| 姚望,姚庆华.四君子汤加减治疗胃癌化疗所致骨髓抑制的临床观察研究[J].浙江中西医结合杂志,2019,29(12): |
| 四君子汤加减治疗胃癌化疗所致骨髓抑制的临床观察研究 |
| Clinical Observation of Sijunzi Decoction Modified in Treating Myelosuppression Caused by Gastric Cancer Chemotherapy |
| 投稿时间：2019-04-23 修订日期：2019-09-22 |
| DOI： |
| 中文关键词: 骨髓抑制 四君子汤 胃恶性肿瘤 脾虚证候 |
| 英文关键词:Myelosuppression Sijunzi decoction Gastric malignant tumor Spleen deficiency syndrome |
| 基金项目: |
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| 摘要点击次数: 560 |
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| 中文摘要: |
| 目的：评价四君子汤加减干预胃癌患者化疗所致相关毒副反应的影响。方法：将80例胃癌患者化疗后出现骨髓抑制的脾虚型患者按入院顺序采用随机数字法随机分成对照组和实验组，每组40例。对照组予以粒细胞集落刺激因子(granulocyte colony stimulating factor, G-CSF)治疗，实验组在对照组基础上配合四君子汤加减，连用21d。观察各组治疗前后两组脾虚证候积分、血象指标、免疫指标及治疗疗效等情况。结果：治疗前1d，两组脾虚积分无统计学意义(P＞0.05)，治疗后，两组的脾虚积分具有不同程度地降低(P＜0.05)，与对照组比，实验组脾虚积分明显降低(P＜0.05)。治疗前1d，两组中白细胞、中性粒细胞、红细胞、血小板和血红蛋白无明显统计学意义(P>0.05)，治疗后6d、14d及21d，两组的白细胞计数及中性粒细胞均有不同程度地增高，与对照组比，实验组的白细胞计数及中性粒细胞增高明显(P<0.05)，治疗前后对照组红细胞和血小板计数差异无统计学意义(P>0.05)，治疗后6d、14d及21d，实验组的红细胞和血小板计数均有不同程度地增高(P<0.05)，与对照组比，实验组的红细胞和血小板计数均有不同程度地增高(P<0.05)，两组的血红蛋白在治疗前后差异无统计学意义(P＞0.05)。治疗前，两组T细胞亚群和免疫球蛋白差异无统计学意义(P>0.05)，治疗后，两组的T细胞亚群和和免疫球蛋白均有不同程度增高(P＜0.05)，与对照组比，实验组的T细胞亚群和和免疫球蛋白增高明显(P＜0.05)。两组的显效、有效、无效和总有效率差异无统计学意义(P＞0.05)。与对照组比，实验组发生不良反应例数较少，差异存在统计学意义(P＜0.05)。结论：四君子汤加减治疗可改善患者化疗后脾虚状态，减轻骨髓抑制的毒副反应，缩短骨髓抑制恢复的时间，提高机体免疫力。 |
| 英文摘要: |
| To evaluate the effect of Sijunzi Decoction modified on the toxic and side effects induced by chemotherapy in patients with gastric cancer. Methods: 80 patients with gastric cancer who had myelosuppression after chemotherapy were randomly divided into the control group and the experimental group by the random number method. The control group(40 cases) was treated with granulocyte colony stimulating factor (G-CSF). The experimental group(40 cases) was treated with Sijunzi Decoction on the basis of the control group for 21 days. The scores of spleen deficiency syndrome, blood index, immune index and therapeutic effect were observed before and after treatment. Results: There was no significant difference in spleen deficiency score between 2 groups (P＞0.05). After treatment, the spleen deficiency scores of 2 groups were decreased to different degrees(P＜0.05). Compared with the control group, the spleen deficiency score of the experimental group was significantly lower(P＜0.05). There was no significant difference in white blood cells, neutrophils, red blood cells, platelets and hemoglobin between the two groups (P>0.05). At 6d, 14d and 21d after treatment, the white blood cell count and neutrophils were observed in both groups. Compared with the control group, the white blood cell count and neutrophil increased significantly in the experimental group (P＜0.05). There was no significant difference in the red blood cell and platelet count between the control group before and after treatment (P＞0.05), 6d after treatment. On the 14th day and the 21st day, the red blood cell count and platelet count of the experimental group increased to different degrees(P＜0.05). Compared with the control group, the red blood cell and platelet counts of the experimental group increased to different degrees(P＜0.05). There was no significant difference in hemoglobin between before and after treatment (P＞0.05). Before treatment, there was no significant difference in T cell subsets and immunoglobulin between 2 groups (P＞0.05) After treatment, the T cell subsets and immunoglobulins in 2 groups were increased to different degrees(P＜0.05). Compared with the control group, the T cell subsets and immunoglobulins in the experimental group were significantly increased (P＜0.05). There was no significant difference in the effective, effective, ineffective and total effective rates between 2 groups(P＞0.05). Conclusion: Sijunzi Decoction modified can improve the spleen deficiency state after chemotherapy, reduce the side effects of bone marrow suppression, shorten the time of bone marrow suppression recovery, and improve the body immunity. |
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