【摘要】：目的:本課題系統(tǒng)觀察退熱貼治療肝癌發(fā)熱的有效性和安全性,并通過與柴胡口服液做對比,觀察退熱貼治療肝癌發(fā)熱的臨床療效,對其安全性作出客觀的評價。為退熱貼在治療肝癌發(fā)熱中的推廣作初步的臨床研究,為中醫(yī)藥在肝癌發(fā)熱治療中的運用提供一種安全有效的方法。方法:所有資料均來自河南中醫(yī)藥大學附屬開封市中醫(yī)院(肝膽脾胃科、腫瘤科)、開封市第二中醫(yī)院(肝病科)及開封市傳染病醫(yī)院(肝病科)2014年2月—2016年2月住院病人。將84例符合納入標準的肝癌發(fā)熱患者,隨機分為兩組,治療組、對照組各42例。在常規(guī)治療(兩組病人均給予肝癌基礎知識宣教,制定合理的飲食及藥物治療處方)基礎上,治療組:予退熱貼貼于神闕穴,每日1次,一次4小時(中藥退熱貼開封市中醫(yī)院制劑室提供,藥物組成:地黃、丹皮、水牛角、冰片等藥物。)對照組:予柴胡口服液,一日3次,一次10ml((國藥準字Z41021539),河南省百泉制藥有限公司。);觀察退熱貼對肝癌發(fā)熱患者的退熱療效、中醫(yī)證候積分、卡氏評分、不良反應等相關指標等的影響。結果:(1)一般情況比較:兩組患者在年齡、性別、治療前一天發(fā)熱程度、中醫(yī)證候積分、KPS評分等方面,經統(tǒng)計學分析,差異無統(tǒng)計學意義(P0.05),兩者具有均衡可比性;(2)退熱療效比較:經秩和檢驗,治療組總有效率為92.86%;對照組總有效率為71.43%(P0.05),差異有統(tǒng)計學意義,提示這兩種方法都能降低體溫,但治療組效果優(yōu)于對照組。(3)中醫(yī)癥狀積分比較:組內比較,兩組治療后較治療前中醫(yī)癥狀積分均下降,差異均有統(tǒng)計學意義(P0.05);組間比較,治療組較對照組下降更明顯,差異有統(tǒng)計學意義(P0.05)。(4)KPS比較:經秩和檢驗,治療組治療后評分水平較治療前改善,差異有統(tǒng)計學意義(P0.05),對照組治療后與治療前評分水平比較,差異無統(tǒng)計學意義(P0.05);KPS積分差,經秩和檢驗,治療組治療后積分差改善程度較對照組更明顯(P0.05),差異有統(tǒng)計學意義。(5)安全性分析:治療組與對照組在治療前后均未出不良反應及毒副作用,其臨床實驗室檢查等未見與藥物治療相關的變化。結論:1.退熱貼可降低肝癌發(fā)熱患者的體溫,退熱療效顯著。2.退熱貼可緩解肝癌發(fā)熱患者的中醫(yī)癥狀及降低中醫(yī)證候積分。3.退熱貼可改善肝癌發(fā)熱患者KPS評分,提高患者生活質量。
[Abstract]:Objective: to observe the efficacy and safety of antipyretic plaster in the treatment of liver cancer fever, and to evaluate its safety objectively by comparing it with Chaihu oral liquid in the treatment of liver cancer fever. To make a preliminary clinical study on the application of antipyretic paste in the treatment of liver cancer fever, and to provide a safe and effective method for the application of traditional Chinese medicine in the treatment of liver cancer fever. Methods: all the data were collected from Kaifeng Hospital of traditional Chinese Medicine (Department of liver, gallbladder, spleen and stomach, Department of Oncology), Kaifeng second Hospital of traditional Chinese Medicine (Department of liver Diseases) and Kaifeng City Hospital of Infectious Diseases (Department of liver Diseases) from February 2014 to February 2016. 84 patients with liver cancer fever were randomly divided into two groups: treatment group (n = 42) and control group (n = 42). On the basis of routine treatment (two groups of patients were given basic knowledge of liver cancer education, formulation of reasonable diet and drug treatment prescriptions), the treatment group: antipyretic sticking to Shenque point, once a day, 4 hours a time (traditional Chinese medicine antipyretic paste Kaifeng City traditional Chinese Medicine Hospital preparation room, drug composition: Rehmannia, pastry, buffalo horn, borneol and other drugs.) Control group: Chaihu oral liquid, 3 times a day, once 10ml (Z41021539), Henan Baiquan Pharmaceutical Co., Ltd.); to observe the antipyretic effect on patients with liver cancer fever, TCM syndrome score, card score, Effects of adverse reactions and other related indicators. Results: (1) comparison of general conditions: two groups of patients in age, sex, fever before treatment, TCM syndrome score and KPS score were statistically analyzed. The difference was not statistically significant (P0.05), the two were balanced and comparable; (2) comparison of antipyretic efficacy: the total effective rate of the treatment group was 92.86 by rank sum test, the total effective rate of the control group was 71.43% (P0.05), the difference was statistically significant, indicating that both methods can reduce body temperature. But the effect of the treatment group was better than that of the control group. (3) the scores of TCM symptoms in the treatment group were significantly lower than those before the treatment (P0.05), and the scores in the treatment group were significantly lower than those in the control group (P0.05). The difference was statistically significant (P0.05). (4) KPS comparison: by rank sum test, the score level of treatment group was improved compared with that before treatment, the difference was statistically significant (P0.05), the difference between control group and pre-treatment score level was not statistically significant (P0.05). By rank sum test, the improvement of integral difference after treatment in the treatment group was more obvious than that in the control group (P0.05), the difference was statistically significant. (5) Safety analysis: there were no adverse reactions and side effects before and after treatment in the treatment group and the control group. No changes related to drug therapy were found in clinical laboratory examination. Conclusion 1. Antipyretic plaster can reduce the temperature of patients with liver cancer fever, the antipyretic effect is significant. 2. Antipyretic plaster can alleviate the TCM symptoms of patients with liver cancer fever and reduce TCM syndrome integral. 3. Antipyretic plaster can improve KPS score and quality of life of patients with liver cancer fever.
【學位授予單位】：河南中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R273

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