纳子法指导下金龙硝黄散择时外敷联合胸腔灌注治疗恶性胸腔积液的临床研究

摘要/Abstract

摘要： 目的评估纳子法指导下金龙硝黄散择时外敷联合胸腔灌注的有效性和安全性。方法本研究为前瞻性、随机、对照试验。研究包括90例符合条件的患者,随机分为治疗组（n=45）和对照组（n=45）。采用胸腔积液疗效评价标准、中医证候积分及EORTC QLQ-C30量表来进行疗效的评估。结果两组总有效率比较,差异有统计学意义（P<0.05）。两组患者中医证候积分在治疗后较治疗前均降低,且治疗组低于对照组,差异有统计学意义（P<0.05）。治疗组患者躯体功能状况、总体健康状况、疲倦及气促症状得到明显改善,与本组治疗前比较,差异有统计学意义（P<0.05）。无患者出现皮肤过敏、胸闷等不良反应。结论纳子法指导下金龙硝黄散择时外敷联合胸腔灌注治疗MPE疗效显著,能够显著改善患者生活质量,并且安全性高。

关键词: 外敷, 腔内化疗, 恶性胸腔积液, 纳子法, 金龙硝黄散

Abstract: Objective The aim of this study was to evaluate the efficacy and safety of time-selected external application of Jinlong Nituhuang Powder combined with thoracic perfusion under the guidance of Nazi method. Methods This study was a prospective, randomized, controlled trial. The efficacy was evaluated according to evaluation criteria for the treatment of pleural effusion, the improvement of TCM symptoms and the EORTC QLQ-C30. Results The study included 90 eligible patients. They were randomly divided into treatment group (n=45) and control group (n=45). The difference of total effective rate between the two groups was statistically significant (P<0.05). The scores of TCM symptoms in both groups were lower after treatment than before treatment, and the difference was statistically significant compared with that in this group (P<0.05), and the reduction of treatment group was better than control group (P<0.05). The physical function status, general health status, fatigue and shortness of breath were significantly improved in the treatment group. No patients had skin allergy, chest tightness and other adverse reactions. Conclusion Under the guidance of Nazi method, Jinlong Nituhuang Powder combined with pleural perfusion has significant therapeutic effect on MPE, can significantly improve patients’ quality of life and with high safety.

Key words: external application, intrathoracic chemotherapy, malignant pleural effusion, natrium method, Jinlong Nithuang Powder

中图分类号:

R273

单兰, 宋芳蕾, 陈媛媛. 纳子法指导下金龙硝黄散择时外敷联合胸腔灌注治疗恶性胸腔积液的临床研究[J]. 中华养生保健, 2024, 42(17): 9-12.

SHAN Lan, SONG Fang-lei, CHEN Yuan-yuan. Clinical Study on the Treatment of Malignant Pleural Effusion by Time-Selected External Application of Jinlong Nituhuang Powder Combined with Pleural Perfusion under the Guidance of Nazi Method[J]. ZHONGHUA YANGSHENG BAOJIAN, 2024, 42(17): 9-12.

参考文献

[1] BASSO S M M, LUMACHI F, DEL CONTE A, et al. Diagnosis of malignant pleural effusion using CT scan and pleural-uid cytology together. A preliminary case-control study[J]. Anticancer Res,2020,40:1135-1139.
[2] TIAN T, ZHANG P, ZHONG F, et al.Nomogram construction for predicting survival of patients with non-small cell lung cancer with malignant pleural or pericardial effusion based on SEER analysis of 10,268 patients[J]. Oncol Lett,2020,19:449-459.
[3] ADEYINKA A, KONDAMUDI N P.Pediatric Malignant Pleural Effusion[J]. The Eurasian Journal of Medicine,2020,41:186-193.
[4] KARAPOLAT S, BURAN A, TEKINBAS C.Management of malignant pleural effusion with different pleural catheters[J]. Lung India,2018,35:92.
[5] KOEGELENBERG C F N, ALLWOOD B W. The optimal management of malignant pleural effusion: steady progress towards an evidence-based approach[J]. Respiration,2018,96:497-499.
[6] LI P, GRAVER A, HOSSEINI S, et al.Clinical predictors of successful and earlier pleurodesis with a tunnelled pleural catheter in malignant pleural effusion: a cohort study[J]. CMAJ Open,2018,6:E235-E240.
[7] MURUGANANDAN S, AZZOPARDI M, FITZGERALD D B, et al.Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial[J]. Lancet Respir Med,2018,6:671-680.
[8] KAWAGUCHI Y, HANAOKA J.Cytoreductive surgery and hyperthermic chemotherapy for intrathoracic pseudomyxoma peritonei[J].Ann Thorac Surg,2020,110(6):e541-e543.
[9] 朱思遥,陈嘉楠,丁文龙,等.中医药治疗恶性胸腔积液的研究进展[J].广西中医药,2022,45(4):76-78.
[10] 石丽莉. 中医综合方案联合顺铂胸腔灌注治疗恶性胸腔积液的临床效果[J].内蒙古中医药,2021,40(12):94-95.
[11] 樊柄杰,周彤,李铮,等.基于“病痰饮者,当以温药和之”探讨恶性胸腔积液治疗思路[J].湖南中医药大学学报,2021,41(11):1756-1760.
[12] 于盼,韩建宏,田建辉.中医药治疗肺癌恶性胸腔积液研究进展[J].西部中医药,2021,34(5):152-155.
[13] 中国恶性胸腔积液诊断与治疗专家共识组.恶性胸腔积液诊断与治疗专家共识[J].中华内科杂志,2014,53(3):252-256.
[14] 吴勉华,王新月.中医内科学[M].北京:中国中医药出版社,2012:373-383.
[15] 朱文锋. 中医诊断学[M].北京:中国中医药出版社,2002:164-168
[16] 朱钟鸣,孙耕耘.恶性胸腔积液治疗指南摘要[J].临床肺科杂志,2002,7(4):49-52
[17] 国家药品监督管理局.中药新药临床研究指导原则(试行)[M].北京:中国医药科技出版社,2002:216-224.
[18] 王玉华. 综合护理在肺癌放疗患者中的效果分析及对EORTC QLQ-C30评分的影响[J].中国医学创新,2021,18(22):114-118.
[19] 赵天池. 大黄药效成分及其药理活性研究进展[J].中国民康医学,2021,33(11):104-105,107.
[20] 薄晗,赵晓平,范小璇,等.基于网络药理学探究大黄治疗脑水肿作用机制[J].中国中医急症,2022,31(6):950-954.
[21] 胡晓涵. 大黄素的体内外代谢研究[D].天津:天津中医药大学,2022.
[22] 李东辉,王临艳,吴红伟,等.大黄素药理作用研究新进展[J].中华中医药学刊,2021,39(9):100-104.
[23] 吴丛宇,周悦,上官璐茜,等.大黄素的药理作用机制研究进展[J].中国药科大学学报,2023,54(5):634-643.
[24] 袁菊花,贾立群,娄彦妮,等.以水通道蛋白microRNA探讨中医外治恶性胸水研究进展[J].现代中西医结合杂志,2021,30(25):2839-2842,2850.
[25] 张敬,刘芳,刘菁祖,等.子午流注理论指导下穴位贴敷在多节段腰椎间盘突出症术后腹胀、便秘护理中的疗效评价[J].中医药临床杂志,2023,35(11):2227-2231.
[26] 李彩莲,田春艳,管浩,等.纳子法辰时针刺对脾胃阳虚型中风后呃逆的影响[J].针灸临床杂志,2019,35(4):39-42.
[27] 杨颖. 子午流注纳子法联合眼罩热敷治疗室性早搏伴失眠疗效观察[J].上海针灸杂志,2019,38(1):12-16.
[28] 周振坤,卢金荣.纳子法针刺治疗脾胃虚弱型复发性口腔溃疡临床研究[J].针灸临床杂志,2018,34(3):28-31.