本文選題：扶正化痰祛瘀法 + 肺腺癌��； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：研究目的:運(yùn)用扶正化痰祛瘀方聯(lián)合化療治療中晚期肺腺癌患者,分析扶正化痰祛瘀法對(duì)中晚期肺腺癌患者近期療效、生存質(zhì)量及化療毒副反應(yīng)的影響;觀察扶正化痰祛瘀方對(duì)A549肺癌BALB/c裸鼠皮下移植瘤生長(zhǎng)的影響,并探討此法可能的抗腫瘤作用機(jī)制。研究方法:1.將42例經(jīng)細(xì)胞學(xué)或病理學(xué)確診為中晚期的肺腺癌患者,隨機(jī)分為試驗(yàn)組(扶正化痰祛瘀方+化療組)21例和對(duì)照組(單純化療組)21例,通過(guò)2個(gè)周期的治療,觀察兩組近期客觀有效率、肺癌相關(guān)腫瘤標(biāo)志、中醫(yī)癥候和KPS評(píng)分的變化,并觀察兩組化療期間毒副反應(yīng)的發(fā)生狀況。2.培養(yǎng)A549肺癌細(xì)胞,建立裸鼠皮下移植瘤模型,將其分成生理鹽水組、中藥組(扶正化痰祛瘀方)、順鉑組、中藥(扶正化痰祛瘀方)+順鉑組,觀察給藥期間裸鼠日�；顒�(dòng)、精神狀態(tài)及腫瘤生長(zhǎng)變化,計(jì)算瘤體體積、瘤重抑制率;用免疫組化法測(cè)定四組瘤體中bcl-2、bax和突變型p53基因的表達(dá)情況。研究結(jié)果:1.治療2個(gè)周期后,試驗(yàn)組在咳痰、痰血、胸痛及乏力四個(gè)癥狀上有顯著改善,與對(duì)照組相比,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組相比,試驗(yàn)組在化療毒副反應(yīng)如骨髓抑制、惡心嘔吐的發(fā)生率上明顯減少,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.中藥+順鉑組裸鼠皮下移植瘤體積及瘤重明顯小于生理鹽水組,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01),同時(shí)亦小于中藥組和化療組,差異有統(tǒng)計(jì)學(xué)差異(P0.05);中藥+順鉑組bcl-2、突變型p53基因表達(dá)陽(yáng)性面積光密度值(IOD)明顯低于生理鹽水組,差異具有顯著統(tǒng)計(jì)學(xué)意義(P0.01),同時(shí)亦低于中藥組及順鉑組(P0.05);中藥+順鉑組bax基因表達(dá)IOD值高于生理鹽水組,差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01),同時(shí)亦高于中藥組和順鉑組(P0.05)。研究結(jié)論:扶正化痰祛瘀法在提高患者生存質(zhì)量、減輕化療帶來(lái)的骨髓抑制和惡心嘔吐方面有確切療效,與化療聯(lián)用療效更優(yōu);扶正化痰祛瘀法聯(lián)合化療能明顯抑制肺癌皮下移植瘤生長(zhǎng),其作用機(jī)制可能與下調(diào)bcl-2基因、突變型p53基因,上調(diào)bax基因,從而加速腫瘤細(xì)胞凋亡有關(guān)。
[Abstract]:Objective: to study the effect of Fuzheng Huatan Quyu recipe combined with chemotherapy in the treatment of middle and late stage lung adenocarcinoma, and to analyze the effect of Fuzheng Huatan Quyu method on the short-term curative effect, quality of life and side effects of chemotherapy in patients with middle and late stage lung adenocarcinoma. To observe the effect of Fuzheng Huatan Quyu recipe on the growth of A549 lung cancer BALB / C nude mice subcutaneously transplanted tumor and to explore the possible anti-tumor mechanism of this method. Research method: 1. 42 cases of lung adenocarcinoma diagnosed by cytology or pathology were randomly divided into two groups: the experimental group (21 cases) and the control group (21 cases). Observe the short-term objective effective rate, lung cancer related tumor markers, TCM symptoms and KPS score changes, and observe the occurrence of adverse reactions during the two groups of chemotherapy. 2. A549 lung cancer cells were cultured and subcutaneously transplanted tumor models were established in nude mice. They were divided into normal saline group, traditional Chinese medicine group (Fuzheng Huatan Quyu recipe), cisplatin group and traditional Chinese medicine (Fuzheng Huatan Quyu recipe) cisplatin group. The daily activities of nude mice during administration were observed. Mental state and tumor growth, tumor volume and tumor weight inhibition rate were calculated, and the expression of bcl-2mbax and mutant p53 gene were detected by immunohistochemical method. The result of the study was: 1. After 2 cycles of treatment, the four symptoms of expectoration, phlegm and blood, chest pain and fatigue in the experimental group were significantly improved, compared with the control group, the difference was statistically significant (P0.05). The incidence of nausea and vomiting was significantly reduced, the difference was statistically significant (P0.05). The volume and weight of subcutaneous transplanted tumor in Cisplatin group were significantly smaller than those in normal saline group (P0.01), but also smaller than those in traditional Chinese medicine group and chemotherapy group. The positive area optical density (IOD) of mutant p53 gene expression in Cisplatin group was significantly lower than that in normal saline group. The difference was statistically significant (P0.01), but also lower than the traditional Chinese medicine group and cisplatin group (P0.05); the bax gene expression in the Cisplatin group was higher than that in the saline group (P0.01), but also higher than the traditional Chinese medicine group and cisplatin group (P0.05). Conclusion: the method of tonifying and removing phlegm and removing blood stasis is effective in improving the quality of life of patients and alleviating the bone marrow depression and nausea and vomiting caused by chemotherapy, and the combination of chemotherapy and chemotherapy is more effective. The combination of Fuzheng phlegm dispelling blood stasis method and chemotherapy can obviously inhibit the growth of lung cancer subcutaneously transplanted tumor, its mechanism may be related to down-regulation of bcl-2 gene, mutant p53 gene, upregulation of bax gene, thus accelerating the apoptosis of tumor cells.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R734.2

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