实用肿瘤学杂志 ›› 2010, Vol. 24 ›› Issue (2): 134-137.doi: 10.3969/j.issn.1002-3070.2010.02.009

• 论著 • 上一篇    下一篇

补肾健脾化瘀法治疗EPO拮抗的癌症化疗后贫血

陆崇, 龙华, 莫贤毅, 舒阳春, 刘魁凤   

  1. 广东药学院附属第一医院(广州 510080)
  • 收稿日期:2010-03-18 出版日期:2010-04-28 发布日期:2015-01-24
  • 通讯作者: 陆崇,E-mail:lc116688@sohu.com
  • 作者简介:陆崇,女,(1968-),硕士,副主任医师,从事肿瘤的中西医结合治疗
  • 基金资助:
    本课题受2007年广东省中医药管理局基金资助(项目编号:2007147)

A Clinical Study of Improving Efficacy of Chemotherapy-induced Anemia Patients with Recombinant human erythropoietin resistance in Chinese Herbal Medicine

LU Chong, LONG Hua, MO Xianyi, SHU Yangchun, LIU Kuifeng   

  1. The First Affiliated Hospital of Guangdong Pharmacutical University,Guangzhou 510080
  • Received:2010-03-18 Online:2010-04-28 Published:2015-01-24

摘要: 目的 探讨补肾健脾化瘀法治疗难治性恶性肿瘤化疗后贫血可行性。方法 采用前瞻、随机、对照研究方法,将70名对促红细胞生成素(EPO)拮抗的难治性恶性肿瘤化疗后贫血患者,随机分为:研究组34例,以补肾健脾化瘀法治疗8周;对照组36例,采用对症支持治疗,观察两组治疗期间(第0、7、14、21、28、35、42、49、56天)的血红蛋白(Hb)、贫血的中医症候临床症状积分、两组输血率及不良反应。结果 研究组的Hb逐步升高,在第21天升高就较明显,在第56天41.17%的患者的难治性贫血获得改善,而对照组仅20%患者的Hb在缓慢恢复,二者统计学有差异(P=0.023);研究组输血率(14.71%)低于对照组(36.11%)(P=0.04)。贫血的中医症候中,研究组食欲不振的改善出现最早,治疗后第7天有55.17%的患者已开始胃纳好转。血瘀症候为较晚出现改善的中医症候,对照组血瘀症候无1例改善;食欲不振、神疲乏力有效率分别为75.86%、66.67%,其临床症候积分值在研究组治疗前后及两组治疗后相比统计学均有差异(P<0.05),本研究无明显不良反应。结论 针对已对EPO拮抗的难治性恶性肿瘤化疗后贫血患者,仅采用对症支持疗法,治疗贫血的客观疗效不佳,血瘀症候无法改善;补肾健脾化瘀法可使41.17%的难治性化疗后贫血患者进一步获益,降低了输血率,食欲不振、神疲乏力的迅速改善增强了患者治疗的信心,对保障化疗顺利进行有积极的意义,改善血瘀症候可能是治疗难治性化疗后贫血的又一关键。

Abstract: Objective To investigate the efficacy of the Chinese Herbal Medical method of Inviogorating the Spleen,Tonifying the kidney and activating blood to treat chemotherapy-related anemia patients with advanced cancer,who has the problem of recombinant human erythropoietin resistance.Methods A prospective,randomized and control trial was carried out in 70 cases with advanced cancer,These cases were allocated to two groups,Group A(the tial group,n=34)received chinese herbs medicine(the method of Inviogorating the Spleen,Tonifying the Kidney and Activating blood for 8 weeks),Group B(the control group,n=36)received only support treatment。Record the change of haemoglobin,the rate of transfusion,and clinic symptom of anemia.Results The effective rate of treating anemia,Group A was 41.17%,Group B was 20%(χ2=4.29,P=0.023),Group A was better than group B in the decrease the rate of transfusion,14.71% vs 36.11%,and in the improving symptoms.Conclusion The result showed that to chemothery-induced anemia,who has the problem of recombinant human erythropoietin resistance,the method of inviogorating the spleen,Tonifying the kidney and activating blood could increase hemoglobin(Hb),improving symptoms of anemia。It is very safe.It shows the predominance of Chinese Herbal Medical method,and be propitious to patients with advanced cancer,who need chemotherapy.

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