参苓白术散防治伊立替康所致迟发性腹泻疗效及安全性的临床研究

摘要/Abstract

摘要： 目的探讨参苓白术散防治伊立替康（CPT-11）所致迟发性腹泻疗效及安全性。方法回顾性选取2019年1月~2021年8月江苏省中医院收治的中晚期结直肠癌患者60例,按是否口服中药分为观察组（30例）和对照组（30例）。观察组在化疗的前1天开始口服参苓白术散,2次/d,1袋/次（100 mL）,连续服用2个化疗周期;对照组单纯应用化疗。比较两组CPT-11所致迟发性腹泻分级、体力状况评价（KPS评分）、机体免疫状态（CD4⁺、CD8⁺和CD3⁺水平）和不良反应发生情况。结果与对照组迟发性腹泻发生率比较,观察组迟发性腹泻发生率稍降低,对比差异无统计学意义（P>0.05）。观察组KPS评分改善率稍高于对照组,对比差异无统计学意义（P>0.05）。治疗后,两组CD4⁺、CD8⁺和CD3⁺水平均显著高于治疗前（P<0.05）,且观察组CD4⁺、CD8⁺和CD3⁺水平均显著高于对照组（P<0.05）。两组不良反应（骨髓抑制、肝肾功能损害、恶心呕吐、口腔溃疡和食欲减退）发生率比较,差异无统计学意义（P>0.05）。结论参苓白术散防治伊立替康所致迟发性腹泻,可以轻微降低腹泻的发生率,改善体力状况和免疫状态,提高疗效,安全性良好。

关键词: 迟发性腹泻, 伊立替康, 参苓白术散, 化疗

Abstract: Objective To investigate the efficacy and safety of Shenling Baizhu powder in the prevention and treatment of delayed diarrhea caused by irinotecan(CPT-11). Methods A total of 60 patients with advanced colorectal cancer in the Department of Gastrointestinal Oncology, Jiangsu Provincial Hospital of Traditional Chinese Medicine between January 2019 and August 2021 were retrospectively selected and divided into an observation group (n=30) and a control group (n=30) according to whether they took traditional Chinese medicine or not. The treatment group started to take Shenling Baizhu Powder orally on the 1st day before chemotherapy, 2 times a day, 1 bag (100 mL) at a time, for 2 consecutive cycles of chemotherapy; the control group was treated with chemotherapy alone. The grade of delayed diarrhea caused by CPT-11, physical condition evaluation (KPS score), immune status (the levels of CD4⁺, CD8⁺ and CD3⁺) and adverse reactions were compared between the two groups. Results Compared with the delayed diarrhea incidence rate of 46.67% (14/30) in the control group, the delayed diarrhea incidence rate of 26.67% (8/30) in the observation group was slightly reduced with no difference (P>0.05). The improvement rate of KPS score of 53.33% (16/30) in the observation group was slightly higher than 40.00% (12/30) in the control group, and there was no difference after comparison (P>0.05). After treatment, the levels of CD4⁺, CD8⁺ and CD3⁺ in the two groups were significantly higher than those before treatment (P<0.05), and the levels of CD4⁺, CD8⁺ and CD3⁺ in the observation group were significantly higher than those in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions (myelosuppression, liver and kidney function damage, nausea and vomiting, oral ulcers and loss of appetite) between the two groups (P>0.05). Conclusion Shenling Baizhu Powder can prevent and treat delayed diarrhea caused by irinotecan, it can slightly reduce the incidence of diarrhea, improve physical and immune status, and improve the curative effect with good safety.

Key words: delayed diarrhea, Irinotecan, Shenling Baizhu powder, chemotherapy

中图分类号:

R574.62

刘家云, 吴冠楠, 还向坤, 刘福坤, 刘沈林. 参苓白术散防治伊立替康所致迟发性腹泻疗效及安全性的临床研究[J]. 中华养生保健, 2022, 40(23): 22-25.

LIU Jia-yun, WU Guan-nan, HUAN Xiang-kun, LIU Fu-kun, LIU Shen-lin. Clinical Study on the Efficacy and Safety of Shenling Baizhu Powder in the Prevention and Treatment of Delayed Diarrhea Caused by Irinotecan[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(23): 22-25.

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