苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液的临床研究

Clinical study on oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe in treating lung cancer with pleural effusion

目的观察苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液的临床疗效。方法将64例肺癌合并胸腔积液患者随机分为治疗组(32例)和对照组(32例),对照组予西医常规治疗,治疗组在对照组治疗措施的基础上加用苓桂术甘汤加减内服、消水贴外敷,两组均连续治疗7 d。观察临床疗效,比较中医证候积分、免疫指标、炎症因子、肿瘤指标的变化情况,以及胸腔积液穿刺引流、利尿剂的使用情况。结果 (1)试验过程中,治疗组、对照组各脱落2例,最终完成试验者60例,治疗组、对照组各30例。(2)治疗组、对照组的总有效率分别为86.7%、60.0%;两组临床疗效比较,治疗组优于对照组(P<0.05)。(3)治疗前后组内比较,治疗组中医证候总积分及咳嗽、气短、胸闷、神疲乏力积分减少(P<0.05),对照组中医证候总积分及气短积分增加(P<0.05)。组间治疗后比较,治疗组中医证候总积分及咳嗽、气短、胸闷、神疲乏力积分少于对照组(P<0.05)。(4)治疗前后组内比较,治疗组外周血CD3^(+)、CD4^(+)水平升高,白介素-2(IL-2)、白介素-6(IL-6)、白介素-8(IL-8)、恶性肿瘤特异生长因子(TSGF)、癌胚抗原(CEA)水平降低(P<0.05),对照组免疫、肿瘤、炎症因子指标差异无统计学意义(P>0.05)。组间治疗后比较,治疗组外周血CD3^(+)、CD4^(+)水平高于对照组,IL-2、IL-6水平低于对照组(P<0.05)。(5)治疗组胸腔积液穿刺引流率低于对照组(P<0.05);两组利尿剂使用率比较,差异无统计学意义(P>0.05)。结论苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液疗效满意,能有效减少胸腔积液,改善患者的临床症状。

Objective To observe the clinical efficacy of oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe in treating lung cancer with pleural effusion.Methods Sixty-four patients of lung cancer with pleural effusion were randomly divided into the treatment group and control group,32 cases in each group.The control group was treated with conventional western medicine,and the treatment group was treated with Linggui Zhugan Decoction by oral administration and Xiaoshui Recipe by external application based on the treatment for the control group.The treatment course was 7 days in both groups.The clinical efficacy was observed,the changes of Chinese medical syndrome scores,immune indexes,inflammatory factors and tumor indexes were compared,as well as the puncture and drainage of pleural effusion and the use of diuretics.Results (1)During the trial,two cases in the treatment group and two cases in the control group fell off,finally 60 cases completed the trail,among 30 cases in the treatment group and 30 cases in the control group.(2) The total effective rates of the treatment group and the control group were 86.7% and 60.0%respectively.The clinical efficacy of the treatment group was better than that of the control group(P<0.05).(3)Compared with those before treatment,the total score of Chinese medical syndrome and the scores of cough,shortness of breath,chest tightness and mental fatigue were decreased in the treatment group after treatment(P<0.05),while the total score of Chinese medical syndrome and the score of shortness of breath were increased in the control group(P<0.05).After treatment,the total score of Chinese medical syndrome and the scores of cough,shortness of breath,chest tightness and mental fatigue in the treatment group were lower than those in the control group(P<0.05).(4)Compared with those before treatment,the levels of CD3^(+) and CD4^(+) in peripheral blood were increased and the levels of interleukin-2(IL-2),interleukin-6(IL-6),interleukin-8(IL-8),malignant tumor specific growth factor(TSGF)and carcinoembryonic antigen(CEA)were decreased in the treatment group(P<0.05),but there were no statistically significant differences on the immune,tumor and inflammatory factors in the control group after treatment(P>0.05).After treatment,the levels of CD3^(+) and CD4^(+) in the treatment group were higher than those in the control group,and the levels of IL-2 and IL-6 in the treatment group were lower than those in the control group(P<0.05).(5)The rate of pleural effusion puncture and drainage in the treatment group was lower than that in the control group(P<0.05),and there was no statistically significant difference in the use of diuretics between the two groups(P>0.05).Conclusion Oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe shows good efficacy in treating lung cancer with pleural effusion,which can effectively reduce pleural effusion and improve the clinical symptoms of patients.