Cinobufacin Injection in the treatment of malignant pleural effusion with“damp heat toxin syndrome”.Methods Thirty patients with malignant pleural effusion of“damp heat toxin syndrome”admitted to Dongfang Hospital of Beijing University of Chinese Medicine from September 2017 to March 2019 were randomly divided into treatment group and control group,with 15 cases in each group.All patients were treated with closed thoracic puncture and drainage to drain the pleural effusion.Treatment group was given Cinobufacin Injection,while control group was given IL-2 perfusion,three times a week,two weeks as a course of treatment.The quantity of pleural effusion,the quality of pleural effusion(RBC,LDH,TM),the symptom score of Chinese Medicine,KPS score and VEGF level were compared before and after treatment between two groups.Results There was no significant difference in the amount of pleural effusion between two groups(P>0.05).The differences of RBC and TM after treatment between two groups were statistically significant(P<0.05);the difference of LDH after treatment between two groups was not statistically significant(P>0.05).After treatment,the symptom scores of two groups were lower than before treatment,the differences were statistically significant(P<0.05).There was no significant difference in KPS between two groups(P>0.05).There was no significant difference in VEGF level between two groups before and after treatment(P>0.05).Conclusion Treatment of malignant pleural effusion with Cinobufacin Injection is related to the decrease of RBC and TM in pleural effusion,and its possible mechanism is to reduce the expression of VEGF in pleural effusion.