四味消瘤汤联合放疗治疗恶性脑转移瘤临床研究

Clinical Study on Siwei Xiaoliu Tang Combined with Radiotherapy for Malignant Brain Metastases

目的:观察四味消瘤汤联合放疗治疗对恶性脑转移瘤的疗效。方法:选取90例恶性脑转移瘤患者,按随机数字表法分为观察组与对照组各45例,对照组给予放疗治疗,观察组在对照组基础上给予四味消瘤汤治疗。1周为1个疗程,2组均治疗4个疗程。比较2组治疗前后T淋巴细胞亚群指标、卡氏(KPS)评分的变化,观察2组临床疗效及生活质量总改善率以及治疗期间不良反应发生情况。结果:治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)指标值均较治疗前上升,CD8^(+)指标值均较治疗前下降,差异均有统计学意义(P<0.05);治疗后,观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)指标值均高于对照组,差异均有统计学意义(P<0.05),观察组CD8^(+)指标值低于对照组,差异无统计学意义(P>0.05)。治疗后,2组KPS评分均较治疗前上升,观察组KPS评分高于对照组,差异均有统计学意义(P<0.05)。观察组生活质量总改善率为95.56%,对照组生活质量总改善率为82.22%,2组比较,差异有统计学意义(P<0.05)。治疗后,观察组临床疗效总有效率为93.33%,对照组为77.78%,2组比较,差异有统计学意义(P<0.05)。观察组与对照组皮肤不良反应发生率分别为40.00%、68.89%,腹泻发生率分别为33.33%、64.44%,口腔炎发生率分别为46.66%、73.33%;比较2组I-II级皮肤不良反应及腹泻,差异有统计学意义(P<0.05);其余2组比较,差异均无统计学意义(P>0.05)。结论:四味消瘤汤联合放疗治疗脑转移瘤疗效显著,可改善患者生活质量,提高免疫功能,用药安全性较高。

Objective:To observe the curative effect of Siwei Xiaoliu tang combined with radiotherapy for malignant brain metastases.Methods:A total of 90 cases of patients with malignant brain metastases were selected and divided into the observation group and the control group according to the random number table method,with 45 cases in each group.The control group was given radiotherapy,and the observation group was additionally given Siwei Xiaoliu tang based on the treatment of the control group.Both groups were treated for four courses,with one week being a course.The changes in indexes of T lymphocyte subsets and Karnofsky(KPS)scores before and after treatment in the two groups were compared;the incidence of adverse reactions during treatment,the clinical effects and the total improvement rate of quality of life in the two groups were observed.Results:After treatment,the values of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the two groups were increased when compared with those before treatment,and CD8^(+)indexes were decreased,differences being significant(P<0.05).After treatment,the values of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,differences being significant(P<0.05);CD8^(+)index in the observation group was lower than that in the control group,there being no significant difference(P>0.05).After treatment,KPS scores in the two groups were increased when compared with those before treatment,and KPS score in the observation group was higher than that in the control group,differences being significant(P<0.05).The total improvement rate of quality of life was 95.56%in the observation group and 82.22%in the control group,the difference being significant(P<0.05).After treatment,the total effective rate was 93.33%in the observation group and 77.78%in the control group,the difference being significant(P<0.05).The incidence of adverse skin reactions was 40.00%and 68.89%respectively in the observation group and the control group,the incidence of diarrhea was 33.33%and 64.44%respectively,the incidence of stomatitis was 46.66%and 73.33%respectively;there was significant difference being found in the comparison of adverse skin reactions and diarrhea of grade I to grade II between the two groups(P<0.05);there was no significant difference being found in the comparison of the other indexes between two groups(P>0.05).Conclusion:The therapy of Siwei Xiaoliu tang combined with radiotherapy for malignant brain metastases has a significant curative effect,which can improve quality of life and immune function,with high medication safety.