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康肺散结汤直肠给药治疗非小细胞肺癌的临床研究

ISSN号：1008-9691
期刊名称：《中国中西医结合急救杂志》
时间：0
分类：R734.2[医药卫生—肿瘤;医药卫生—临床医学]
作者机构：[1]烟台市中医医院,山东烟台264013
相关基金：山东省中医药科技发展计划项目（2013-174）

作者：张金波[1]

关键词：康肺散结汤, 直肠给药, 非小细胞肺癌, Kangfei Sanjie decoction , Rectal administration , Non-small cell lung cancer

中文摘要：

目的观察中医辨证直肠给药对非小细胞肺癌（NSCLC）患者临床疗效及化疗毒副反应的影响。方法将72例NSCLC患者按随机原则分为单纯化疗组和直肠给药组，每组36例。单纯化疗组采用单纯化疗方案治疗，直肠给药组在化疗的同时加用中药自拟康肺散结汤（组成：麻黄6g，连翘20g，枳实20g，桔梗10g，杏仁10g，大黄炭6g，半枝莲30g，白花蛇舌草30g，藤梨根15g，浙贝母10g，白芷10g，细辛3g，芒硝6g）加减雾化灌肠，每日1次，21d为1个疗程。观察2个化疗周期后两组患者的肿瘤病灶控制情况、KPS评分和化疗后不良反应发生程度。结果直肠给药组总有效率高于单纯化疗组，但两组比较差异无统计学意义（63．89％比55．56％，P〉0．05）。治疗后直肠给药组KPS评分明显高于单纯化疗组（分：89．52±10．25比83．17±8．08，P〈0．05）；Ⅱ～Ⅲ度抗癌药物不良反应明显减少，其中白细胞计数（WBC）减少（4例比11例）、恶心呕吐（1例比6例）、乏力（0例比4例）、脱发（3例比9例）发生程度均较单纯化疗组轻，差异均有统计学意义（均P〈O．05），两组对肝肾功能的影响差异无统计学意义（均P〉0．05）。结论中药辨证直肠给药治疗NSCLC能够明显改善患者生存质量，减轻化疗毒副反应，方法简便廉验。

英文摘要：

Objective To investigate the clinical efficacy of application of differentiation of traditional Chinese medicine （TCM） syndrome and rectal administration of TCM decoction for treatment of patients with non-small cell lung cancer （NSCLC） and its influence on chemotherapy toxic side effects. Methods Seventy-two patients with NSCLC were randomly divided into two groups ： the chemotherapy alone group and rectal administration group （ each 36 cases ） . Both groups received chemotherapy, and the rectal administration group additionally took the rectal administration of self made Kangfei Sanjie decoction （composition ： ephcdra 6 g, forsythia 20 g, citrus aurantium 20 g, platycodon root 10 g, almonds 10 g, rhubarb charcoal 6 g, scutellariae barbatae 30 g, hedyotic diffusa 30 g, actinidiae 15 g, fritillariae thunbergii 10 g, angelica 10 g, asarum 3 g, mirabilitum depuratum 6 g）, and according to the patient＇s individual situation, the ingredients of the decoction could be added or subtracted to perform pulverization enema, once a day, 21 days constituting one therapeutic course. After two cycles of chemotherapy, the changes of tumor lesions, KPS score and the occurrence and degree of chemotherapy adverse reaction were observed. Results The total therapeutic efficiency of rectal administration group was higher than that of chemotherapy alone group, but there was no significant difference between them （63.89% vs. 55.56%, P 〉0.05 ） ; the KPS score of rectal administration group was apparently higher than that of chemotherapy alone group （89.52 ± 10.25 vs. 83.17 ± 8.08, P〈0.05 ） . The occurrences of Ⅱ -Ⅲ degree adverse reaction after chemotherapy of the rectal administration group was significantly less than those of the chemotherapy alone group ： leukopenia （4 cases vs. 11 cases）, nausea and vomiting （1 cases vs. 6 cases）, fatigue （0 vs. 4 cases）, hair loss （3 cases vs. 9 cases）, the differences between the two groups being statistically significant （all P〈 0.05 ?