温阳逐水方外敷联合顺铂腔内灌注治疗恶性胸水的临床研究
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摘要
目的:观察温阳逐水方外敷联合化疗腔内灌注治疗恶性胸水疗效。方法:66例大中量胸腔积液的肺癌患者,随机分为试验组、对照组,每组33例。对照组120 mg顺铂分两次胸腔灌注,试验组顺铂胸腔灌注的基础上加用温阳逐水方外敷。疗效评价:胸水客观缓解率(ORR)、无进展生存期(PFS)、临床症状改善等。结果:试验组和对照组ORR分别是81.8%和72.7%(P>0.05),胸水中位PFS分别是5.2月和3.2月(P<0.05),主要临床症状(乏力、咳嗽、胸痛、气紧)分析,治疗1个月后试验组乏力改善明显优于对照组(P<0.05),其余症状改善无明显差异(P>0.05),3个月后胸水相关临床症状试验组改善均优于对照组(P<0.05)。结论:温阳逐水方外敷联合顺铂腔内灌注,可明显延长胸水PFS,缓解临床症状,值得临床推广。
Objective:To observe the clinical effect of Wenyang Zhushui Decoction combined with cisplatin local chemotherapy in the treatment of malignant hydrothorax(MPE).Methods:Sixty-six patients with MPE were randomly divided into experimental group(Chinese medicine combined with DDP) and contral group(only DDP),each group 33 cases.Contral group and experimental group received 120 mg DDP thoracic perfusion.Experimental group used external therapy of Wenyang Zhushui Decoction on chest wall.Results:The remission rates of contral group and experimental group were 81.8% VS 72.7%(P>0.05).There were no significant statistical differences between two groups.The progression free survivals(PFS)of experimental group and contral group were 5.2 vs 3.2 mouths(P<0.05).One month later,experimental group′s fatigue was higher remission than the contral group patients′(P<0.05).Cough,thoracalgia and anhelation had no significant difference between two groups(P>0.05).After 3 months,experimental group′s cough,thoracalgia and anhelation have higher remission than the contral group patients′.There was significant difference between two groups(P<0.05).Conclusion:Extra-apply of Wenyang Zhushui Decoction is an effective treatment for malignant pleural effusion and improve progression free survival and patients′ quality of life,and reduce clinical symptoms.It is worthy of further clinical promotion.
Objective:To observe the clinical effect of Wenyang Zhushui Decoction combined with cisplatin local chemotherapy in the treatment of malignant hydrothorax(MPE).Methods:Sixty-six patients with MPE were randomly divided into experimental group(Chinese medicine combined with DDP) and contral group(only DDP),each group 33 cases.Contral group and experimental group received 120 mg DDP thoracic perfusion.Experimental group used external therapy of Wenyang Zhushui Decoction on chest wall.Results:The remission rates of contral group and experimental group were 81.8% VS 72.7%(P>0.05).There were no significant statistical differences between two groups.The progression free survivals(PFS)of experimental group and contral group were 5.2 vs 3.2 mouths(P<0.05).One month later,experimental group′s fatigue was higher remission than the contral group patients′(P<0.05).Cough,thoracalgia and anhelation had no significant difference between two groups(P>0.05).After 3 months,experimental group′s cough,thoracalgia and anhelation have higher remission than the contral group patients′.There was significant difference between two groups(P<0.05).Conclusion:Extra-apply of Wenyang Zhushui Decoction is an effective treatment for malignant pleural effusion and improve progression free survival and patients′ quality of life,and reduce clinical symptoms.It is worthy of further clinical promotion.
引文
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[13] 悬饮的诊断依据·证候分类·疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.1-94)[J].辽宁中医药大学学报,2014,16(11):222.
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[15] 王景良.蠲饮汤联合胸腔化疗及射频热疗治疗恶性胸腔积液36例临床观察[J].中医杂志,2013,54(15):1312-1315.
[16] 许建新,王燕山,吴炳辰,等.腹水消外敷治疗晚期肿瘤恶性腹水21例疗效观察[J].新中医,2013,45(5):106-107.
[17] 姚晓东.葶苈大枣泻肺汤联合鸦胆子油乳治疗癌性胸水42例[J].江西中医药,2011,42(6):30-31.
[18] 刘传坪.烧伤局部外涂鸡蛋清疗效观察[J].吉林医药学院学报,1997,19(3):147-148.
[2] 中国恶性胸腔积液诊断与治疗专家共识组.恶性胸腔积液诊断与治疗专家共识[J].中华内科杂志,2014,53(3):252-256.
[3] Oken MM,Creech RH,Tormey DC,et al.Toxicity and response criteria of the Eastern Cooperative Oncology Group[J].Am J Clin Oncol,1982,5(6):649-655.
[4] 周际昌.实用肿瘤内科学[M].3版.北京:人民卫生出版社,2005.
[5] 魏大燕.中药引起皮肤不良反应的原因分析[J].河南中医,2015,35(5):1088-1090.
[6] 顾康生.肿瘤内科诊治手册[M].合肥:安徽科学技术出版社,2006:66-67,67-69.
[7] Jiang T,Li A,Su C,et al.Addition of bevacizumab for malignant pleural effusion as the manifestation of acquired EGFR-TKI resistance in NSCLC patients[J].Oncotarget,2015,8(37):62648-62657.
[8] 蒋健,李延晖.灵通胶囊治疗原发性痛经随机双盲对照临床研究[J].中国中西医结合杂志,2014,34(4):439-441.
[9] Jehn M,Schindler C,Meyer A,et al.Associations of daily walking activity with biomarkers related to cardiac distress in patients with chronic obstructive pulmonary disease[J].Respiration,2013,85(3):195-202.
[10] Roberts ME,Neville E,Berrisford RG,et al.Management of a malignant pleural effusion:British Thoracic Society Pleural Disease Guideline 2010[J].Thorax,2010,65(Suppl 2):ii32-40.
[11] 黄琼.中药外敷联合胸腔内化疗治疗肺癌恶性胸腔积液30例[J].浙江中医杂志,2012,47(2):102.
[12] 赵永军,宁中茹.恶性胸腔积液治疗现状与进展[J].医学信息(中旬刊),2011,24(4):1677-1678.
[13] 悬饮的诊断依据·证候分类·疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.1-94)[J].辽宁中医药大学学报,2014,16(11):222.
[14] 于晓丽.《诸病源候论》痰饮病病因病机浅议[J].黑龙江中医药,2014(2):7-8.
[15] 王景良.蠲饮汤联合胸腔化疗及射频热疗治疗恶性胸腔积液36例临床观察[J].中医杂志,2013,54(15):1312-1315.
[16] 许建新,王燕山,吴炳辰,等.腹水消外敷治疗晚期肿瘤恶性腹水21例疗效观察[J].新中医,2013,45(5):106-107.
[17] 姚晓东.葶苈大枣泻肺汤联合鸦胆子油乳治疗癌性胸水42例[J].江西中医药,2011,42(6):30-31.
[18] 刘传坪.烧伤局部外涂鸡蛋清疗效观察[J].吉林医药学院学报,1997,19(3):147-148.