本文選題：非小細胞肺癌 + 化療后骨髓抑制��； 參考：《湖北中醫(yī)藥大學》2017年碩士論文

【摘要】：目的觀察歸脾湯對氣血虧虛型非小細胞肺癌患者化療后骨髓抑制的改善情況。從歸脾湯臨床應(yīng)用方面研究其對保護骨髓造血功能的應(yīng)用價值,意在改善患者化療后骨髓抑制,提高患者生存質(zhì)量,以使患者順利完成化療從而可能一定程度延長生存期。方法臨床觀察收集的病例資料來自2015年3月至2016年10月在武漢中醫(yī)醫(yī)院腫瘤科,因NSCLC擬行第3周期AP方案化療,且中醫(yī)辨證為氣血虧虛為主證的患者的56例,按就診號隨機分為對照組和治療組,對照組28例行常規(guī)AP方案化療,治療組28例在行常規(guī)化療同時,加服歸脾湯,日1劑,每日2次,每次200毫升,連用21天。記錄兩組患者在治療期間中不同時間血液各組分水平、重組人粒細胞刺激因子使用情況、KPS評分、中醫(yī)證候積分,同時記錄不良反應(yīng),并進行安全性評價。本試驗數(shù)據(jù)均采用統(tǒng)計學軟件SPSS 19.0軟件系統(tǒng)對上述所得數(shù)據(jù)進行分析,并設(shè)定P0.05為具有統(tǒng)計學意義,同時結(jié)合臨床,得出結(jié)論。結(jié)果(1)白細胞變化情況:觀察期間第7天、第14天、第21天白細胞計數(shù)治療組高于對照組,差異有統(tǒng)計學意義,(P0.05);(2)在補救使用重組人粒細胞刺激因子例數(shù)方面,對照組高于治療組,差異有統(tǒng)計學意義,(P0.05);(3)血小板變化情況:觀察期間第7天、第14天、第21天血小板計數(shù)治療組高于對照組,差異有統(tǒng)計學意義,(P0.05);(4)血紅蛋白變化情況:對照組與治療組第21天血紅蛋白值均有下降,比較差異無統(tǒng)計學意義,(P0.05);(5)KPS評分變化情況:第21天對照組KPS評分較治療前比較差異有統(tǒng)計學意義,(P0.05);治療組較治療前比較差異無統(tǒng)計學意義,(P0.05);(6)其中頭昏眼花、神疲、乏力、懶言、自汗癥狀等改善方面差異有統(tǒng)計學意義,(P0.05)。結(jié)論歸脾湯可以一定程度減輕非小細胞肺癌化療后骨髓抑制的發(fā)生,使粒細胞集落刺激因子使用量減少,有效地緩解神疲乏力等癥狀,從而使腫瘤患者生存質(zhì)量提高。對于臨床上防治惡性腫瘤患者化療時出現(xiàn)的骨髓抑制,中醫(yī)證屬氣血虧虛證者采用歸脾湯輔助治療,患者恢復(fù)情況好。
[Abstract]:Objective to observe the improvement of Guipi decoction on bone marrow suppression in patients with non-small cell lung cancer with deficiency of qi and blood after chemotherapy. To study the value of Guipi decoction in protecting the hematopoietic function of bone marrow in order to improve the suppression of bone marrow after chemotherapy and improve the quality of life of patients so as to make the patients finish chemotherapy successfully and prolong the survival time to some extent. Methods the clinical data collected from March 2015 to October 2016 in Department of Oncology, Wuhan traditional Chinese Medicine Hospital, were 56 patients with AP regimen chemotherapy in the third cycle of NSCLC, and the main syndrome was deficiency of qi and blood. The control group (28 cases) received routine AP regimen chemotherapy, and the treatment group (28 cases) received routine chemotherapy plus Guipi decoction once a day, 200 ml per day for 21 days. The levels of blood components, KPS score, TCM syndrome score and adverse reactions were recorded in the two groups at different time during the treatment period, and the safety evaluation was carried out. The data of this experiment were analyzed by SPSS 19.0 software system, and P05 was set as statistical significance. At the same time, combined with clinical data, the conclusion was reached. Results 1) changes of leukocyte: the white blood cell count in the treatment group was higher than that in the control group on the 7th, 14th and 21st day during the observation period, and the difference was statistically significant (P 0.05). The platelet count in the control group was higher than that in the control group on the 7th day, the 14th day and the 21st day, and the platelet count in the treatment group was higher than that in the control group. The change of hemoglobin in control group and treatment group decreased on the 21st day. There was no significant difference between the two groups. There was no significant difference in KPS score between the control group and the control group on the 21st day after treatment. There was no significant difference between the treatment group and the pre-treatment group (P 0.05), and there was no significant difference between the treatment group and the pre-treatment group (P < 0.05), and the scores of dizziness, fatigue, fatigue and laziness were found in the treatment group, and there was no significant difference between the treatment group and the pre-treatment group (P < 0.05). There was significant difference in the improvement of self-sweating symptoms (P 0.05). Conclusion Guipi decoction can alleviate the occurrence of bone marrow suppression after chemotherapy in non-small cell lung cancer, reduce the use of granulocyte colony stimulating factor, relieve fatigue and other symptoms, and improve the quality of life of tumor patients. For the clinical prevention and treatment of malignant tumor patients with bone marrow suppression, TCM syndrome of deficiency of qi and blood use Guipi decoction adjuvant treatment, the patient recovered well.
【學位授予單位】：湖北中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R734.2

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