补肾益髓方防治恶性肿瘤化疗后血小板减少症的临床效果

Clinical effect of Bushen Yisui Decoction on the prevention and treatment of thrombocytopenia after chemotherapy of malignancies

目的分析补肾益髓方防治恶性肿瘤化疗后血小板减少症的临床效果。方法收集2014年1月至2015年1月既往化疗≥2次、符合诊断标准及本研究纳入标准、需要再次进行化疗的住院患者。采用完全随机方法随机分为治疗组和对照组,每组35例。对照组以标准化疗方案进行单纯化疗治疗,治疗组在单纯化疗治疗基础上,于化疗前1 d开始加以补肾益髓方中药汤剂口服21 d。以2组PLT及MPV指标、不同时间中医临床症状积分、KPS评分、不良反应发生率为依据。结果治疗组治疗前PLT水平与对照组差异无统计学意义(P>0.05);2组治疗后14 d、21 d PLT水平均高于治疗前(P<0.05);治疗组治疗后14 d、21 d PLT水平均高于对照组(P<0.05);治疗组治疗前中医证候积分与对照组差异无统计学意义(P<0.05);治疗组、对照组治疗后14 d、21 d中医证候积分均低于治疗前(P<0.05);治疗组及对照组治疗后21 d中医证候积分均低于治疗后14 d(P<0.05);治疗组治疗后14 d、21 d中医证候积分均低于对照组(P<0.05);治疗组治疗后总有效率高于对照组(P<0.05);2组患者均无严重肝肾功能损害;治疗组不良反应总发生率低于对照组(P<0.05)。结论中药补肾益髓方对防治接受化疗的恶性肿瘤患者血小板减少症能够发挥良好临床效果,安全性也较好,值得进一步研究和大力推广。

Objective To analyze the clinical effect of Bushen Yisui Decoction on the prevention and treatment of thrombocytopenia after chemotherapy of malignancies.Methods From January 2014 to January 2015,eligible hospitalized patients who have received a minimum of two cycles of chemotherapy and needed chemotherapy again in the Oncology Department of Huanghua people’s Hospital were recruited.They were randomly divided into treatment group and control group,with 35 cases in each group.Patients in both groups were treated with a standard chemotherapy,and those in the treatment group were additionally given to Bushen Yisui Decoction on 1 day before chemotherapy,the treatment was performed for 21 days.Platelet count(PLT),mean platelet volume(MPV),traditional Chinese medicine(TCM)symptom scores at different time points,Karnofsky(KPS)scores and adverse incidence between groups were included as comparison.Results There was no significant difference in the PLT level between the treatment group and the control group before treatment(P>0.05),which was significantly enhanced in both groups on the 14th and 21st day of treatment(P<0.05).PLT on the 14th and 21st day of treatment in the treatment group was significantly higher than that of control group(both P<0.05).There was no significant difference in the TCM symptom scores between the treatment group and the control group before treatment(P>0.05),which was significantly reduced in both groups on the 14th and 21st day of treatment(P<0.05).TCM symptom scores on the 21st day of treatment in both groups were significantly lower than those on the 14th day(both P<0.05),which were significantly lower in the treatment group than in the control group on the 14th and 21st day of treatment(both P<0.05).The total effective rate after treatment in the treatment group was significantly higher than that in the control group(P<0.05).Serious liver and kidney damage were not reported in both groups.The total incidence of adverse events in the treatment group was significantly lower than that in the control group(P<0.05).Conclusion Bushen Yisui Decoction has a certain clinical effect on the prevention and treatment of thrombocytopenia in malignant tumor patients receiving chemotherapy,which is safe and worthy of further research and vigorous promotion.