黄连解毒汤加减对EC放疗患者的增效减毒效果观察
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摘要
目的分析黄连解毒汤加减对食管癌(EC)放疗患者的增效减毒效果。方法 60例实施三维适型放疗(3D-CRT)的EC患者随机分为联合组与对照组,联合组加服黄连解毒汤加减治疗。治疗前后评估患者症状积分和Karnofsky评分改善效果;治疗2个月后判定近期疗效,并统计毒副反应情况。结果治疗后,联合组症状积分降低幅度、Karnofsky评分升高幅度较对照组明显(P <0.05);联合组治疗后总缓解率与对照组比较无显著性差异(P> 0.05),但总稳定率明显高于对照组(P <0.05)。与对照组比较,联合组毒副反应发生率大幅降低(P <0.05),且程度更轻。结论黄连解毒汤加减配合3D-CRT治疗EC,有助于改善患者临床症状及体力状况,提高治疗效果,并减少和减轻放疗毒副作用,继而达到增效、减毒双重效果。
Objective To analyze the synergistic and detoxifying effects of Huanglian Jiedu Decoction on patients with esophageal cancer(EC) undergoing radiotherapy. Methods A total of 60 EC patients who underwent three-dimensional conformal radiotherapy(3 D-CRT) were randomly divided into a combined group and a control group. The combined group was treated with Huanglian Jiedu Decoction additionally. The improvement effect of symptom score and Karnofsky score was evaluated before and after the treatment;after two months of treatment, the short-term efficacy was determined and the toxicity and side effects were counted. Results After the treatment, the decrease of symptom score and the increase of Karnofsky score in the combined group were significantly higher than those in the control group(P < 0.05); the total remission rate in the combined group was not significantly different from that in the control group(P > 0.05), but the total stability rate was significantly higher than that in the control group(P < 0.05). Compared with the control group, the incidence of toxic and side effects in the combined group was significantly lower(P < 0.05), and the degree was lighter. Conclusion Huanglian Jiedu Decoction combined with 3 D-CRT in the treatment of EC is helpful for improving the clinical symptoms and physical condition of patients as well as the therapeutic effect and reducing the toxic side effects of radiotherapy, and then achieving the dual effects of synergy and attenuation.
Objective To analyze the synergistic and detoxifying effects of Huanglian Jiedu Decoction on patients with esophageal cancer(EC) undergoing radiotherapy. Methods A total of 60 EC patients who underwent three-dimensional conformal radiotherapy(3 D-CRT) were randomly divided into a combined group and a control group. The combined group was treated with Huanglian Jiedu Decoction additionally. The improvement effect of symptom score and Karnofsky score was evaluated before and after the treatment;after two months of treatment, the short-term efficacy was determined and the toxicity and side effects were counted. Results After the treatment, the decrease of symptom score and the increase of Karnofsky score in the combined group were significantly higher than those in the control group(P < 0.05); the total remission rate in the combined group was not significantly different from that in the control group(P > 0.05), but the total stability rate was significantly higher than that in the control group(P < 0.05). Compared with the control group, the incidence of toxic and side effects in the combined group was significantly lower(P < 0.05), and the degree was lighter. Conclusion Huanglian Jiedu Decoction combined with 3 D-CRT in the treatment of EC is helpful for improving the clinical symptoms and physical condition of patients as well as the therapeutic effect and reducing the toxic side effects of radiotherapy, and then achieving the dual effects of synergy and attenuation.
引文
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[9]Duffaud F,Therasse P.New guidelines to evaluate the response to treatment in solid tumors[J].Journal of National Cancer Institute,2000,92(1):16-27.
[10]Cliffton EE,Goodner JT,Bronstein E.Preoperative irradiation for cancer of the esophagus[J].Cancer,2015,13(1):37-45.
[11]周青,孙长侠,孙斐,等.启膈化痰合剂对顺铂治疗小鼠食管癌的减毒增效作用[J].中国现代中药,2018,20(3):283-287.
[12]刘洁,李立平,赵亚刚.食管癌中医证型分布与中药治疗研究进展[J].中华中医药学刊,2017,35(7):1772-1774.
[13]黄煦霞.黄连解毒汤加减治疗老年全身炎症反应综合征的临床研究[J].中医药学报,2016,44(4):33-36.
[14]王林,罗苑苑,陶如,等.黄连解毒汤加减治疗热毒型脓毒症临床研究[J].中医学报,2017,32(8):1527-1530.
[2]黄伟,钱梦,谢鸣.肿瘤放射治疗配合中药增效减毒的临床研究进展[J].中国药师,2017,20(8):1374-1381.
[3]谢利,刁本恕,刁灿阳,等.扶正减毒抗癌方联合艾灸对非小细胞肺癌放射治疗增效减毒作用的临床研究[J].辽宁中医杂志,2016,43(4):762-764.
[4]耿惠,张永红,王玉强,等.中药组方联合放疗治疗中晚期食管癌效果观察[J].肿瘤研究与临床,2016,28(6):412-414.
[5]Nomura M,Shitara K,Kodaira T,et al.Prognostic impact of the6th and 7th American Joint Committee on Cancer TNM Staging Systems on esophageal cancer patients treated with chemoradiotherapy[J].International Journal of Radiation Oncology Biology Physics,2012,82(2):946.
[6]周岱翰.临床中医肿瘤学[M].北京:人民卫生出版社,2003:214-217.
[7]张伯臾.中医内科学[M].上海:上海科学技术出版社,1985:139-141.
[8]樊晓静,史志涛,孙昕.活血健脾中药联合顺铂化疗对直肠癌患者肿瘤相关指标、Karnofsky评分及ECOG评分的影响分析[J].中华中医药学刊,2017,35(11):2969-2972.
[9]Duffaud F,Therasse P.New guidelines to evaluate the response to treatment in solid tumors[J].Journal of National Cancer Institute,2000,92(1):16-27.
[10]Cliffton EE,Goodner JT,Bronstein E.Preoperative irradiation for cancer of the esophagus[J].Cancer,2015,13(1):37-45.
[11]周青,孙长侠,孙斐,等.启膈化痰合剂对顺铂治疗小鼠食管癌的减毒增效作用[J].中国现代中药,2018,20(3):283-287.
[12]刘洁,李立平,赵亚刚.食管癌中医证型分布与中药治疗研究进展[J].中华中医药学刊,2017,35(7):1772-1774.
[13]黄煦霞.黄连解毒汤加减治疗老年全身炎症反应综合征的临床研究[J].中医药学报,2016,44(4):33-36.
[14]王林,罗苑苑,陶如,等.黄连解毒汤加减治疗热毒型脓毒症临床研究[J].中医学报,2017,32(8):1527-1530.