本文選題：二苓苡仁湯　切入點(diǎn)：腸癌術(shù)后　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:評(píng)價(jià)二苓苡仁湯治療大腸癌術(shù)后脾虛濕熱證患者的臨床療效,探討其可能的作用機(jī)制。方法:根據(jù)西醫(yī)診斷依據(jù)和中醫(yī)證候辨證標(biāo)準(zhǔn),搜集40例脾虛濕熱證的大腸腺癌術(shù)后患者,隨機(jī)分為治療組(中藥+化療)20例和對(duì)照組(單純化療)20例。兩組均采用XELOX方案化療,治療組在化療基礎(chǔ)上給予二苓苡仁湯加減治療,每3周為一個(gè)周期,連續(xù)觀察4個(gè)周期,觀察兩組治療前后臨床癥狀、體力狀況、生存質(zhì)量、細(xì)胞免疫功能狀態(tài)、血清腫瘤指標(biāo)等的變化情況及化療后不良反應(yīng),并進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1.對(duì)中醫(yī)癥狀的影響:治療后,治療組中醫(yī)癥狀總積分低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組治療前后"納呆食少"、"口干口苦"、"腹痛"、"失眠多夢"、"面色萎黃"、"肢體困重"、"消瘦"癥狀積分比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05);"脘腹脹滿"、"疲倦乏力"、"氣短懶言"、"大便干結(jié)"、"大便稀溏"癥狀積分治療前后差異無統(tǒng)計(jì)學(xué)意義(P0.05)。對(duì)照組治療后"腹痛"、"大便稀溏"、"消瘦"癥狀較治療前比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后治療組對(duì)"納呆食少"、"口干口苦"、"肢體困重"癥狀改善明顯,與對(duì)照組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.對(duì)生活質(zhì)量評(píng)分的影響:KPS評(píng)分方面,治療后,治療組KPS評(píng)分明顯高于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組治療前后比較,治療組差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組差異無統(tǒng)計(jì)學(xué)意義(P0.05)。生存質(zhì)量評(píng)分方面,治療后,治療組在生理狀況、社會(huì)家庭狀況、情感狀況、功能狀況、附加狀況方面評(píng)分均明顯高于對(duì)照組,有統(tǒng)計(jì)學(xué)差異(P0.05)。兩組治療前后比較,治療組治療后各評(píng)分高于治療前,差異有統(tǒng)計(jì)學(xué)意義(P0.05),對(duì)照組除情感狀況評(píng)分提高有統(tǒng)計(jì)學(xué)意義(P0.05),其余差異不明顯(P0.05)。3.對(duì)細(xì)胞免疫功能的影響:治療后,治療組細(xì)胞免疫指標(biāo)CD3、CD4、CD4/CD8均較前升高,CD8較前降低,對(duì)照組CD3、CD4、CD4/CD8均較前降低,CD8較前升高,治療組免疫功能提高,對(duì)照組免疫功能降低。兩組患者治療后各細(xì)胞免疫指標(biāo)差異有統(tǒng)計(jì)學(xué)意義(P0.05)。4.對(duì)血清腫瘤指標(biāo)的影響:兩組CEA、CA199治療前后及組間對(duì)比,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。5.對(duì)化療不良反應(yīng)的影響:兩組治療后骨髓抑制、肝腎功能損傷、神經(jīng)毒性組間比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組治療后消化道反應(yīng)惡心嘔吐及腹瀉組間比較,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:與單純化療相比,二苓苡仁湯聯(lián)合化療治療腸癌術(shù)后脾虛濕熱證患者,可在臨床癥狀、體力狀況、生存質(zhì)量、細(xì)胞免疫功能等方面有明顯改善作用,可減輕化療所致消化道反應(yīng),在血清腫瘤指標(biāo)、骨髓抑制、肝腎功能損害及神經(jīng)毒性方面未見明顯優(yōu)勢。
[Abstract]:Objective: to evaluate the clinical effect of Erling Yi Ren decoction on spleen deficiency and dampness heat syndrome after operation of colorectal cancer and to explore its possible mechanism.The changes of cellular immune function, serum tumor indexes and adverse reactions after chemotherapy were analyzed statistically.The result is 1: 1.Effect on TCM symptom: after treatment, the total score of TCM symptom in the treatment group was lower than that in the control group, and the difference was statistically significant (P 0.05).Before and after treatment, the scores of symptoms such as "less food intake", "dry mouth and bitter mouth", "abdominal pain", "insomnia and dreams", "yellow complexion", "body weight" and "wasting weight" were compared before and after treatment in the treatment group.The difference was statistically significant (P 0.05), but there was no significant difference between before and after treatment for symptoms of "abdominal distention", "fatigue and fatigue", "shortness of breath and lazy speech", "dry stool knot" and "loose stool" before and after treatment.The symptoms of "abdominal pain", "loose stools" and "emaciation" in the control group were significantly different from those before treatment (P 0.05).After treatment, the symptoms of "less food intake", "bitter mouth dry mouth" and "heavy limbs" in the treatment group were obviously improved, and the difference was statistically significant compared with that in the control group (P 0.05).The effect on the quality of life score: after treatment, the KPS score in the treatment group was significantly higher than that in the control group, and the difference was statistically significant (P 0.05).The difference between the two groups before and after treatment was statistically significant (P 0.05), while that in the control group was not significant (P 0.05).The scores of quality of life in the treatment group were significantly higher than those in the control group in terms of physiological status, social and family status, emotional status, functional status, and additional status after treatment, with statistical difference (P 0.05).Before and after treatment, the scores in the treatment group were higher than those before treatment, the difference was statistically significant (P 0.05). In the control group, there was no significant difference except for the improvement of the emotional status score (P 0.05), while the other differences were not significant (P 0.05).After treatment, there was a significant difference in the cellular immune indexes between the two groups (P 0.05, P < 0. 05, P 0. 05, P 0. 05).Effect on serum tumor index: there was no significant difference between the two groups before and after CEACA199 treatment.Effects of chemotherapy on adverse reactions: there was no significant difference in bone marrow suppression, liver and kidney function injury and neurotoxicity between the two groups after treatment, but there was significant difference between the two groups in digestive tract reaction, nausea, vomiting and diarrhea after treatment.Conclusion: compared with chemotherapy alone, Erling Yi Ren decoction combined with chemotherapy can improve the clinical symptoms, physical condition, quality of life and cellular immune function in patients with spleen deficiency and dampness heat syndrome after operation.It has no obvious advantage in serum tumor index, bone marrow suppression, liver and kidney function damage and neurotoxicity.
【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
【分類號(hào)】：R735.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬思遠(yuǎn);黃初升;劉紅星;韋柳斌;;中華獼猴桃根化學(xué)成分及藥理活性的研究進(jìn)展[J];廣西師范學(xué)院學(xué)報(bào)(自然科學(xué)版);2016年04期

2 黃斌;;新輔助化療對(duì)可切除局部晚期結(jié)腸癌患者腫瘤組織和血清標(biāo)本中惡性分子含量的影響[J];海南醫(yī)學(xué)院學(xué)報(bào);2016年20期

3 王鐵;韓錦勝;韓亞妹;馬新杰;孫智廣;于景超;蔡建輝;;結(jié)腸癌患者CME術(shù)后化療聯(lián)合DC-CIK細(xì)胞免疫治療的臨床療效和安全性[J];中國腫瘤生物治療雜志;2016年03期

4 王世賀;;經(jīng)肛門內(nèi)鏡微創(chuàng)手術(shù)治療直腸腫瘤臨床分析[J];中國醫(yī)藥科學(xué);2016年06期

5 王建美;章永紅;;章永紅教授治療腸癌經(jīng)驗(yàn)探要[J];陜西中醫(yī);2016年01期

6 郭劍;周淑卿;李杰;陳淵;鄭少鵬;;不同手術(shù)方式治療大腸癌對(duì)患者圍手術(shù)期的影響分析[J];實(shí)用癌癥雜志;2015年12期

7 馮媛媛;周利紅;李琦;;健脾法治療大腸癌的進(jìn)展及研究現(xiàn)狀[J];中華中醫(yī)藥雜志;2015年11期

8 劉宣;季青;柴妮;隋華;顏琳琳;江海麗;陳靜;李琦;;濕熱因素對(duì)結(jié)腸癌血管新生與肝轉(zhuǎn)移的影響[J];中華中醫(yī)藥雜志;2015年06期

9 朱正杰;李猛;余昌俊;歐陽歡;龍滕云;;大腸癌現(xiàn)階段治療進(jìn)展[J];安徽醫(yī)學(xué);2015年04期

10 赫軍;李棟;馬秉智;魏鳳玲;趙鐵;;藤梨根化學(xué)成分和抗腫瘤藥理作用研究進(jìn)展[J];中國實(shí)驗(yàn)方劑學(xué)雜志;2015年04期

，

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