加味香砂六君子汤联合吴茱萸穴位贴敷防治铂类化疗药物引起的急性消化道反应

Modified Xiangsha Liujunzi Decoction Combined with Evodia Acupoint Application in Preventing and Treatment Acute Gastrointestinal Reactions Caused by Platinum-based Chemotherapy Drugs

目的:观察加味香砂六君子汤联合吴茱萸穴位贴敷防治铂类化疗药物致急性消化道反应的临床疗效。方法:80例化疗患者随机分为治疗组和对照组各40例。对照组根据患者不同病种选用不同化疗方案,化疗期间同时给予5-羟色胺3受体拮抗剂等防治消化道反应。治疗组在对照组治疗基础上给予加味香砂六君子汤口服联合吴茱萸穴位贴敷。两组均治疗1个化疗周期。治疗后,比较两组患者急性消化道反应发生情况、临床疗效、中医证候积分改善情况、不良反应发生情况。结果:化疗第1天,治疗组共有18例出现急性消化道反应,发生率为45.0%;对照组有26例出现急性消化道反应,发生率为65.0%,两组比较,差异有统计学意义(χ^(2)=4.114,P=0.0359)。治疗组有效率为87.5%,对照组为65.0%,两组有效率比较,差异有统计学意义(P<0.05)。治疗组改善率为82.5%,对照组改善率为60.0%,两组改善率比较,差异有统计学意义(P<0.05)。治疗后,两组患者卡氏评分均显著下降,且治疗组低于同期对照组,差异均有统计学意义(P<0.05)。治疗组出现2例Ⅰ度骨髓抑制,对照组出现4例Ⅰ度骨髓抑制,两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:加味香砂六君子汤内服联合吴茱萸穴位贴敷能有效降低铂类化疗药物引起的急性消化道反应,改善中医临床证候积分,提高生活质量。

Objective:To observe the clinical efficacy of Jiawei Xiangsha Liujunzi Decoction combined with Evodia acupoint sticking in the prevention and treatment of acute gastrointestinal reactions induced by platinum chemotherapy drugs.Methods:80 chemotherapy patients were randomly divided into treatment group and control group,40 cases in each group.In the control group,different chemotherapy regimens were selected according to different diseases of the patients.During chemotherapy,serotonin 3 receptor antagonists were given simultaneously to prevent and treat digestive tract reactions.On basis of the treatment in the control group,the treatment group was given oral administration of modified Xiangsha Liujunzi Decoction combined with Evodia acupoint sticking.Both groups were treated for 1 cycle of chemotherapy.After treatment,the occurrence of acute gastrointestinal reactions,clinical efficacy,improvement of TCM syndrome scores,and adverse reactions were compared between the two groups.Results:On the first day of chemotherapy,a total of 18 patients in the treatment group developed acute gastrointestinal reactions,with an incidence rate of 45.0%;26 patients in the control group developed acute gastrointestinal reactions,with an incidence rate of 65.0%,and the difference was statistically significant(χ^(2)=4.114,P=0.0359).The effective rate of the treatment group was 87.5%,and that of the control group was 65.0%.There was a statistically significant difference between the two groups(P<0.05).The improvement rate of the treatment group was 82.5%,and the improvement rate of the control group was 60.0%,and the difference was statistically significant(P<0.05).After treatment,the Karnofsky scores of the two groups were significantly decreased,and the treatment group was lower than that of the control group at the same period,and the difference was statistically significant(P<0.05).There were 2 cases of grade I myelosuppression in the treatment group and 4 cases of grade I myelosuppression in the control group.There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The oral administration of Jiawei Xiangsha Liujunzi Decoction combined with Evodia acupoint sticking can effectively reduce the acute digestive tract reaction caused by platinum chemotherapy drugs,improve the clinical syndrome scores of traditional Chinese medicine,and improve the quality of life.