生血方拮抗奥沙利铂联合替吉奥方案致晚期胃癌骨髓抑制的临床观察
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安徽省卫生计生委中医药科研项目(2016zy43)


Blood- promoting Prescriptionin Antagonizes Bone Marrow Suppression Induced by the Regimen of Oxaliplatin Combined with Tegafur, Gimeracil, and Oteracil Potassium for Advanced Gastric Cancer:A Clinical Observation
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    摘要:

    目的 观察自拟生血方治疗脾肾两虚型晚期胃癌行奥沙利铂联合替吉奥方案化学治疗致骨髓抑制的疗效和安全性。方法 将60例中医辨证为脾肾两虚型晚期胃癌患者随机分成对照组和观察组,每组30例。对照组予以奥沙利铂联合替吉奥方案化学治疗,观察组在对照组基础上加用自拟生血方汤剂口服及粉剂加工后外敷穴位联合治疗。观察两组患者首次骨髓抑制发生时间、骨髓抑制持续时间、0~3周骨髓抑制等级变化,采用卡氏功能状态量表(Karnofskys performance scale,KPS)、中医证候积分评价患者生活质量,观察两组患者的无进展生存期(progression- free survival, PFS)。结果 与对照组比较,观察组患者首次出现白细胞、血红蛋白、血小板下降的时间明显延长(P<0.05),白细胞、血红蛋白、血小板抑制持续时间明显缩短(P<0.05)。两组患者不同时点白细胞、血红蛋白、血小板抑制等级比较,差异有统计学意义(P<0.05),两组患者化学治疗第21天与化学治疗第1天白细胞抑制等级变化比较,差异有统计学意义(P<0.05)。与治疗前比较,对照组患者治疗后KPS评分显著降低(P<0.05)。两组患者治疗前后KPS评分差值比较,差异有统计学意义(P<0.05)。与治疗前比较,观察组患者中医证候积分显著下降(P<0.05),观察组中医证候积分下降程度明显大于对照组(P<0.05)。观察组患者PFS为10个月,较对照组PFS(6个月)明显延长。结论 自拟生血方治疗晚期脾肾两虚型胃癌奥沙利铂联合替吉奥方案化学治疗所致骨髓抑制,能延迟首次骨髓抑制发生时间并缩短持续时间,降低白细胞骨髓抑制等级,在一定程度上改善晚期胃癌患者临床症状及生活质量。

    Abstract:

    Objective Toinvestigate the clinical effect and safety of a self- made blood- promoting prescription in the treatment of bone marrow suppression induced by the chemotherapeutic regimen of oxaliplatin combined with tegafur, gimeracil, and oteracil potassium for advanced gastric cancer with deficiency of spleen and kidney. Methods A total of 60 patients with advanced gastric cancer with deficiency of spleen and kidney based on traditional Chinese medicine (TCM) syndrome differentiation were randomly divided into control group and observation group, with 30 patients in each group. The patients in the control group were given chemotherapy with the regimen of oxaliplatin combined with tegafur, gimeracil, and oteracil potassium, and those in the observation group were given oral administration of the decoction of a self- made blood- promoting prescription combined with external acupoint application of its powder after processing in addition to the treatment in the control group. The two groups were observed in terms of the time to the first episode of bone marrow suppression, duration of bone marrow suppression, and change in the grade of bone marrow suppression episodes of reductions in leukocytes, hemoglobin, and platelets (P<0.05) and significantly shorter duration of the inhibition of leukocytes, hemoglobin, and platelets (P<0.05). There were significant differences in the grades of inhibition of leukocytes, hemoglobin, and platelets between the two groups at different time points (P<0.05), and both groups had a significant change in the grade of inhibition of leukocytes from day 1 to day 21 of chemotherapy (P<0.05). The control group had a significant reduction in KPS score after treatment (P<0.05), and there was a significant difference between the two groups in the change of KPS score after treatment (P<0.05). After treatment, the observation group had a significant reduction in TCM syndrome score (P<0.05) and a significantly greater reduction in TCM syndrome score than the control group (P<0.05). The observation group had significantly longer PFS than the control group (10 months vs 6 months). Conclusion In the treatment of bone marrow suppression induced by the chemotherapeutic regimen of oxaliplatin combined with tegafur, gimeracil, and oteracilpotassium for advanced gastric cancer with deficiency of spleen and kidney, the self- made blood- promoting prescription can delay the time to the first episode of bone marrow suppression, shorten its duration, reduce the grade of leukocyte inhibition, and thus improve the clinical symptoms and quality of life of patients with advanced gastric cancer to a certain degree.within 0- 3 weeks; Karnofskys performance scale(KPS) and TCM syndrome score were used to evaluate quality of life, and progression- free survival (PFS) was observed. Results Compared with the control group, the observation group had significantly longer time to the first

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陈国庆,喻怀斌,丁美钱.生血方拮抗奥沙利铂联合替吉奥方案致晚期胃癌骨髓抑制的临床观察[J].安徽中医药大学学报,2021,40(3):30-34

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  • 在线发布日期: 2021-06-16