半夏降逆汤防治顺铂致恶心呕吐（脾胃虚弱型）的临床观察

Clinical observation of Banxia Jiangni Decoction in the prevention and treatment of nausea and vomiting (spleen and stomach weakness) caused by cisplatin

关键词:  化疗相关性恶心呕吐  半夏降逆汤  顺铂  脾胃虚弱型

Key words:  chemotherapy related nausea and vomiting  Banxia Jiangni Decoction  cisplatin  spleen and stomach weakness

摘要:

[目的] 观察半夏降逆汤对含顺铂（DDP）化疗方案致恶心呕吐（脾胃虚弱型）的疗效及对患者生活质量的影响。[方法] 选取2017年4—12月在河南中医药大学第二附属医院肿瘤科住院，经病理组织学或（和）细胞学诊断为非小细胞肺癌、食管癌、宫颈癌、鼻咽癌，符合中西医诊断标准，需行包含DDP化疗方案的患者72例，随机分为对照组（36例）和试验组（36例），对照组在DDP应用前使用阿扎司琼联合地塞米松止吐，试验组在对照组的基础上加服半夏降逆汤，8d为1个疗程。服药期间观察患者恶心、呕吐次数、中医证候疗效、食欲状况、体力状况、安全指标，评价半夏降逆汤的疗效。[结果] 与对照组比较，试验组化疗后延迟性恶心次数明显减少，试验组有效率82.85%，对照组有效率55.88%，两组比较差异有统计学意义（P＜0.05）；与对照组比较，试验组化疗后延迟性呕吐次数明显减少，试验组有效率77.14%，对照组有效率52.94%，两组比较差异有统计学意义（P＜0.05）；急性恶心、呕吐方面两组相比差异无统计学意义（P＞0.05）。治疗后两组中医证候疗效相比差异有统计学意义（P＜0.05）。治疗后两组患者食欲均有所下降，对照组下降较明显，两组食欲分级相比差异有统计学意义（P＜0.05）。两组治疗后体力均较前下降，对照组体力下降更明显，两组体力状况评分经统计学分析，差异有统计学意义（P＜0.01）。安全性方面，两组均未出现明显不良反应，差异无统计学意义（P＞0.05）。[结论] 半夏降逆汤能减轻含DDP化疗方案脾胃虚弱型患者延迟性恶心、呕吐、改善中医证候、食欲、体力状况，安全有效。

Abstract:

[Objective] To observe the effect of Banxia Jiangni Decoction on nausea and vomiting (spleen stomach weakness) caused by chemotherapy containing cisplatin (DDP) and its effect on the quality of life of patients.[Methods] 72 patients who were hospitalized in the oncology department of Henan Province Hospital of Traditional Chinese Medicine from April 2017 to December 2017 and were diagnosed as non-small cell lung cancer,esophageal cancer,cervical cancer and nasopharyngeal carcinoma by histopathology or (and) cytology. They met the diagnostic criteria of traditional Chinese and western medicine and needed DDP chemotherapy. They were randomly divided into control group (36 cases) and experimental group (36 cases),the control group used azasetron+dexamethasone to stop vomiting before DDP application,and the experimental group took Banxia Jiangni Decoction on the basis of the control group,8 days as a course of treatment. During the medication,the times of nausea and vomiting,the curative effect of traditional Chinese medicine syndrome,appetite,physical strength and safety indexes were observed,and the curative effect of Banxia Jiangni decoction was evaluated.[Results] Compared with the control group,the number of delayed nausea after chemotherapy in the experimental group was significantly reduced. The effective rate in the experimental group was 82.85% and that in the control group was 55.88%. There was significant difference between the two groups(P<0.05);compared with the control group,the times of delayed vomiting after chemotherapy in the experimental group were significantly reduced. The effective rate in the experimental group was 77.14% and that in the control group was 52.94%. There was significant difference between the two groups (P<0.05);there was no significant difference in acute nausea and vomiting between the two groups (P>0.05). There was significant difference between the two groups after treatment (P<0.05). After treatment,the appetite of the two groups decreased,and that of the control group decreased significantly. There was significant difference in the grade of appetite between the two groups (P<0.05). The physical strength of the two groups decreased significantly after treatment,and the physical strength of the control group decreased significantly. There was significant difference between the two groups by statistical analysis(P<0.01). In terms of safety,there was no significant adverse reaction between the two groups,and there was no difference by statistical analysis (P>0.05).[Conclusion] Banxia Jiangni Decoction can reduce delayed spleen and stomach weakness patients nausea and vomiting,improve traditional Chinese medicine syndrome,appetite and physical strength,which is safe and effective.