化噎汤联合TP方案治疗中晚期食管癌的临床探究.pdfVIP

提 要 目的：食管癌患者经常出现吞咽困难、胸膈痞满、呃逆嗳气、呕吐粘液、食欲减 退等气滞痰阻和脾胃失调的症状，故对中医辨证为此型的患者采用化噎汤加减配合化 疗，以观察中西医结合治疗中晚期食管癌的疗效。方法：将 40 例食管癌住院患者， 随机分为两组，其中观察组 20 例，对照组 20 例，观察组给予中药化噎汤（每日 1 剂）联合TP方案化疗；对照组只给予TP方案化疗。每3周为1周期，连续观察两个 化疗周期后，比较两组治疗前后肿瘤病灶大小，中医临床症状，生活状态（卡氏评分、 体重）和毒副反应的变化情况，并进行量化评分作为疗效评价指标，最后统计分析两 组在上述指标方面的差异。结果：本研究显示观察组在病灶缓解的有效率及稳定率方 面均高于对照组，但经统计学分析两组无显著性差异（P＞0.05）。观察组治疗前后中 医症状积分比较，差异有统计学意义(P＜0.05 )；对照组治疗前后积分比较，差异无 统计学意义(P＞0.05 )；治疗后两组积分比较，差异有统计学意义(P＜0.05 )，表明 观察组的中医症状改善效果优于对照组。其中吞咽困难的症状改善，观察组与对照组 相比，差异无统计学意义(P＞0.05)；胸膈痞满、呃逆嗳气、呕吐粘液、食欲减退的 症状改善，观察组优于对照组，两组差异有统计学意义(P＜0.05 )。治疗后两组在卡 氏评分、体重及减轻消化系统副反应方面比较差异有统计学意义(P＜0.05 )，而在减 轻血液和周围神经毒性方面比较，差异无统计学意义（P＞0.05）。结论：化噎汤加减 配合化疗可较好改善食管癌患者临床症状，提高生活质量，稳定并增加体重，是治疗 食管癌的有效方法之一。 关键词 食管癌；化噎汤；TP方案；中西医结合 clinical study on patients with mid and late stage esophageal cancer treated by hua ye tang combined with PTX+DDP chemotherapy Speciality: Internal Medicine of TCM Author: Liang Liyan Tutor: Professor Qi Yuanfu Abstract Objective: The most common clinical manifestations of advanced esophageal cancer are dysphagia , fullness in chest and tabula, belching, vomiting mucus，poor appetite, ect. This type of patients were given with “hua ye tang” combined with chemotherapy (PTX+DDP regimen) to observe the effect of the treatment with integrated traditional chinese and western medicine on esophageal cancer. Methods: Selected 40 patients with mid and late stage esophageal cancer were randomly divided into two groups, 20 patients in treatment group were administered with “hua ye tang” (one time per day) and chemotherapy (PTX+DDP regimen), 20 in control group with chemotherapy alone. Every 3 weeks as a cycle，after 2 consecutive chemotherapy cycles, changes were compared in the tumor size, clinical symptoms, living