散结通膈汤联合常规化疗方案治疗中晚期食管癌(痰气互阻)临床研究

Clinical Study of Using Sanjie Tongge Decoction Combined with Conventional Chemotherapy in the Treatment of Advanced Esophageal Cancer Interlegm of Tum Mutual Resistance Syndrome

目的:观察散结通膈汤联合常规化疗方案治疗中晚期痰气互阻型食管癌的临床效果。方法:选取2018年8月~2020年8月于本院就诊接受化疗方案的80例中晚期痰气互阻型食管癌患者为研究对象,根据随机数表法分为对照组(40例)、观察组(40例),对照组给予常规化疗方案治疗,观察组在对照组的基础上联合散结通膈汤治疗,以21d为一个周期,治疗4个周期后比较客观有效率、疾病控制率、不良反应发生率,记录治疗前后KPS评分、中医症候积分以及凝血功能指标变化情况。结果:两组患者客观有效率比较无差异(55.00%VS47.50%,χ2=0.450,P=0.502),观察组疾病控制率高于对照组(90.00%VS72.50%,χ2=4.021,P=0.045);治疗后两组患者KPS评分均升高、中医症候积分均下降,且观察组KPS评分升高、医症候积分下降更显著(P<0.05);治疗后两组患者血浆纤维蛋白原(FIB)水平较治疗前均升高,凝血酶时间(TT)、血浆凝血酶原时间(PT)以及活化部分凝血活酶时间(APTT)较治疗前均下降,且治疗后观察组FIB水平升高,TT、PT以及APTT水平下降更显著(P<0.05);观察组III-IV级恶心呕吐、血小板减少、白细胞减少、肝肾功能损害以及腹泻便秘等不良反应发生率低于对照组(17.5%VS25.00%,χ2=4.013,P=0.045)。结论:在常规化疗的基础上联合散结通膈汤能有效改善中晚期痰气互阻型食管癌患者不适症状,降低毒副反应发生率,提高患者生活质量。

Objective: To investigate the clinical effect of using Sanjie Tongge Decoction combined with conventional chemotherapy in the treatment of advanced esophageal cancer with mutual resistance of phlegm and Qi syndrome. Methods: From August 2018 to August 2020,80 patients with advanced sputum mutual resistance esophageal cancer in our hospital were selected as the research objects. According to the random number table method, they were divided into a controlled group(40 cases) and an observation group(40 cases). The controlled group was treated with conventional chemotherapy, and the observation group was treated with Sanjie Tongge Decoction on the basis of the controlled group, with 21 days as a cycle, effective rate, disease control rate and incidence of adverse reactions were compared after 4 treatment cycles. KPS score, TCM symptom score and coagulation function index before and after treatment were recorded. Results: There was no difference in the objective effective rate between the two groups(55.00% vs 47.50%,χ2=0.450,P=0.502),and the disease control rate of the observation group was higher than that of the controlled group(90.00% vs 72.50%,χ2=4.021,P=0.045). After treatment, KPS score of both groups increased and TCM symptom score decreased, and KPS score increased and medical symptom score decreased more significantly in the observation group(P<0.05). After treatment, FIB level in the observation group was higher than that before treatment, while thrombin time(TT),plasma prothrombin time(PT) and activated partial thromboplastin time(APTT) were decreased compared with those before treatment. After treatment, FIB level in the observation group increased, TT, Pt and APTT decreased more significantly(P<0.05). Nausea and vomiting, thrombocytopenia and leucopenia were observed in the observation group III-IV. The incidence of adverse reactions such as less, liver and kidney function damage, diarrhea and constipation was lower than that of the controlled group(17.5% vs 25.00%,χ2=4.013,P=0.045). Conclusion: On the basis of conventional chemotherapy combined with Sanjie Tongge Decoction can effectively improve the discomfort symptoms of patients with advanced phlegm-Qi resistance type of esophageal cancer, reduce the incidence of adverse reactions, and improve the quality of life of patients.