中西医结合治疗去势抵抗性前列腺癌近期临床疗效分析

Analysis on the short-term clinical effect of the combination of traditional Chinese and Western medicine in the treatment of castrated resistant prostate cancer

目的:观察中药复方健脾利湿化瘀方协同西医疗法治疗去势抵抗性前列腺癌(CRPC)的近期临床疗效。方法:将60例CRPC患者随机分为联合组(30例)和对照组(30例)。对照组采用《中国去势抵抗性前列腺癌诊治专家共识》中CRPC的西医治疗方法,联合组在对照组基础上加用健脾利湿化瘀方,治疗6个月后,观察患者血清总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)、血清游离睾酮水平、最大尿流率、FACT-P量表评分、国际前列腺症状(I-PSS)评分、KPS评分、中医临床症状、不良反应的情况。结果:与对照组比较,联合组治疗后显著降低患者tPSA水平、fPSA水平、血清游离睾酮水平、I-PSS评分(P<0.01),显著提高患者最大尿流率(P<0.01),升高患者KPS评分(P<0.05)。联合组患者尿频、尿痛、会阴部等局部坠胀、尿后滴沥、头晕眼花、精神萎靡症状显著改善(P<0.05),会阴部等局部疼痛,尿道灼热,尿中白浊、尿血、腐肉,阴囊潮湿症状改善不明显。患者生活质量均得到显著改善(P<0.05),具体表现在生理状况及身体功能的提高、社会及家庭关系的融洽、不良情绪的减少、前列腺癌相关临床症状的改善5个方面。治疗后均未出现严重的肝肾功能毒性,且联合组降低了肝肾毒性的发生率。结论:中药复方健脾利湿化瘀方协同西医治疗CRPC可以降低患者tPSA水平、fPSA水平、血清游离睾酮水平、I-PSS评分,提高患者最大尿流率和KPS评分、生活质量,且安全性良好。

Objective:To observe the short-term clinical efficacy of the traditional Chinese medicine compound Jianpi Lishi Huayu Formula in synergistic treatment of castratied-resistant prostate cancer(CRPC).Methods:Sixty patients with CRPC were randomly divided into combined group(30 cases)and control group(30 cases).The control group adopted the Western medicine treatment method of CRPC in the Consensus of Experts in the Diagnosis and Treatment of Castration-Resistant Prostate Cancer in China,and the combined group was supplemented with Jianpi Lishi Huayu Formula on the basis of the control group.Total prostate specific antigen(tPSA),free prostate specific antigen(fPSA),serum free testosterone level,maximum urinary flow rate,FACT-P scale score,international prostate symptom(I-PSS)score,KPS score,clinical symptoms of traditional Chinese medicine,toxic and side effects were observated after 6 months of treatment.Results:compared with the control group,combined group could reduce patients’tPSA level,fPSA level,serum free testosterone level,I-PSS score,increase patient’s maximum urinary flow rate(P<0.01),increase patient’s KPS score(P<0.05),patients in the combined group had frequent urination,dysuria,diarrhea,diarrhea after urine,dizziness,dizziness,and symptoms of mental depression(P<0.05),pain in the perineum,burning in the urethra,turbidity in urine,hematuria,carrion,scrotum moisture symptoms did not improve significantly.The quality of life of patients had been significantly improved(P<0.05),which was manifested in five aspects:the improvement of physiological conditions and physical functions,the harmony of social and family relationships,the reduction of negative emotions,and the improvement of clinical symptoms related to prostate cancer.After treatment,no serious liver and kidney toxicity occurred,and the incidence of liver and kidney toxicity was reduced in the combined group.Conclusion:The traditional Chinese medicine compound Jianpi Lishi Huayu Formula synergistic treatment of CRPC can reduce the patients’tPSA level,fPSA level,serum free testosterone level,I-PSS score,improve the patient’s maximum urinary flow rate,improve the patient KPS score,quality of life,and good safety.