【作者】 王云启；

【导师】 黄立中；

【作者基本信息】 湖南中医学院 ， 中西医结合临床， 2002， 硕士

【摘要】 目的：观察桂葶百合汤配合胸腔灌注化疗治疗肺癌胸水肺气虚和气阴两虚证的疗效。 方法：选取肺癌胸水肺气虚和气阴两虚证住院患者50例，分层后随机分为桂葶百合汤配合胸腔灌注化疗组(治疗组)和单纯胸腔灌注化疗组(对照组)各25例，从胸水缓解、原发灶变化、主要症状体征变化、生活质量变化、毒副反应等方面进行临床疗效观察和评价。 结果：①桂葶百合汤配合胸腔灌注化疗治疗肺癌胸水肺气虚和气阴两虚证的疗效优于单纯胸腔灌注化疗，两组比较有显著性差异(P＜0.05)；②桂葶百合汤配合胸腔灌注化疗治疗肺癌胸水原发灶的有效率与单纯胸腔灌注化疗比较无显著差异(P＞0.05)；③在改善肺癌胸水患者的主要症状、生活质量(卡氏评分)方面，桂葶百合汤配合胸腔灌注化疗与单纯胸腔灌注化疗比较有显著性差异(P＜0.05)，前者优于后者；④在减轻化疗毒副反应方面，中药桂葶百合汤配合胸腔灌注化疗与单纯胸腔灌注化疗减轻消化道反应比较，二者有显著性差异(P＜0.05)，前者优于后者。两组在骨髓抑制及肝肾功能方面影响均不大。⑤两组中肺气虚和气阴两虚证的证型疗效比较(含胸水缓解和原发灶疗效)均无显著性差异(p＞0.05)。 结论：桂葶百合汤配合胸腔灌注化疗治疗肺癌胸水肺气虚和气阴两虚证疗效明显，其作用机制在于两者有协同作用，其综合疗效明显优于单纯胸腔灌注化疗。两组中肺气虚和气阴两虚证的证型疗效比较均无显著性差异。更多还原

【Abstract】 Objective: To investigate the curative effects of Guitingbaihe decoction combined with the chemotherapy through pleural perfusion on the pleural effusion with Pulmonary QiXu and QiYinLiangXu syndromes subsequent to the lung cancer.Methods: 50 inpatients of pleural effusion subsequent to the lung cancer were selected, and divided randomly into treatment group (treated with the Guitingbaihe decoction combined with chemotherapy through the pleural perfusion) and control group (treated with only chemotherapy through the pleural perfusion) after stratification. The clinic curative effect was observed and compared.Results:The treatment group had a better curative effect than the control group, and there was a significant difference between these two groups(p<0.05). There was no difference between the treatment group and the control group on the effective rate of curing the primary focus of pleural effusion subsequentto lung cancer (p>0.05). (3)As to the effect of ameliorating the main symptoms, the scoring method of Karnofsky was used to evaluate the quality of life. The results showed that there was a remarkable difference between the treatment group and the control group, and the former was better. (4)On alleviating the toxicity and side-effect of chemotherapy, the therapy of Chinese traditional medicine Guitingbaihe decoction combined with chemotherapy had a slighter side effect of alimentary canal(p<0.05).But there was no obviously difference between both groups on the effect of bone marrow depression and impairment of liver and kidney’s function. In both groups, there was no significant difference between Pulmonary QiXu syndromes and QiYinLiangXu syndromes on syndromatic curative effect (p>0.05 ) .Conclusion: Therapy of the combination of Guitingbaihe decoction and chemotherapy through the pleural perfusion has a satisfactory curative effect on the pleural effusion with Pulmonary QiXu and QiYinLiangXu syndromes subsequent to lung cancer. Its mechanism is that both therapies have a cooperative effect and the synthesis effect is better than the effect of chemotherapy only. In both groups, there was no significant difference between these two syndromes on syndromatic curative effect.更多还原