1.上海中医药大学附属岳阳中西医结合医院肿瘤一科(上海 200437)
2.空军军医大学第一附属医院内科(陕西 西安 7100327)
袁逸帆,女,硕士研究生,主要从事中医药防治恶性肿瘤临床与研究工作
龚亚斌,主任医师,硕士研究生导师; E-mail:gongyabin@hotmail.com
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袁逸帆,朱睿,龚亚斌等.苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液的临床研究[J].上海中医药杂志,2022,56(02):45-48.
YUAN Yifan,ZHU Rui,GONG Yabin,et al.Clinical study on oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe in treating lung cancer with pleural effusion[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(02):45-48.
袁逸帆,朱睿,龚亚斌等.苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液的临床研究[J].上海中医药杂志,2022,56(02):45-48. DOI: 10.16305/j.1007-1334.2022.2101128.
YUAN Yifan,ZHU Rui,GONG Yabin,et al.Clinical study on oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe in treating lung cancer with pleural effusion[J].Shanghai Journal of Traditional Chinese Medicine,2022,56(02):45-48. DOI: 10.16305/j.1007-1334.2022.2101128.
目的,2,观察苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液的临床疗效。,方法,2,将64例肺癌合并胸腔积液患者随机分为治疗组(32例)和对照组(32例),对照组予西医常规治疗,治疗组在对照组治疗措施的基础上加用苓桂术甘汤加减内服、消水贴外敷,两组均连续治疗7 d。观察临床疗效,比较中医证候积分、免疫指标、炎症因子、肿瘤指标的变化情况,以及胸腔积液穿刺引流、利尿剂的使用情况。,结果,2,①试验过程中,治疗组、对照组各脱落2例,最终完成试验者60例,治疗组、对照组各30例。②治疗组、对照组的总有效率分别为86.7%、60.0%;两组临床疗效比较,治疗组优于对照组(,P,<,0.05)。③治疗前后组内比较,治疗组中医证候总积分及咳嗽、气短、胸闷、神疲乏力积分减少(,P,<,0.05),对照组中医证候总积分及气短积分增加(,P,<,0.05)。组间治疗后比较,治疗组中医证候总积分及咳嗽、气短、胸闷、神疲乏力积分少于对照组(,P,<,0.05)。④治疗前后组内比较,治疗组外周血CD3,+,、CD4,+,水平升高,白介素-2(IL-2)、白介素-6(IL-6)、白介素-8(IL-8)、恶性肿瘤特异生长因子(TSGF)、癌胚抗原(CEA)水平降低(,P,<,0.05),对照组免疫、肿瘤、炎症因子指标差异无统计学意义(,P,>,0.05)。组间治疗后比较,治疗组外周血CD3,+,、CD4,+,水平高于对照组,IL-2、IL-6水平低于对照组(,P,<,0.05)。⑤治疗组胸腔积液穿刺引流率低于对照组(,P,<,0.05);两组利尿剂使用率比较,差异无统计学意义(,P,>,0.05)。,结论,2,苓桂术甘汤加减内服联合消水贴外敷治疗肺癌合并胸腔积液疗效满意,能有效减少胸腔积液,改善患者的临床症状。
Objective,2,To observe the clinical efficacy of oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe in treating lung cancer with pleural effusion.,Methods,2,Sixty-four patients of lung cancer with pleural effusion were randomly divided into the treatment group and control group, 32 cases in each group. The control group was treated with conventional western medicine, and the treatment group was treated with Linggui Zhugan Decoction by oral administration and Xiaoshui Recipe by external application based on the treatment for the control group. The treatment course was 7 days in both groups. The clinical efficacy was observed, the changes of Chinese medical syndrome scores, immune indexes, inflammatory factors and tumor indexes were compared, as well as the puncture and drainage of pleural effusion and the use of diuretics.,Results,2,①During the trial, two cases in the treatment group and two cases in the control group fell off, finally 60 cases completed the trail, among 30 cases in the treatment group and 30 cases in the control group. ②The total effective rates of the treatment group and the control group were 86.7% and 60.0% respectively. The clinical efficacy of the treatment group was better than that of the control group (,P,<,0.05). ③Compared with those before treatment, the total score of Chinese medical syndrome and the scores of cough, shortness of breath, chest tightness and mental fatigue were decreased in the treatment group after treatment (,P,<,0.05), while the total score of Chinese medical syndrome and the score of shortness of breath were increased in the control group (,P,<,0.05). After treatment, the total score of Chinese medical syndrome and the scores of cough, shortness of breath, chest tightness and mental fatigue in the treatment group were lower than those in the control group (,P,<,0.05). ④Compared with those before treatment, the levels of CD3,+, and CD4,+, in peripheral blood were increased and the levels of interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), malignant tumor specific growth factor (TSGF) and carcinoembryonic antigen (CEA) were decreased in the treatment group (,P,<,0.05), but there were no statistically significant differences on the immune, tumor and inflammatory factors in the control group after treatment (,P,>,0.05). After treatment, the levels of CD3,+, and CD4,+, in the treatment group were higher than those in the control group, and the levels of IL-2 and IL-6 in the treatment group were lower than those in the control group (,P,<,0.05). ⑤The rate of pleural effusion puncture and drainage in the treatment group was lower than that in the control group (,P,<,0.05), and there was no statistically significant difference in the use of diuretics between the two groups (,P,>,0.05).,Conclusion,2,Oral administration of modified Linggui Zhugan Decoction combined with external application of Xiaoshui Recipe shows good efficacy in treating lung cancer with pleural effusion, which can effectively reduce pleural effusion and improve the clinical symptoms of patients.
肺癌胸腔积液苓桂术甘汤消水贴中医外治临床试验
lung cancerpleural effusionLinggui Zhugan DecoctionXiaoshui Recipeexternal application of Chinese medicineclinical trial
施展,花宝金. 恶性胸腔积液的中医药治疗现状及展望[J]. 中国中医基础医学杂志,2009, 15(5): 397-399.
中华医学会,中华医学会肿瘤学分会,中华医学会杂志社. 中华医学会肺癌临床诊疗指南(2018版)[J] . 中华肿瘤杂志,2018, 40(12): 935-964.
World Health Organization. WHO handbook for reporting results of cancer treatment[R].Geneva: World Health Orgnaization, 1979.
国家药品监督管理局. 中药新药临床研究指导原则(试行)[M]. 北京:中国医药科技出版社,2002: 216-224.
PORCEL J M, GASOL A, BIELSA S, et al. Clinical features and survival of lung cancer patients with pleural effusions[J]. Respirology, 2015, 20(4): 654-659.
宋娟,刘丹,李镭,等. 肺癌伴发胸腔积液的临床特征及生存特点[J]. 华西医学,2018, 33(1): 36-40.
丁静怡,高习文,张惠萍,等. 胸腔积液患者心理状态分析[J]. 山西医药杂志,2018(12): 1362-1365.
MURUGANANDAN S, AZZOPARDI M, FITZGERALD D B, et al. Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters(AMPLE-2): an open-label randomised trial[J]. Lancet Respir Med, 2018, 6(9): 671-680.
BHATNAGAR R, KEENAN E K, MORLEY A J, et al. Outpatient talc administration by indwelling pleural catheter for malignant effusion[J]. N Engl J Med, 2018, 378(14): 1313-1322.
李蒙,张培彤. 中医药治疗恶性胸腔积液研究进展[J]. 中国肿瘤,2014,23(11): 943-946.
郑磊,刘猛,贾立群. 恶性胸腔积液中医证候及用药规律分析[J]. 北京中医药,2015, 34(7): 529-531.
谢瑜,王中奇. 中药外敷治疗恶性胸腔积液的研究进展[J]. 中国民间疗法,2018, 26(6): 100-102.
陈君媚,周春祥. 苓桂术甘汤药理作用及其机制研究进展[J]. 中国实验方剂学杂志,2019, 25(14): 222-227.
杨凯华,王文妤,曾敬清,等. 芒硝外敷预防儿童ERCP术后胰腺炎的临床研究[J]. 上海中医药杂志,2021, 55(9): 60-63.
杨振,江一平,黎艳珊,等. 中药外敷疗法治疗肝硬化腹水的研究进展[J]. 江西中医药,2016, 47(3): 76-78.
杨炀,税丕先,陈滟,等. 中药大黄在临床应用中的功效以及对其药理作用[J]. 基因组学与应用生物学,2017, 36(3): 1226-1231.
修彦凤,曹艳花,张永太. 甘遂的药理作用研究进展[J]. 上海中医药杂志,2008, 42(4): 79-81.
刘畅,赵晓珍,王中奇,等. 肺岩宁方联合抗瘤增效方对中晚期肺腺癌患者化疗后癌因性疲乏、免疫功能及肿瘤标志物影响的临床研究[J]. 上海中医药杂志,2019, 53(6): 49-53.
杨冀,刘星池,于颖,等. 非小细胞肺癌患者外周血T淋巴细胞亚群与NK细胞活化性受体的表达及临床意义[J]. 细胞与分子免疫学杂志,2020, 36(12): 1118-1123.
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