柴胡疏肝散合歸脾湯治療腫瘤化療相關(guān)抑郁臨床研究
發(fā)布時(shí)間：2018-11-05 10:18
【摘要】：目的:評(píng)價(jià)柴胡疏肝散合歸脾湯治療腫瘤化療相關(guān)抑郁臨床療效及對(duì)患者的生活質(zhì)量、骨髓功能及免疫功能的影響。方法:1患者來(lái)源:所選病例均為2015年05月至2016年9月在中國(guó)人民解放軍第251醫(yī)院行首次化療,經(jīng)組織病理學(xué)明確診斷為乳腺癌、肺癌住院患者。共觀察293例經(jīng)2個(gè)周期化療患者,符合入組126例患者,隨機(jī)分為黛力新對(duì)照組及柴胡疏肝散合歸脾湯治療組。123例患者進(jìn)入統(tǒng)計(jì)處理分析,對(duì)照組60例,治療組61例。2臨床資料:本研究采用隨機(jī)對(duì)照,以漢密爾頓抑郁量表24條目(HAMD-24)、生活質(zhì)量評(píng)定量表(QLQ-C30)、骨髓功能、IL-6、IGF-1、CD4+/CD8+、Treg T/CD4+T值為觀察指標(biāo)。全部入組病例分別在第3、4、5化療周期前1天進(jìn)行HAMD24量表評(píng)分及生活質(zhì)量量表評(píng)分,檢測(cè)外周血CD4+/CD8+值、Treg T/CD4+T值和血清中白介素-6(IL-6)、胰島素樣生長(zhǎng)因子-1(IGF-1)含量及治療前后血常規(guī)。3采用SPSS 20.0軟件對(duì)結(jié)果進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:1對(duì)照組、治療組HAMD24評(píng)分治療后與治療前相比差異均有統(tǒng)計(jì)學(xué)意義(P0.001),治療組1個(gè)療程與2個(gè)療程后比較差異有統(tǒng)計(jì)學(xué)意義(P=0.000);組間比較,2個(gè)療程后和1個(gè)療程后比較差異均有統(tǒng)計(jì)學(xué)意義(P=0.034)。2個(gè)療程后,黛力新組治療抑郁有效率為76.67%;柴胡舒肝散合歸脾湯組有效率為90.16%,兩組間比較差異有統(tǒng)計(jì)學(xué)意義(P=0.046)。2與治療前比較,經(jīng)2個(gè)療程后兩組均能明顯地改善情緒功能(P0.05)。治療組在軀體、角色功能、食欲下降、疲倦及整體生活質(zhì)量較治療前均有明顯改善(P0.05),與對(duì)照組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。3與治療前比較,治療組2個(gè)療程后骨髓抑制發(fā)生率下降,(P=0.019);組間比較,2個(gè)療程后治療組骨髓抑制發(fā)生率低于對(duì)照組(P=0.001)。組內(nèi)比較,兩組治療后CD4+/CD8值與治療前相比差異均有統(tǒng)計(jì)學(xué)意義(P0.01),治療組1個(gè)與2個(gè)療程后比較差異有統(tǒng)計(jì)學(xué)意義(P=0.000);兩組間比較,2個(gè)療程后比較差異均有統(tǒng)計(jì)學(xué)意義(P=0.042)。兩組治療后Treg/CD4+值與治療前相比差異均有統(tǒng)計(jì)學(xué)意義(P0.05),治療組1個(gè)與2個(gè)療程后比較差異有統(tǒng)計(jì)學(xué)意義(P=0.006);組間比較,2個(gè)療程后比較差異均有統(tǒng)計(jì)學(xué)意義(P=0.005)。4兩組經(jīng)1、2療程后血清IL-6水平與治療前相比差異均有統(tǒng)計(jì)學(xué)意義(P0.001),治療組1個(gè)與2個(gè)療程后比較差異有統(tǒng)計(jì)學(xué)意義(P=0.000);兩組間比較治療前后比較均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。兩組經(jīng)1、2療程后治療后血清IGF-1水平與治療前相比均有統(tǒng)計(jì)學(xué)意義(P0.001),治療組1個(gè)與2個(gè)療程后比較有統(tǒng)計(jì)學(xué)意義(P=0.000);兩組間比較,2個(gè)療程后比較有統(tǒng)計(jì)學(xué)意義(P=0.006)。結(jié)論:1柴胡舒肝散合歸脾湯及黛力新均能改善化療相關(guān)抑郁患者的抑郁狀態(tài),柴胡舒肝散合歸脾湯遠(yuǎn)期療效好于西藥黛力新。2柴胡舒肝散合歸脾湯及黛力新能改善化療相關(guān)抑郁患者的情緒功能,柴胡舒肝散合歸脾湯可改善患者的總健康狀況、軀體功能、角色功能、食欲下降、疲倦,提高患者生活質(zhì)量。3柴胡舒肝散合歸脾湯組方能減少骨髓抑制的發(fā)生率,能提高腫瘤化療相關(guān)抑郁患者的免疫功能。4柴胡舒肝散合歸脾湯能降低腫瘤化療相關(guān)抑郁患者血清中IL-6、IGF-1水平,兩者水平與腫瘤化療后抑郁程度正相關(guān)。
[Abstract]:Objective: To evaluate the clinical efficacy and quality, bone marrow function and immune function in patients with tumor chemotherapy associated with chemotherapy-related depression. Method: 1 patient's source: All selected cases were first chemotherapy in the 251 Hospital of Chinese People's Liberation Army from May 2015 to September 2016, and histopathologic diagnosis was diagnosed as breast cancer and lung cancer inpatients. A total of 293 patients were treated with 2 cycles of chemotherapy, and 126 patients were randomly divided into the new control group of Deforce and the treatment group of Buihu Shugan Powder. 123 patients entered statistical processing analysis, control group (n = 60), treatment group (61 cases). Clinical data: This study adopted a randomized controlled trial. Hamilton depression scale 24 (HAMD-24), quality of life scale (QLQ-C30), bone marrow function, IL-6, IGF-1, CD4 +/ CD8 +, Treg T/ CD4 + T were observed. The HAMD24 scale scores and life quality scale scores were scored on the first day before the 3rd, 4th and 5th chemotherapy cycles, and the CD4 +/ CD8 + value, Treg T/ CD4 + T value and interleukin-6 (IL-6) in serum were tested. Insulin-like growth factor-1 (IGF-1) and blood routine before and after treatment were analyzed statistically by SPSS 10.0 software. Results: Compared with the control group, the difference between treatment group HAMD24 and treatment group was statistically significant (P = 0.001), and the difference between treatment group and treatment group was statistically significant (P = 0.000). After two courses of treatment, the effective rate of treatment depression was 76. 67%, and the effective rate was 90. 16%, and the difference between the two groups was statistically significant (P = 0.046). After 2 courses of treatment, the mood function was significantly improved (P0.05). Compared with the control group (P = 0.019), the incidence of bone marrow suppression was decreased after two courses of treatment (P = 0.019). Compared with the control group, the incidence of bone marrow suppression in the treatment group was lower than that in the control group (P = 0.01). There was significant difference in CD4 +/ CD8 after treatment (P = 0.01) compared with that in the treatment group (P = 0.000). The difference of Treg/ CD4 + after treatment was statistically significant (P = 0.05) compared with that before treatment (P = 0. 006). There was significant difference in serum IL-6 level after 1 and 2 treatment courses (P = 0. 005). The difference of serum IL-6 level in the treatment group was statistically significant (P = 0.000) compared with the treatment group (P = 0.000). There was no significant difference between the two groups before and after treatment (P0.05). After 1 and 2 courses of treatment, the serum IGF-1 level was statistically significant (P = 0.000) compared with the treatment group (P = 0.000), and there was a statistical difference between the two groups (P = 0. 006). Conclusion: We can improve the depression status of the patients with depression, and the long-term curative effect of Chaihu Shugan Powder combined with spleen soup is better than that of western medicine. The decoction can improve the overall health status, body function, role function, appetite loss, fatigue and improve the quality of life of patients. can improve the immune function of the tumor chemotherapy-related depression patient. The 4-Buhu decoction can reduce the level of IL-6 and IGF-1 in the serum of the tumor chemotherapy-related depression patients, and the level of the two levels is positively related to the degree of depression after tumor chemotherapy.
【學(xué)位授予單位】：承德醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R730.5
[Abstract]:Objective: To evaluate the clinical efficacy and quality, bone marrow function and immune function in patients with tumor chemotherapy associated with chemotherapy-related depression. Method: 1 patient's source: All selected cases were first chemotherapy in the 251 Hospital of Chinese People's Liberation Army from May 2015 to September 2016, and histopathologic diagnosis was diagnosed as breast cancer and lung cancer inpatients. A total of 293 patients were treated with 2 cycles of chemotherapy, and 126 patients were randomly divided into the new control group of Deforce and the treatment group of Buihu Shugan Powder. 123 patients entered statistical processing analysis, control group (n = 60), treatment group (61 cases). Clinical data: This study adopted a randomized controlled trial. Hamilton depression scale 24 (HAMD-24), quality of life scale (QLQ-C30), bone marrow function, IL-6, IGF-1, CD4 +/ CD8 +, Treg T/ CD4 + T were observed. The HAMD24 scale scores and life quality scale scores were scored on the first day before the 3rd, 4th and 5th chemotherapy cycles, and the CD4 +/ CD8 + value, Treg T/ CD4 + T value and interleukin-6 (IL-6) in serum were tested. Insulin-like growth factor-1 (IGF-1) and blood routine before and after treatment were analyzed statistically by SPSS 10.0 software. Results: Compared with the control group, the difference between treatment group HAMD24 and treatment group was statistically significant (P = 0.001), and the difference between treatment group and treatment group was statistically significant (P = 0.000). After two courses of treatment, the effective rate of treatment depression was 76. 67%, and the effective rate was 90. 16%, and the difference between the two groups was statistically significant (P = 0.046). After 2 courses of treatment, the mood function was significantly improved (P0.05). Compared with the control group (P = 0.019), the incidence of bone marrow suppression was decreased after two courses of treatment (P = 0.019). Compared with the control group, the incidence of bone marrow suppression in the treatment group was lower than that in the control group (P = 0.01). There was significant difference in CD4 +/ CD8 after treatment (P = 0.01) compared with that in the treatment group (P = 0.000). The difference of Treg/ CD4 + after treatment was statistically significant (P = 0.05) compared with that before treatment (P = 0. 006). There was significant difference in serum IL-6 level after 1 and 2 treatment courses (P = 0. 005). The difference of serum IL-6 level in the treatment group was statistically significant (P = 0.000) compared with the treatment group (P = 0.000). There was no significant difference between the two groups before and after treatment (P0.05). After 1 and 2 courses of treatment, the serum IGF-1 level was statistically significant (P = 0.000) compared with the treatment group (P = 0.000), and there was a statistical difference between the two groups (P = 0. 006). Conclusion: We can improve the depression status of the patients with depression, and the long-term curative effect of Chaihu Shugan Powder combined with spleen soup is better than that of western medicine. The decoction can improve the overall health status, body function, role function, appetite loss, fatigue and improve the quality of life of patients. can improve the immune function of the tumor chemotherapy-related depression patient. The 4-Buhu decoction can reduce the level of IL-6 and IGF-1 in the serum of the tumor chemotherapy-related depression patients, and the level of the two levels is positively related to the degree of depression after tumor chemotherapy.
【學(xué)位授予單位】：承德醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R730.5
【參考文獻(xiàn)】
相關(guān)期刊論文 前10條
1 高佩芳;朱益敏;;黃芪當(dāng)歸湯改善晚期肺癌化療骨髓抑制療效觀察[J];山西中醫(yī);2016年07期
2 田景平;溫澤淮;郭新峰;李艷;呂志平;;歸脾湯治療抑郁癥療效與安全性的系統(tǒng)評(píng)價(jià)[J];中國(guó)中醫(yī)藥信息雜志;2016年04期
3 孫士玲;楊麗萍;張紅瑞;吳耀松;;逍遙散加味對(duì)乳腺癌術(shù)后化療患者抑郁癥的影響[J];中華中醫(yī)藥雜志;2016年04期
4 沈潤(rùn);何洪生;梁彩霞;;艾迪注射液配合化療對(duì)惡性腫瘤化療患者生活質(zhì)量及抑郁的影響[J];齊齊哈爾醫(yī)學(xué)院學(xué)報(bào);2015年34期
5 胡洪;陳功;;中國(guó)惡性腫瘤患者抑郁患病率及其相關(guān)因素的研究[J];中國(guó)腫瘤臨床與康復(fù);2015年08期
6 郭麗麗;史亞飛;朱磊;;從虛、瘀、痰、毒探討腫瘤抑郁癥病因病機(jī)[J];中醫(yī)學(xué)報(bào);2014年08期
7 車(chē)勇;范宗nc;張琦君;;化痰導(dǎo)解湯治療惡性腫瘤患者抑郁障礙30例[J];河南中醫(yī);2014年08期
8 康娜;賈玫;王曉星;趙瑋t，
本文編號(hào)：2311756
本文鏈接：http://sikaile.net/yixuelunwen/zlx/2311756.html
最近更新
教材專(zhuān)著
