摘要
目的探讨消胀抑瘤方联合全身及腹腔内化疗治疗晚期胃癌所致恶性腹腔积液的临床疗效及安全性。方法 70例晚期胃癌所致恶性腹腔积液辨证属肝郁脾虚证型患者,按随机数表法分成治疗组和对照组各35例。对照组仅给予左亚叶酸钙100 mg/m^2+5-氟尿嘧啶2.0 g/m^2+紫杉醇95 mg/m2(静脉滴注)+紫杉醇30 mg/m^2(腹腔灌注化疗)双周方案化疗。治疗组采用相同方案化疗,并口服消胀抑瘤方,每日1剂。两组疗程均为30天,疗程结束后观察两组患者腹腔积液疗效及中医证候疗效,治疗期间记录引流腹腔积液次数、化疗毒副反应发生情况。结果治疗组腹腔积液疗效有效率为62.86%,稳定率为85.71%;对照组分别为为51.43%和62.86%,治疗组稳定率优于对照组(P<0.05)。治疗组引流腹水次数显著少于对照组(P<0.05)。治疗组恶心、呕吐,腹泻,中性粒细胞下降,转氨酶升高等化疗毒副反应的发生率显著低于对照组(P<0.05)。治疗组中医证候疗效优于对照组(P<0.05)。结论消胀抑瘤方联合全身及腹腔内化疗治疗肝郁脾虚型胃癌所致恶性腹腔积液患者,与单纯化疗相比,可提高腹腔积液治疗稳定率,减少治疗过程中引流腹水次数,减轻化疗毒副反应,改善中医证候,且临床应用安全。
Objective To explore the clinical efficacy and safety of Xiaozhang Yiliu Fang （消肿抑瘤方） com- bined with systemic or intraperitoneal chemotherapy in treating advanced gastric cancer-induced malignant ascites.Methods Seventy patients with advanced gastric cancer-induced malignant ascites and differentiated as liver con- straint and spleen deficiency type were randomized into treatment group and control group with 35 eases in each group. The control group was administered Calcium levofolinate 100 mg/ mE ＋ 5-fluorouracil 2.0 g/m^2 ＋ Paclitaxel 95 mg/m^2 （ intravenous infusion） ＋ Paclitaxel 30 mg/m^2 （ intraperitoneal chemotherapy） biweekly therapy. In addi- tion to the same chemotherapy, the treatment group also took Xiaozhang Yiliu Fang orally with one dose a day. Both groups were treated for 30 days. After treatment, the ascites changes and Chinese medicine syndrome changes were observed. During treatment, the drainage times and adverse reactions were recorded. Results For the ascites, the total effective rate in the treatment group was 62. 86%, and the stable rate was 85.71% ; those in the control group were respectively 51.43% and 62.86%. The stable rate in the treatment group was significantly higher than that in the control group （ P 〈 0. 05 ）. The drainage frequency in the treatment was significantly lower than that in the control group （P 〈 0. 05 ）. So was the incidence rate of adverse reactions such as nausea, emesis, diarrhea, neutrophil de- creasing and transaminases elevating （ P 〈 0. 05 ）. The efficacy of improving the Chinese medicine syndrome in the treatment group was significantly better than that in the control group （ P 〈 0. 05 ）. Conclusion Xiaozhang Yiliu Fang combined with systematic or intraperitoneal chemotherapy shows better effect than chemotherapy alone in treating gastric cancer-induced malignant ascites patients of liver constraint and spleen deficiency type. It could increase the stable rate in treating ascites, reduce the drainage times induced adverse reactions and improving Chinese medicine during treatment as well as relieving the chemotherapy- syndromes with good clinical safety.
出处
《中医杂志》
CSCD
北大核心
2017年第11期936-940,共5页
Journal of Traditional Chinese Medicine
基金
福建省自然科学基金(2015J01437)
福建省卫生计生委国家临床重点专科建设项目(2013年度)
关键词
胃癌
恶性腹腔积液
消胀抑瘤方
gastric cancer
malignant ascites
Xiaozhang Yiliu Fang （消肿抑瘤方）
