首页|清金化痰汤加味联合痰热清注射液治疗肺癌性淋巴管炎患者的临床观察

清金化痰汤加味联合痰热清注射液治疗肺癌性淋巴管炎患者的临床观察

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目的:观察清金化痰汤加味联合痰热清注射液治疗肺癌性淋巴管炎患者的临床疗效.方法:将符合标准的 30例确诊肺癌性淋巴管炎且中医辨证为痰热壅肺的患者随机分为观察组和对照组.对照组为西医对症支持治疗,观察组在西医对症支持治疗的基础上给予清金化痰汤加味联合痰热清注射液治疗,2 组疗程均为 14 天.比较 2 组患者治疗前后的临床表现、中医证候总积分、C反应蛋白(CRP)、降钙素原(PCT)、血管内皮生长因子(VEGF)水平、免疫球蛋白(IgA、IgG、IgM)、T淋巴细胞亚群(CD3+、CD4+)、血氧分压(PO2)、血二氧化碳分压(PaCO2)以及癌胚抗原(CEA)、糖类抗原CA125(CA125)、细胞角蛋白 19 片段(CYFRA21-1)等肿瘤标志物指标水平,观察治疗过程中2 组不良反应发生情况.结果:治疗后,观察组患者气促、呼吸困难等临床症状、肺弥散功能和咳嗽、气喘、发热、口渴、面红、便结等中医症状积分均显著改善,且显著优于对照组(P<0.05);观察组患者治疗后VEGF、CEA、CA125、CYFRA21-1、CRP、PCT、IgA、IgG、IgM、CD3+、CD4+水平均降低,观察组较对照组降低更为显著(P<0.05);2 组患者治疗后PO2 均升高,且观察组较对照组升高更为显著(P<0.05),观察组患者治疗后PaCO2 较治疗前降低,且低于对照组(P<0.05),对照组患者治疗后PaCO2 较治疗前差异无统计学意义(P>0.05);2 组患者治疗过程中均出现一定程度骨髓抑制、皮肤反应、消化道反应、肝肾功能异常等不良反应,经处理可缓解,2 组比较结果差异无统计学意义(P>0.05).结论:在清金化痰汤加味联合痰热清注射液治疗肺癌性淋巴管炎患者临床疗效显著,可改善患者呼吸功能、减轻炎症反应、增强抗肿瘤免疫功能,可以有效提高患者生活质量,并在一定程度上改善远期预后.
Clinical Observation of Modified Qingjin Huatan Decoction Jiawei Combined with Tanreqing Injection in the Treatment of Patients with Pulmonary Lymphangitic Carcinomatosis
Objective:To observe the clinical efficacy of Qingjin Huatan Decoction plus Tanreqing Injection in the treatment of patients with lung cancer lymphangitis.Methods:Thirty patients diagnosed with lung cancer lymphangi-tis and diagnosed with phlegm-heat obstructing the lung according to TCM differentiation who met the criteria were randomly divided into an observation group and a control group.The control group received symptomatic supportive treatment of Western medicine,while the observation group was given Qingjin Huatan Decoction plus Tanreqing Injec-tion on the basis of symptomatic supportive treatment of Western medicine.The treatment course of both groups was 14 days.The clinical manifestations,total score of TCM syndrome,C-reactive protein(CRP),procalcitonin(PCT),vas-cular endothelial growth factor(VEGF)levels,immunoglobulins(IgA,IgG,IgM),T lymphocyte subsets(CD3+,CD4+),blood oxygen partial pressure(PO2),blood carbon dioxide partial pressure(PaCO2),carcinoembryonic antigen(CEA),carbohydrate antigen CA125(CA125),cytokeratin 19 fragment(CYFRA21-1)and other tumor markers were compared between the two groups before and after treatment,and the occurrence of adverse reactions in the two groups during treatment was observed.Results:After treatment,the clinical symptoms such as shortness of breath and dyspnea,lung diffusion function and TCM symptom scores such as cough,wheezing,fever,thirst,flushing and constipation in the observation group were significantly improved,and were significantly better than those in the control group(P<0.05).After treatment,the levels of VEGF,CEA,CA125,CYFRA21-1,CRP,PCT,IgA,IgG,IgM,CD3+and CD4+in the observation group were all reduced,and the reduction in the observation group was more significant than that in the control group(P<0.05).After treatment,PO2 of the two groups of patients increased,and the increase in the observa-tion group was more significant than that in the control group(P<0.05).After treatment,PaCO2 of the observation group was reduced compared with that before treatment,and was lower than that of the control group(P<0.05).There was no significant difference in PaCO2 of the control group after treatment compared with that before treatment(P>0.05).Both groups of patients had a period of treatment.Adverse reactions such as bone marrow suppression,skin reaction,diges-tive tract reaction,liver and kidney dysfunction,etc.were relieved after treatment.There was no significant difference between the two groups(P>0.05).Conclusion:Qingjin Huatan Decoction plus Tanreqing Injection has significant clini-cal efficacy in the treatment of patients with lung cancer lymphangitis,which can improve the respiratory function of patients,reduce inflammatory response,enhance anti-tumor immune function,effectively improve the quality of life of patients,and improve the long-term prognosis to a certain extent.

Lung cancer lymphangitisTanreqing InjectionQingjin Huatan DecoctionPhlegm-heat blocking the lungs

贺新玉、张红

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湖南中医药大学 湖南 长沙 410208

湖南中医药大学第一附属医院 湖南 长沙 410007

肺癌性淋巴管炎 痰热清注射液 清金化痰汤 痰热壅肺

2024

中医药临床杂志
中华中医药学会

中医药临床杂志

影响因子:0.636
ISSN:1672-7134
年,卷(期):2024.36(11)