健脾益髓方对胰腺癌化疗后骨髓抑制影响的临床观察

Clinical Study on the Effect of Jianpi Yisui Recipe on Myelosuppression inPatients with Pancreatic Cancer after Chemotherapy

目的观察健脾益髓方对化疗后胰腺癌患者骨髓抑制的影响。方法回顾性分析2018年3月至2019年10月诸城中医医院化疗的胰腺癌患者90例,根据是否口服中药分为治疗组和对照组,各45例,两组患者均予以吉西他滨联合顺铂(GP)方案化疗,治疗组患者在化疗基础上给予健脾益髓方,对照组患者接受利血生进行治疗。比较分析治疗前后两组患者骨髓抑制指标WBC、HB、PLT的差异、中医症候改善情况、生活质量变化情况以及不良反应发生率。结果化疗第7天两组患者骨髓抑制指标均不同幅度下降,且治疗组低于对照组(P<0.05);第14天两组患者骨髓抑制指标均有不同幅度上升,治疗组高于对照组(P<0.05)。治疗组患者中医症候改善有效率高于对照组(P<0.05)。治疗组患者消化道反应(恶心、呕吐)发生率低于对照组(P<0.05)。两组患者肝肾功损害对比差异无统计学意义(P>0.05)。结论健脾益髓方联合化疗治疗晚期胰腺癌患者,能减轻化疗相关毒性反应,保护骨髓,改善患者生活质量。

Objective To observe the clinical effect of Jianpi Yisui Recipe on the prevention and treatment of myelosuppression after chemotherapy of pancreatic cancer.Methods From March 2018 to October 2019,90 patients with pancreatic cancer treated by chemotherapy in Zhucheng Hospital of traditional Chinese medicine were divided into treatment group and control group according to whether oral Chinese medicine was taken or not,45 cases in each group,both groups were treated with GP regimen chemotherapy,the treatment group was treated with Jianpi Yisui formula on the basis of chemotherapy,and the control group was treated with Lixuesheng.The difference of WBC,Hb and PLT,the improvement of TCM symptoms,the change of quality of life and the incidence of adverse reactions were compared before and after treatment.Results On the 7th day of chemotherapy,the bone marrow inhibition indexes of the two groups decreased in different ranges,and the treatment group was significantly lower than the control group(P<0.05);on the 14th day,the bone marrow inhibition indexes of the two groups increased in different ranges,and the treatment group was significantly higher than the control group(P<0.05).The effective rate of syndrome improvement in the treatment group was higher than that in the control group(P<0.05).The incidence of gastrointestinal reaction(nausea and vomiting)in the treatment group was lower than that in the control group(P<0.05).There was no significant difference between the two groups(P>0.05).Conclusion Jianpi Yisui decoction combined with chemotherapy can reduce chemotherapy-related toxicity,protect bone marrow and improve the quality of life of patients with advanced pancreatic cancer.