本文選題：益氣化瘀解毒方 + 晚期胃癌　； 參考：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究旨在探討益氣化瘀解毒方聯(lián)合TS方案化療治療晚期胃癌,以期體現(xiàn)其在腫瘤客觀療效、癥狀改善及安全性等方面的作用,為晚期胃癌的進一步規(guī)范化治療及深入研究提供依據(jù)。方法:將60例晚期胃癌患者,用隨機數(shù)字表法分成2組,每組各30例。治療組采用益氣化瘀解毒方聯(lián)合TS(紫杉醇脂質(zhì)體+替吉奧)化療方案;對照組僅采用TS方案化療。分別記錄兩組治療前后的中醫(yī)證候、實體瘤大小、腫瘤標(biāo)志物(CEA、CA125、CA199)值、凝血功能(D-二聚體、FDP)、KPS評分、生活質(zhì)量量表評分及化療毒副反應(yīng)的情況,換算成積分,整理信息錄入數(shù)據(jù)庫,并運用SPSS20.0、EXCEL 2007等軟件,將益氣化瘀解毒方聯(lián)合TS方案治療前后的數(shù)據(jù)分析結(jié)果分析對比,同時與單純TS方案進行療效對比。結(jié)果:在中醫(yī)證候的方面,治療組顯效+有效率為66%,與對照組相比(P0.01),提示治療組能有效改善患者的不適癥狀;在凝血功能方面,治療組治療后的D-二聚體和FDP值均較前明顯下降(P0.05),且在D-二聚體下降方面治療組優(yōu)于對照組(P0.05);在KPS評分方面,治療組治療后KPS評分較顯著升高(P0.01),對照組治療后KPS評分較前有所下降,提示治療組在改善體力狀況方面的療效明顯高于對照組;在生活質(zhì)量方面,治療組治療后生活質(zhì)量較前有明顯改善(P0.05),而對照組的在這方面的改善不夠突出;在安全性方面,兩組均未出現(xiàn)惡性不良事件,主要毒副作用為白細(xì)胞減少和腹瀉,且治療組能有效減少白細(xì)胞減少和腹瀉方面的發(fā)生,差異有統(tǒng)計學(xué)意義(P0.05);兩組患者治療后腫瘤指標(biāo)均較前降低,但在實體瘤療效、腫瘤標(biāo)志物(CEA、CA199、CA125)值變化方面,兩組未顯示出明顯差異。結(jié)論:晚期胃癌患者臨床不適癥狀較多,體力狀況和生活質(zhì)量均不高,而益氣化瘀解毒方聯(lián)合TS化療方案,在保證臨床療效的同時能夠明顯減輕患者的不適癥狀、提高體力狀況、改善生活質(zhì)量,同時能夠緩解腫瘤患者普遍出現(xiàn)的血液高凝狀態(tài),并減輕化療出現(xiàn)的毒副反應(yīng)。
[Abstract]:Objective: to explore the effect of Yiqi Huayu jiedu recipe combined with TS regimen in the treatment of advanced gastric cancer in order to reflect its effect on the objective curative effect, symptom improvement and safety of cancer. To provide the basis for further standardized treatment and further study of advanced gastric cancer. Methods: 60 patients with advanced gastric cancer were randomly divided into two groups, 30 cases in each group. The treatment group was treated with Yiqi Huayu jiedu recipe combined with TS1 (paclitaxel liposome tiguor), while the control group was treated with TS regimen only. Before and after treatment, the TCM syndromes, solid tumor size, tumor marker CEA CA125 / CA199, coagulation function D- D- dimer KPS score, quality of life scale and chemotherapy toxicity were recorded before and after treatment. The results of data analysis before and after treatment of Yiqi Huayu jiedu prescription combined with TS regimen were analyzed and compared with those of simple TS regimen by using SPSS 20.0 + excel 2007 and other softwares. Results: in the aspect of TCM syndrome, the effective rate of the treatment group was 66g. Compared with the control group, the treatment group could effectively improve the uncomfortable symptoms of the patients and the coagulation function. After treatment, the values of D- dimer and FDP in the treatment group were significantly lower than those in the previous treatment group (P 0.05), and the treatment group was superior to the control group in terms of D- dimer decline (P 0.05), and the KPS score was higher in the treatment group than in the control group. The KPS score of the treatment group was significantly higher than that of the control group, and the KPS score of the control group was lower than that of the control group, indicating that the therapeutic effect of the treatment group on improving physical condition was significantly higher than that of the control group, and the quality of life in the treatment group was significantly higher than that in the control group. The quality of life in the treatment group was significantly improved than that in the previous treatment group, but the improvement in the control group was not obvious. In terms of safety, there were no malignant adverse events in both groups, and the main side effects were leukopenia and diarrhea. The treatment group could effectively reduce leukopenia and diarrhea, the difference was statistically significant (P 0.05), the tumor indexes of the two groups were lower than those before treatment, but in the effect of solid tumor, the tumor marker CEA CA199CA125 was changed. There was no significant difference between the two groups. Conclusion: the patients with advanced gastric cancer have more clinical symptoms, lower physical condition and lower quality of life. The combination of Yiqi Huayu jiedu recipe and TS chemotherapy regimen can significantly reduce the discomfort symptoms of patients with advanced gastric cancer while ensuring the clinical efficacy. Improve physical condition, improve quality of life, at the same time can alleviate the hypercoagulability of patients with cancer, and reduce the toxic side effects of chemotherapy.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2

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