本文選題：惡性胸腔積液　切入點：竭泉飲　出處：《黑龍江中醫(yī)藥大學》2013年碩士論文　論文類型：學位論文

【摘要】：研究目的：觀察竭泉飲聯(lián)合胸腔生物化療治療惡性胸腔積液的臨床療效。 研究方法：選擇黑龍江中醫(yī)藥大學附屬第一醫(yī)院門診和住院部符合納入標準的飲停胸脅型惡性胸腔積液患者64例,隨機分為兩組,治療組32例,對照組32例。治療組脫落2例,對照組脫落2例。兩組患者經(jīng)B超定位后,局部利多卡因麻醉,胸腔內(nèi)置管,將胸腔積液盡量抽盡,首次抽液者抽液600ml,以后每次不超過1000ml,予以胸腔內(nèi)注入生理鹽水20ml+力爾凡50mg,隔一天一次,共三次,第七天胸腔內(nèi)注入生理鹽水20ml+順鉑80mg。治療組同時口服竭泉飲,由我院中藥制劑室統(tǒng)一煎制,真空包裝,每袋150ml,300ml早晚分服,連續(xù)服用5周為一療程。重點觀察兩組近期療效,中醫(yī)證候?qū)W療效,生活質(zhì)量,隨訪6個月胸水復(fù)發(fā)率比較等指標。 研究結(jié)果： 1.近期療效：治療組CR3例,PR23例,SD3例,PD1例,無病情加重患者,緩解率為86.7%。對照組CR0例,PR16例,SD9例,PD5例,無病情加重患者,緩解率為55.2%。兩組間有統(tǒng)計學差異(P0.05)。 2.中醫(yī)證候療效：治療組臨床痊愈4例,顯效3例,有效20例,無效3例,總有效率為90%。對照組臨床痊愈1例,顯效3例,有效13例,無效13例,總有效率為56.67%。兩組間有統(tǒng)計學差異(P0.05)。 3.6個月療效：觀察胸水復(fù)發(fā)增長情況,兩組間有統(tǒng)計學差異(P0.05)。 4.生活質(zhì)量評分：治療組治療前后具有顯著性差異(P0.01)。 5.毒副反應(yīng)比較：兩組治療前后比較均無統(tǒng)計學意義(P0.05)。 結(jié)論： 1.竭泉飲聯(lián)合胸腔生物化療治療惡性胸腔積液具有明顯療效； 2.竭泉飲聯(lián)合胸腔生物化療對中醫(yī)證候具有明顯改善作用； 3.竭泉飲聯(lián)合胸腔生物化療對生活質(zhì)量具有顯著改善作用； 4.竭泉飲聯(lián)合胸腔生物化療試驗期間毒副反應(yīng)較輕。
[Abstract]:Objective: To observe the clinical effect of the treatment of malignant pleural effusion with the combined thoracic cavity biologic chemotherapy.
Research methods: the First Affiliated Hospital of Heilongjiang University Of Chinese Medicine outpatient and inpatient department in accordance with the inclusion criteria of 64 cases of chest and hypochondrium Yin type malignant pleural effusion were randomly divided into two groups, 32 cases in the treatment group, 32 cases in the control group. The treatment group 2 cases were lost and the control group. 2 cases. Two groups of patients by ultrasound localization, local lidocaine anesthesia, intrapleural catheter, pleural effusion was aspirated completely for the first time, pumping liquid liquid extraction 600ml, after no more than 1000ml, to be the intrapleural injection of 20ml+ saline lifein 50mg, once every other day, a total of three times, seventh days of intrapleural injection of 20ml+ saline treatment group and cisplatin 80mg. an oral spring drink by traditional Chinese medicine preparation in our hospital room, unified fried, vacuum packaging, each bag is 150ml 300ml, sooner or later the service, taking 5 consecutive weeks as a course of treatment. Observe two groups of curative effect, TCM syndrome curative effect, quality of life, after 6 months of follow-up chest water complex Rate comparison and other indicators.
The results of the study:
1., short-term efficacy: treatment group CR3 cases, PR23 cases, SD3 cases, PD1 cases, no exacerbation of patients, the remission rate is 86.7%. control group CR0 cases, PR16 cases, SD9 cases, PD5 cases, no exacerbation of patients, the remission rate is 55.2%., there is a significant difference between the two groups (P0.05).
2., the efficacy of TCM syndrome: the treatment group was cured in 4 cases, markedly effective in 3 cases, effective in 20 cases, ineffective in 3 cases, the total effective rate was 90%.. In the control group, 1 cases were cured, 3 cases were markedly effective, 13 cases were effective, 13 cases were ineffective, the total effective rate was 56.67%., and there was a significant difference between two groups (P0.05).
3.6 months of curative effect: To observe the recurrence of hydrothorax, and there was a statistical difference between the two groups (P0.05).
4. quality of life score: there was a significant difference in the treatment group before and after treatment (P0.01).
The comparison of 5. toxic and side effects: there was no significant difference between the two groups before and after treatment (P0.05).
Conclusion:
1. exhausted spring drink combined with thoracic cavity biologic chemotherapy is effective in the treatment of malignant pleural effusion.
2. Qi Quan drink combined with thoracic cavity biologic chemotherapy has an obvious effect on TCM syndrome.
3. Qi Quan drink combined with thoracic cavity biologic chemotherapy has a significant improvement on the quality of life.
The toxic side effects of the 4. exhausted spring drink combined with the pleural chemo chemotherapy test were mild.

【學位授予單位】：黑龍江中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R561.3

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