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1.绍兴第二医院医共体总院(浙江 绍兴 312000)
2.杭州市萧山区中医院医共体总院新街分院(浙江 杭州 311200)
骆学新,男,本科,主任中医师,主要从事中医内科临床与研究工作
张梨琴,主治中医师;E-mail:924783271@qq.com
收稿日期:2024-07-04,
纸质出版日期:2025-04-10
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骆学新,张梨琴,周罗瑜.加味温胆汤联合甲地孕酮治疗脾胃湿热型癌性厌食的疗效观察[J].上海中医药杂志,2025,59(4):55-58.
LUO Xuexin,ZHANG Liqin,ZHOU Luoyu.Clinical efficacy of modified Wendan Decoction combined with megestrol acetate in treating cancer‑related anorexia with spleen⁃stomach damp⁃heat syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(4):55-58.
骆学新,张梨琴,周罗瑜.加味温胆汤联合甲地孕酮治疗脾胃湿热型癌性厌食的疗效观察[J].上海中医药杂志,2025,59(4):55-58. DOI: 10.16305/j.1007-1334.2025.z20240704001.
LUO Xuexin,ZHANG Liqin,ZHOU Luoyu.Clinical efficacy of modified Wendan Decoction combined with megestrol acetate in treating cancer‑related anorexia with spleen⁃stomach damp⁃heat syndrome[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(4):55-58. DOI: 10.16305/j.1007-1334.2025.z20240704001.
目的
2
观察加味温胆汤联合甲地孕酮治疗脾胃湿热型癌性厌食的临床疗效,探讨癌性厌食的中西医结合治疗方案。
方法
2
将67例脾胃湿热型癌性厌食患者随机分为对照组(34例)、观察组(33例),对照组给予醋酸甲地孕酮分散片治疗,观察组在此基础上联合使用加味温胆汤,两组疗程均为28 d。观察临床疗效,比较欧洲癌症治疗研究组织生命质量测定量表(EORTC QLQ-C30)评分、中医证候积分的变化情况,同时进行安全性评价。
结果
2
①观察组、对照组总有效率分别为100%、82.4%;两组临床疗效比较,差异有统计学意义(
P
<
0.05)。②治疗前后组内比较,观察组角色功能、情绪功能、总体健康状况等评分升高,疲劳、疼痛、恶心呕吐等评分降低,差异有统计学意义(
P
<
0.05);对照组总体健康状况评分升高,疲劳、疼痛、恶心呕吐等评分降低,差异有统计学意义(
P
<
0.05)。组间治疗后比较,角色功能、情绪功能、疲劳、恶心呕吐等评分差异有统计学意义(
P
<
0.05)。③治疗前后组内比较,观察组胃脘痞满不舒、食少纳呆、口苦或黏、呃逆泛酸、大便不畅评分降低(
P
<
0.05),对照组食少纳呆评分降低(
P
<
0.05);组间治疗后比较,观察组胃脘痞满不舒、食少纳呆、口苦或黏、呃逆泛酸、大便不畅评分低于对照组(
P
<
0.05)。④试验期间,所有患者均未出现明显不良反应。
结论
2
与单纯采用醋酸甲地孕酮分散片治疗比较,联合使用加味温胆汤治疗脾胃湿热型癌性厌食疗效满意,能更好地改善患者的消化不良相关症状及生存质量,且安全性良好。
Objective
2
To evaluate the clinical efficacy of modified Wendan Decoction combined with megestrol acetate in the treatment of cancer-related anorexia with spleen-stomach damp-heat syndrome, and to explore an integrated protocol combining Chinese and Western medicine for cancer-related anorexia.
Methods
2
A total of 67 patients with cancer-related anorexia with the spleen-stomach damp-heat syndrome were randomly assigned to either a control group (
n
=34) or an observation group (
n
=33). The control group received treatment with megestrol acetate dispersible tablets, while th
e observation group received the same treatment in addition to modified Wendan Decoction. Both groups were treated for 28 days. Clinical efficacy was assessed, and changes in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) scores, as well as traditional Chinese medicine (TCM) syndrome scores, were compared. A safety evaluation was also conducted.
Results
2
①The total effective rate in the observation group and the control group was 100% and 82.4%, respectively. The difference between the two groups was statistically significant (
P
<
0.05). ②Intra-group comparisons before and after treatment showed that, in the observation group, scores for role function, emotional function, and overall health status increased on the EORTC QLQ-C30, while scores for fatigue, pain, and nausea/vomiting difficulty decreased (
P
<
0.05). In the control group, scores for overall health status increased, while scores for fatigue, pain, and nausea/vomiting decreased (
P
<
0.05). Inter-group comparisons after treatment revealed statistically significant differences in role function, emotional function, fatigue, and nausea/vomiting (
P
<
0.05). ③Intra-group comparisons before and after treatment showed that, in the observation group, scores for symptoms such as epigastric fullness, poor appetite, bitterness or stickiness in the mouth, belching and acid regurgitation, and constipation significantly decreased (
P
<
0.05); in the control group, scores for poor appetite also decreased (
P
<
0.05). Inter-group comparisons after treatment showed that the observation group had significantly lower scores for epigastric fullness, poor appetite, bitterness or stickiness in the mouth, belching and acid regurgitation, and constipation than the control group (
P
<
0.05). ④No significant adverse reactions were observed in any of the patients during
the trial.
Conclusions
2
Treatment with the combination of modified Wendan Decoction and megestrol acetate dispersible tablets is more effective than using megestrol acetate alone in treating cancer-related anorexia with the spleen-stomach damp-heat syndrome. This combined treatment more effectively alleviates indigestion-related symptoms, improves patients' quality of life, and demonstrates good safety.
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