基于真实世界芪术扶正饮治疗癌性恶病质的疗效观察

Real-world Study on the Treatment of Cancer Cachexia with Qizhu Fuzheng Decoction

目的:观察芪术扶正饮联合甲地孕酮治疗癌性恶病质的疗效及作用机制。方法:收集癌性恶病质脾肾两虚证患者208例,按照1:1分为观察组和对照组。对照组给予醋酸甲地孕酮分散片160mg 1次/d口服治疗,1月为1个疗程,连续服用2个疗程。观察组在对照组基础上给予芪术扶正饮治疗,1日1副,1月为1个疗程,连续服用2个疗程。比较2组患者治疗前后体力状况ECOG评分、中医症候积分、营养评估PG-SGA评分以及血浆白蛋白(ALB)水平和白细胞介素-6(IL-6)水平检验指标的变化以及治疗后不良事件。结果:2组治疗后患者体力状况ECOG评分、中医症候积分、营养评估PG-SGA评分、ALB水平和IL-6水平均优于治疗前,且观察组疗效显著优于对照组,差异有统计学意义。2组患者治疗后常见的不良事件发生率相近。结论:芪术扶正饮能够安全、有效的改善癌性恶病质。

Objective:To observe the efficacy and mechanism of Qishu Fuzheng Yin combined with megestrol acetate in the treatment of cancer cachexia.Methods:A total of 208 patients with cancer cachexia with spleen and kidney deficiency were enrolled and divided into an observation group and a control group at a ratio of 1:1.The control group was treated with megestrol acetate dispersible tablets 160 mg orally once a day,one month as a course of treatment,and continued for 2 courses.The observation group was treated with Qishu Fuzheng Yin on the basis of the control group,one pair per day,one month as a course of treatment,and continued for 2 courses.The ECOG score of physical condition,TCM symptom score,nutritional assessment PG-SGA score,changes in plasma albumin(ALB)level and IL-6 level test indicators before and after treatment,and adverse events after treatment were compared between the two groups.Results:After treatment,the ECOG score,TCM symptom score,nutritional assessment PG-SGA score,plasma albumin(ALB)level and IL-6 level of the two groups of patients were better than before treatment,and the efficacy of the observation group was significantly better than that of the control group,with statistically significant differences.The incidence of common adverse events after treatment in the two groups of patients was similar.Conclusion:Qishu Fuzheng Decoction can safely and effectively improve cancer cachexia.