复方苦参注射液治疗肺癌骨转移疼痛的疗效及对Dickkopf1浓度的影响
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摘要
目的:探讨复方苦参注射液治疗肺癌骨转移疼痛的临床疗效,及其对Dickkopf1浓度的影响。方法:选择本院肿瘤2013年1月至2014年1月诊治的120例确诊为肺癌骨转移的患者为研究对象,采用随机数字表随机分为2组,每组60例。对照组给予常规的化疗方案治疗,予多西紫杉醇联合顺铂化疗方案。治疗组在常规西医化疗的基础上加用复方苦参注射液静滴治疗,2组均给予两个周期的化疗。观察2组患者治疗前后的临床疗效,以及观察2组患者治疗过程中不良反应的发生情况。同时,采用ELISA法检测2组患者治疗前后血清中Dickkopf1的表达。结果:经治疗后,治疗组的有效率及临床受益率达48.33%及81.67%,对照组的有效率及临床受益率达31.67%及70.00%,治疗组的临床疗效明显高于对照组,差异具有统计学意义(P<0.05)。2组患者的VAS评分均有所下降,差异较治疗前均具有统计学意义(P<0.05);而治疗组的下降程度较对照组更为明显,差异具有统计学意义(P<0.05)。2组患者不良事件的反应率比较,差异无统计学意义(P>0.05);2组患者血清中Dickkopf1的表达均有所下降,差异均具有统计学意义(P<0.05);而治疗组的下降程度较对照组更为明显,差异具有统计学意义(P<0.05)。结论:复方苦参注射液能有效的改善肺癌骨转移患者的临床症状,改善患者骨转移后疼痛症状,并能降低患者血清中Dickkopf1的表达,且不良事件反应少,安全性高,值得临床推广应用。
Objective: To investigate clinical efficacy of Composite Lightyellow Sophora Root Injection in the treatment of bone metastasis pain and its influences on Dickkopf1 concentration. Methods: Tumor patients of 120 cases in our hospital from January2013 to January 2014,diagnosed with lung cancer and bone metastases were randomly divided into two groups by random number table. Each group had 60 cases. The control group received conventional chemotherapy by docetaxel plus cisplatin chemotherapy.On the basis of conventional western medicine treatment,the observation group also received Composite Lightyellow Sophora Root Injection treatment,both groups were given two courses of chemotherapy. Clinical efficacy and adverse reactions were observed before and after treatment. Meanwhile,the expression of Dickkopf1 in patients' serum was detected before and after the treatment by ELISA method. Results: After treatment,the effective rate and clinical benefit rate were 48. 33% and 81. 67% of the the observation group,while those in the control were 31. 67% and 70. 00%,which indicated that the observation group had better efficacy,the differences were statistically significant( P < 0. 05). VAS scores of two groups of patients declined,it was significantly( P <0. 05) different compared with that before the treatment; and the degree of declination in the observation group was significantly( P< 0. 05) different compared with that of the control group. As for the reaction rate of adverse reactions in both groups,the difference was not statistically significant( P > 0. 05); serum Dickkopf1 expression in the two groups declined,the differences were statistically significant( P < 0. 05); and the observation group declined in a larger degree than the control group,the difference was statistically significant( P < 0. 05). Conclusion: Composite Lightyellow Sophora Root Injection can effectively improve the clinical symptoms of lung cancer patients with bone metastases and relieve pain,as well as reduce the expression of Dickkopf1 and has lessadverse reactions,which is safe and recommended to promote in clinical administration.
Objective: To investigate clinical efficacy of Composite Lightyellow Sophora Root Injection in the treatment of bone metastasis pain and its influences on Dickkopf1 concentration. Methods: Tumor patients of 120 cases in our hospital from January2013 to January 2014,diagnosed with lung cancer and bone metastases were randomly divided into two groups by random number table. Each group had 60 cases. The control group received conventional chemotherapy by docetaxel plus cisplatin chemotherapy.On the basis of conventional western medicine treatment,the observation group also received Composite Lightyellow Sophora Root Injection treatment,both groups were given two courses of chemotherapy. Clinical efficacy and adverse reactions were observed before and after treatment. Meanwhile,the expression of Dickkopf1 in patients' serum was detected before and after the treatment by ELISA method. Results: After treatment,the effective rate and clinical benefit rate were 48. 33% and 81. 67% of the the observation group,while those in the control were 31. 67% and 70. 00%,which indicated that the observation group had better efficacy,the differences were statistically significant( P < 0. 05). VAS scores of two groups of patients declined,it was significantly( P <0. 05) different compared with that before the treatment; and the degree of declination in the observation group was significantly( P< 0. 05) different compared with that of the control group. As for the reaction rate of adverse reactions in both groups,the difference was not statistically significant( P > 0. 05); serum Dickkopf1 expression in the two groups declined,the differences were statistically significant( P < 0. 05); and the observation group declined in a larger degree than the control group,the difference was statistically significant( P < 0. 05). Conclusion: Composite Lightyellow Sophora Root Injection can effectively improve the clinical symptoms of lung cancer patients with bone metastases and relieve pain,as well as reduce the expression of Dickkopf1 and has lessadverse reactions,which is safe and recommended to promote in clinical administration.
引文
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[9]陈滨海,张雅丽,付焕萍,等.阿片类药物控制癌性疼痛所致不良反应中医治疗体会[J].中医杂志,2015,56(14):1252-1253.
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[13]陈娟,杨红忠.分泌蛋白DKK1(Dickkopf-1)在非小细胞肺癌患者血清及组织中的表达及其意义[J].湖南师范大学学报:医学版,2014,11(3):10-15.
[14]李银鹏,石芳,杨婧,等.肺癌患者血清和胸水中Dickkopf-1的表达及临床意义[J].河北医药,2015,37(6):815-818.
[15]唐玉琦,郑玲.复方苦参注射液的抗肿瘤临床应用现状[J].肿瘤药学,2015,5(2):92-96.
[2]Jemal A,Bray F,Center MM,et al.Global cancer statistics[J].CACancer J Clin,2011,61(2):69-90.
[3]Ferlay J,Shin HR,Bray F,et al.Estimates of worldwide burden of cancer in 2008:GLOBOCAN 2008[J].Int J Cancer,2010,127(12):2893-2917.
[4]张伟,冯燕,金榕兵,等.基于PET/CT的Ⅳ期肺癌转移特点的临床分析[J].第三军医大学学报,2015,37(6):532-537.
[5]石磊.复方苦参注射液联合化疗治疗肺癌骨转移癌痛的比较分析[D].太原:山西医科大学,2014.
[6]Silver J,Mayer R S.Barriers to pain management in the rehabilita-tion of the surgical oncology patient[J].J Surg Oncol,2007,95(5):427-435.
[7]马悦,张启伟,王智民,等.复方苦参注射液研究进展[J].中国实验方剂学杂志,2012,18(23):342-345.
[9]陈滨海,张雅丽,付焕萍,等.阿片类药物控制癌性疼痛所致不良反应中医治疗体会[J].中医杂志,2015,56(14):1252-1253.
[10]刘巍.《欧洲癌痛阿片类药物镇痛指南》带来的启示[J].中国肿瘤临床,2012,29(21):1591-1594.
[11]Licchesi JD,Van Neste L,Tiwari VK,et al.Transcriptional regulation of Wnt inhibitory factor-1 by Miz-1/c-Myc[J].Oncogene,2010,29(44):5923-5934.
[12]von Marschall Z,Fisher L.Secreted frizzled-related protein-2(s FRP2)augments canonical Wnt3a-induced signaling[J].Biochem Biophys Res Commun,2010,400(3):299-304.
[13]陈娟,杨红忠.分泌蛋白DKK1(Dickkopf-1)在非小细胞肺癌患者血清及组织中的表达及其意义[J].湖南师范大学学报:医学版,2014,11(3):10-15.
[14]李银鹏,石芳,杨婧,等.肺癌患者血清和胸水中Dickkopf-1的表达及临床意义[J].河北医药,2015,37(6):815-818.
[15]唐玉琦,郑玲.复方苦参注射液的抗肿瘤临床应用现状[J].肿瘤药学,2015,5(2):92-96.