补肾通络方随证加减治疗老年原发性胃癌化疗后骨髓抑制的临床观察

Clinical observation on treatment of myelosuppression in elderly patients with primary gastric cancer after chemotherapy with modified Bushen Tongluo decoction

中文关键词: 老年  原发性胃癌  骨髓抑制  补肾通络方  化疗毒副反应  临床研究

英文关键词: elderly  primary gastric cancer  myelosuppression  Bushen Tongluo decoction  chemotherapy toxic and side effect  clinical research

中文摘要:

      目的 探讨补肾通络方随证加减治疗老年原发性胃癌化疗后骨髓抑制的临床疗效及安全性.方法 选取2020年12月—2022年12月于南京中医药大学附属苏州市中医医院收治的80例老年原发性胃癌患者,采用随机数字表法分为观察组(n=40)与对照组(n=40).对照组接受常规化疗相关骨髓抑制处理,包括PEG-rhG-CSF、EPO和TPO等;观察组在对照组的基础上联合补肾通络方随证加减.比较2组治疗前后外周血相关指标(包括白细胞、中性粒细胞、血红蛋白、血小板)、骨髓抑制分度、中医证候积分及不良反应发生情况.结果 治疗前,观察组外周血血红蛋白、白细胞、中性粒细胞、血小板分别为(2.65±0.63)、(1.63±0.18)、(93.11±11.94)、(76.75±17.13),对照组分别为(2.81±0.64)、(1.62±0.21)、(92.07±10.76)、(74.04±14.85);治疗后,观察组分别为(4.02±0.55)、(2.09±0.29)、(108.34±11.03)、(98.99±13.31),对照组分别为(3.68±0.64)、(1.79±0.25)、(103.48±10.23)、(92.21±31.89),观察组改善情况优于对照组.治疗前,观察组与对照组中医证候积分差异无统计学意义(P＞0.05).治疗后,2组患者除便溏情况未见明显改善外,其余中医证候较同组治疗前均有改善,差异有统计学意义(P＜0.05);观察组中医证候积分改善均显著优于对照组,不良反应发生率(20％)低于对照组(42.5％),骨髓抑制分度改善情况优于对照组,差异均具有统计学意义(P＜0.05).结论 补肾通络方随证加减可显著改善老年原发性胃癌患者化疗后骨髓抑制,缓解中医证候,减少不良反应,安全性良好,具有较高的临床推广价值.

英文摘要:

      Objective To explore the clinical efficacy and safety of Bushen Tongluo decoction with syndrome-based modifications in the treatment of chemotherapy-induced myelosuppression in elderly patients with primary gastric cancer.Methods A total of 80 elderly patients with primary gastric cancer admitted to Suzhou Hospital of Traditional Chinese Medi-cine(TCM)Affiliated to Nanjing University of Traditional Chinese Medicine from December 2020 to December 2022 were se-lected.They were divided into observation group and control group using a random number table method,with 40 cases in each group.The control group received conventional treatment for chemotherapy-related myelosuppression,including PEG-rhG-CSF,EPO,and TPO.The observation group was given Bushen Tongluo decoction with syndrome-based modification in addi-tion to the conventional treatment.Peripheral blood parameters(including white blood cells,neutrophils,hemoglobin,and platelets),myelosuppression grade,TCM syndrome scores,and adverse reactions were compared between the two groups be-fore and after treatment.Results Before treatment,the levels of hemoglobin,white blood cells,neutrophils,and platelets in the observation group were(2.65±0.63),(1.63±0.18),(93.11±11.94)and(76.75±17.13),respectively,while those in the control group were(2.81±0.64),(1.62±0.21),(92.07±10.76)and(74.04±14.85),respectively.After the treatment,the above indicators in the observation group were(4.02±0.55),(2.09±0.29),(108.34±11.03)and(98.99±13.31),respectively,while those in the control group were(3.68±0.64),(1.79±0.25),(103.48±10.23)and(92.21±31.89),respectively.The improvement in the observation group was better than that in the control group.Before treatment,there was no significant statistical difference in the TCM syndrome scores between the two groups(P＞0.05).After treatment,except for loose stools,the other TCM syndrome scores in both groups improved compared with those in the same group before treatment,and the differences were statistically significant(P＜0.05).The improvement of TCM syndrome scores in the observation group was significantly better than that in the control group,the incidence of adverse reactions(20％)was lower than that in the control group(42.5％),the improvement of myelosuppression grading was better than that in the con-trol group,and the differences were statistically significant(P＜0.05).Conclusion Bushen Tongluo decoction with syndrome-based modification can significantly improve chemotherapy-induced myelosuppression,alleviate TCM syndrome,reduce adverse reactions,and has good safety in elderly patients with primary gastric cancer.It has a relatively high clinical promotion value.