本文選題：加味八珍湯 + 化療��； 參考：《安徽中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：1研究目的以加味八珍湯防治化療所引起的骨髓抑制為切入點(diǎn),為傳統(tǒng)中醫(yī)學(xué)在防治化療后骨髓抑制方面提供臨床研究數(shù)據(jù),為中醫(yī)防治骨髓抑制提供切實(shí)可靠的方法和思路。從減輕化療后骨髓抑制的角度,為中醫(yī)藥減輕化療所致毒副反應(yīng)提供新的內(nèi)涵。2研究方法將60例惡性腫瘤患者隨機(jī)分為兩組,治療組和對(duì)照組各30例。對(duì)照組:常規(guī)一線化療同時(shí)加服地榆升白片,治療組:在化療基礎(chǔ)上加用加味八珍湯顆粒。通過(guò)觀察記錄外周血細(xì)胞變化及骨髓抑制情況,以及化療后中醫(yī)臨床癥候改善情況,生活質(zhì)量變化、體重變化,免疫狀態(tài)變化及其毒副反應(yīng),來(lái)研究加味八珍湯在防治化療后骨髓抑制的臨床療效。3研究結(jié)果血象變化分析:(1)治療前后外周血象變化情況分析比較:經(jīng)化療后第7天的血常規(guī)觀察,對(duì)照組、治療組WBC、NE、HGB、PLT均較治療前明顯下降(P0.05),下降幅度治療組明顯低于對(duì)照組(P0.05);經(jīng)第14天觀察WBC、NE、HGB呈上升趨勢(shì),治療組優(yōu)于對(duì)照組(P0.05),而PLT計(jì)數(shù)水平下降到最低谷;經(jīng)第21天觀察WBC、NE、HGB、PLT,對(duì)照組較治療前明顯下降(P0.05),治療組較治療前無(wú)明顯差異(P0.05),但治療組較對(duì)照組有明顯差異(P0.05)。(2)治療后骨髓抑制發(fā)生率比較:對(duì)化療后1周患者血象觀察,化療后對(duì)于WBC、NE、HGB骨髓抑制發(fā)生率治療組明顯低于對(duì)照組(P0.05),且骨髓抑制程度治療組明顯輕于對(duì)照組(P0.05),對(duì)于PLT骨髓抑制率及骨髓抑制程度,對(duì)照組與治療組無(wú)明顯差異(P0.05)。(3)治療后升高WBC療效比較:經(jīng)觀察化療后2周血象,對(duì)照組有效率53.3%,治療組有效率83.3%,治療組明顯優(yōu)于對(duì)照組(P0.05)。中醫(yī)癥候改善方面:經(jīng)治療后治療組能明顯改善中醫(yī)臨床癥候,其優(yōu)于對(duì)照組(P0.05)。生活質(zhì)量改善方面:化療后治療組的KPS評(píng)分改善情況及體重穩(wěn)定情況均明顯優(yōu)于對(duì)照組(P0.05)。免疫功能改善方面:兩組患者化療前后CD3+、CD4+、CD4+/CD8+、NK細(xì)胞水平比較,均較前有明顯升高(P0.05),而CD8+較前明顯下降(P0.05);兩組患者化療后比較,治療組明顯優(yōu)于對(duì)照組(P0.05)。安全性比較分析:治療組消化道反應(yīng)明顯小于對(duì)照組(P0.05);兩組肝腎功損害對(duì)比無(wú)明顯性差異(P0.05)。4研究結(jié)論加味八珍湯能有效防治腫瘤患者化療后骨髓抑制,改善患者骨髓抑制后中醫(yī)臨床癥狀,提高患者生活質(zhì)量,增強(qiáng)患者免疫力,且安全可靠,無(wú)明顯毒副作用。
[Abstract]:Objective to provide clinical data for the prevention and treatment of bone marrow suppression caused by chemotherapy in traditional Chinese medicine, and to provide practical and reliable methods and ideas for the prevention and treatment of bone marrow suppression in traditional Chinese medicine. From the perspective of alleviating bone marrow suppression after chemotherapy, 60 patients with malignant tumor were randomly divided into two groups: treatment group (n = 30) and control group (n = 30). Control group: routine first-line chemotherapy plus Diyu Shengbai tablet, treatment group: on the basis of chemotherapy plus Jiawei Bazhen decoction granule. The changes of peripheral blood cells and bone marrow suppression, the improvement of TCM clinical symptoms, the changes of quality of life, weight, immune state and side effects after chemotherapy were observed and recorded. To study the clinical efficacy of Jiawei Bazhen decoction in the prevention and treatment of bone marrow suppression after chemotherapy .Results Hematological changes Analysis of Peripheral Blood before and after treatment: blood routine observation on the 7th day after chemotherapy, control group, In the treatment group, the levels of PLT in the treatment group were significantly lower than those in the control group (P 0.05), and on the 14th day, the PLT count in the treatment group was higher than that in the control group (P 0.05), but the PLT count level had decreased to the lowest point. On the 21st day, the incidence of bone marrow suppression in the control group was significantly lower than that before treatment, but there was no significant difference between the treatment group and the control group, but the incidence of bone marrow suppression in the treatment group was significantly higher than that in the control group. After chemotherapy, the incidence of bone marrow suppression in the treatment group was significantly lower than that in the control group (P 0.05), and the degree of bone marrow suppression in the treatment group was significantly lower than that in the control group (P 0.05). The rate of bone marrow suppression and the degree of bone marrow suppression in the treatment group were significantly lower than those in the control group. There was no significant difference between the control group and the treatment group (P0.05U. 3) after the treatment, the effect of WBC was increased: after 2 weeks of chemotherapy, the effective rate of the control group was 53.3%, and the effective rate of the treatment group was 83.3%. The treatment group was obviously superior to the control group (P0.05). The improvement of TCM symptoms: the treatment group can obviously improve the clinical symptoms of TCM after treatment, which is superior to the control group (P 0.05). The improvement of quality of life in the treatment group was better than that in the control group (P 0.05). The improvement of immune function: before and after chemotherapy, the level of CD4 / CD8 / CD8 NK cell of CD3 was significantly higher in both groups than that of the former, while the level of CD8 was significantly lower than that of the former, and the treatment group was significantly better than the control group after chemotherapy. Safety comparison analysis: the digestive tract reaction in the treatment group was significantly lower than that in the control group (P 0.05), and there was no significant difference between the two groups in liver and kidney function damage. Conclusion Jiawei Bazhen decoction can effectively prevent and treat the bone marrow depression of tumor patients after chemotherapy. Improve the clinical symptoms of TCM after bone marrow suppression, improve the quality of life of patients, enhance the immunity of patients, and safe and reliable, no obvious side effects.
【學(xué)位授予單位】：安徽中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類(lèi)號(hào)】：R730.5

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