本文關(guān)鍵詞：四君子湯加味治療Ⅲ、Ⅳ期惡性腫瘤脾胃虧虛型癌性厭食癥的臨床研究　出處：《湖南中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 四君子湯加味 食欲不振 癌性厭食 臨床研究

【摘要】：研究目的:本研究通過觀察四君子湯加味對Ⅲ、Ⅳ期惡性腫瘤脾胃虧虛型癌性厭食癥患者食欲、食量、體重、卡氏評分、中醫(yī)癥候積分及外周血T細胞亞群等各項指標的影響,為今后臨床上運用該方治療癌性厭食癥提供臨床參考依據(jù),亦為中醫(yī)藥方劑改善中晚期腫瘤患者食欲、提高患者免疫力及生活質(zhì)量等方面提供臨床依據(jù)。研究方法:選擇60例Ⅲ、Ⅳ期惡性腫瘤脾胃虧虛型癌性厭食癥患者,采用隨機分組原則,隨機分為治療組和對照組,其中治療組(四君子湯加味組)30例,對照組(甲地孕酮膠囊劑組)30例。自納入研究日起連續(xù)觀察4周。比較兩組治療前后食量、食欲、體重、生活質(zhì)量、外周血T細胞亞群(CD4、CD8、CD4/CD8)、中醫(yī)癥狀及不良反應(yīng)發(fā)生情況等指標。數(shù)據(jù)結(jié)果采用美國SPSS 17.0統(tǒng)計軟件包進行統(tǒng)計分析。結(jié)果:(1)在食量和食欲方面,四君子湯加味及甲地孕酮膠囊均可有效改善患者食欲,增加進食量,且兩組療效相當(dāng),差別無統(tǒng)計學(xué)意義(P0.05);(2)在體重變化方面,治療組和對照組兩組患者體重均有增加,治療后與治療前對比,差異有統(tǒng)計學(xué)意義(P0.01),但比較兩組治療前后體重改善情況,差異無統(tǒng)計學(xué)意義(P0.05);(3)在KPS評分改善方面,四君子湯加味及甲地孕酮均能增加患者KPS評分值,改善患者生活質(zhì)量,兩組治療前后差值有統(tǒng)計學(xué)意義(P0.05),但治療組KPS評分改善情況優(yōu)于對照組(P0.05);(4)在中醫(yī)癥候積分變化方面,兩組治療后中醫(yī)癥候積分均較治療前下降,差值均有高度統(tǒng)計學(xué)意義(P0.01),其中治療組療效總有效率為90%,對照組為70%,兩者治療后組間差異具高度統(tǒng)計學(xué)意義(P0.01),故四君子湯加味對患者中醫(yī)癥候改善較甲地孕酮更佳;(5)在免疫功能方面,四君子加味可顯著升高患者外周血中CD4、CD4/CD8值,降低CD8值,有效提高患者免疫功能(P0.01),而甲地孕酮對患者免疫功能改變影響不明顯(P0.05),兩藥相比,四君子加味療效較甲地孕酮佳(P0.01);(6)在安全指標觀察及不良反應(yīng)監(jiān)測方面,對照組有1人出現(xiàn)輕度凹陷性水腫,予利尿消腫等對癥處理后水腫消退,余未出現(xiàn)其他不良反應(yīng),治療組未觀察到不良反應(yīng),兩組在安全性指標方面對比無明顯異常。結(jié)論:四君子湯加味可有效改善中晚期惡性腫瘤脾胃虧虛型癌性厭食癥患者的食欲,增加其進食量,同時提高改善患者的KPS評分,增加患者體重,其中在食欲、食量及體重改變方面,四君子湯加味功效和甲地孕酮膠囊相當(dāng),但在KPS評分改善方面,四君子湯加味優(yōu)于甲地孕酮膠囊。且湯藥四君子湯加味可有效提高患者免疫功能,降低患者中醫(yī)癥候積分,改善臨床癥狀,其療效明顯優(yōu)于甲地孕酮膠囊,且無明顯副作用及不良反應(yīng),與西藥甲地孕酮相比有其獨特的優(yōu)勢,值得臨床推廣應(yīng)用。
[Abstract]:Objective: This study through the observation of four Decoction of III, IV malignant tumor of the spleen and stomach deficiency type cancer anorexia patients appetite, food intake, body weight, Karnofsky score, TCM syndrome score and the effect of T cell subsets in peripheral blood and other indicators, to provide clinical reference for future clinical use of the treatment of cancer anorexia, is also the advanced traditional Chinese medicine prescriptions in cancer patients to improve appetite, to provide clinical basis to improve immunity and quality of life of patients and so on. Research methods: 60 cases of III, IV malignant tumor of the spleen and stomach deficiency type cancer anorexia patients, randomly divided into the treatment group and the the control group, the treatment group (four Decoction group) 30 cases, control group (megestrol group) 30 cases were included in the study. Since the date of observation for 4 weeks before and after treatment between the two groups of food intake, appetite, body weight, quality of life, T cells in peripheral blood Subsets (CD4, CD8, CD4/CD8), TCM symptoms and the incidence of adverse reactions and other indicators. The data using SPSS 17 statistical software package for statistical analysis. Results: (1) in terms of food intake and appetite, four Decoction and megestrol capsule can effectively improve patients' appetite, increased food intake, and the efficacy of the two groups, the difference was not statistically significant (P0.05); (2) changes in body weight, weight of each treatment group and control group two groups increased after treatment compared with before treatment, the difference was statistically significant (P0.01) before and after treatment between the two groups, but the weight to improve the situation, there was no statistically significant difference (P0.05); (3) the KPS score improvement, four Decoction and megestrol acetate were increased in patients with KPS score, improve the quality of life of patients, the two groups before and after treatment the difference was statistically significant (P0.05), but the KPS score of treatment group was better than that of the control group (P0. 05); (4) in TCM syndrome integral change, two groups after treatment of TCM syndrome integral were lower than that before treatment, the difference was statistically significant (P0.01), the treatment group total effective rate was 90%, the control group was 70%, the difference between groups after treatment with a high degree of statistical significance (P0.01 therefore, four) Decoction on patients with TCM symptoms improved compared with megestrol acetate plus; (5) on immune function, four modified significantly increased in peripheral blood of patients with CD4, CD4/CD8 value, reduce the value of CD8, effectively improve the immune function of the patients (P0.01), and megestrol acetate on immune function in patients with no change obviously, the two drugs (P0.05) compared to four with better effect than a gentleman of megestrol acetate (P0.01); (6) in terms of safety indicators and adverse reactions were observed and monitored, 1 in the control group had mild pitting edema, diuresis detumescence to symptomatic treatment after edema, no other than Adverse reactions, the treatment group had no adverse reaction, two groups of the safety index contrast had no obvious abnormalities. Conclusion: four the decoction can effectively improve the late malignant tumor of the spleen and stomach deficiency type cancer anorexia patients appetite, increase their food intake, and improve the patient's KPS score, and increase patients the body weight, appetite, food intake and body weight changes, four Decoction efficacy and megestrol capsule, but in the KPS score improvement, four decoction is better than megestrol capsules. And four Decoction decoction can effectively improve the immune function of patients with high and lower score in patients with clinical symptoms, improve clinical symptoms, the the curative effect was significantly better than that of megestrol capsule, and no obvious side effects and adverse reactions, has its unique advantages compared with western medicine megestrol, worthy of clinical application.

【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R273

【參考文獻】

相關(guān)期刊論文 前10條

1 董蘭俠;;婦科惡性腫瘤病人化療期間癥狀體驗和生活質(zhì)量調(diào)查分析[J];全科護理;2014年29期

2 劉偉;郭忠聰;王理槐;謝瓊;王少波;曾柏榮;;中醫(yī)藥在腫瘤放射治療中增效減毒的臨床與實驗研究進展[J];湖南中醫(yī)雜志;2014年09期

3 李佳汝;王海威;賈玫;李瀟;杜懷棠;;加味枳術(shù)顆粒改善腫瘤患者癌性厭食的臨床觀察[J];中國臨床醫(yī)生;2014年09期

4 王琳;;癌性惡病質(zhì)的藥物治療進展[J];腫瘤學(xué)雜志;2014年08期

5 黃佩;宋洋;;四君子湯藥理作用和質(zhì)量控制研究[J];遼寧中醫(yī)雜志;2014年07期

6 朱禹;;四君子湯藥理作用及應(yīng)用研究[J];實用中醫(yī)內(nèi)科雜志;2014年05期

7 杭海燕;李佳汝;李瀟;賈玫;杜懷棠;;加味枳術(shù)顆粒對癌性厭食患者瘦素、食欲素的影響[J];現(xiàn)代中醫(yī)臨床;2014年01期

8 張國鳳;;四君子湯的化學(xué)成分鑒定[J];中醫(yī)臨床研究;2013年23期

9 李斌;楊全軍;郭澄;;癌癥惡病質(zhì)的診斷及藥物治療進展[J];中國腫瘤;2013年12期

10 邱文斌;張小紅;;參苓白術(shù)散加味減輕化療所致脾胃虛弱型食欲不振76例[J];福建中醫(yī)藥;2013年04期

相關(guān)會議論文 前2條

1 鄭燁;;康艾注射液聯(lián)合化療對中晚期非小細胞肺癌患者生活質(zhì)量的影響[A];2012年“河南省腫瘤�？谱o士職業(yè)安全防護及新技術(shù)交流”學(xué)術(shù)會議論文集[C];2012年

2 鄭紅剛;熊露;周雍明;樸炳奎;;淺議放化療毒副作用中醫(yī)病因[A];第十屆全國中西醫(yī)結(jié)合腫瘤學(xué)術(shù)大會論文匯編[C];2006年

相關(guān)博士學(xué)位論文 前1條

1 盧建新;高榮林調(diào)理脾胃經(jīng)驗總結(jié)及用治前列腺癌驗證[D];中國中醫(yī)科學(xué)院;2012年

相關(guān)碩士學(xué)位論文 前2條

1 范正麗;郝迎旭教授中醫(yī)藥防治腫瘤化療毒副反應(yīng)臨證經(jīng)驗總結(jié)及臨床研究[D];北京中醫(yī)藥大學(xué);2014年

2 蔡岳;膈下逐瘀湯合四君子湯加減方治療原發(fā)性肝癌介入術(shù)后臨床觀察[D];湖北中醫(yī)藥大學(xué);2012年

，

本文編號：1418041