论文部分内容阅读
摘 要：［目的］ 探讨志苓胶囊联合丝裂霉素腹腔灌注对直肠癌合并恶性胸腹腔积液患者治疗效果。［方法］ 选取收治的82例晚期直肠癌合并恶性胸腹腔积液患者，随机分为观察组和对照组。对照组患者给予丝裂霉素腹腔灌注治疗，观察组在对照组治疗基础上另口服给予志苓胶囊治疗。治疗结束后对腹水控制疗效进行评价；分析治疗前、治疗后第1周、第2周、第3周及第4周卡氏评分评；治疗前后分别对患者恶心呕吐、腹痛、尿量减少、呼吸困难、腹胀等症状进行评价；治疗前后分别检测患者CD3+、CD4+、CD8+及CD19+等T淋巴细胞亚群水平；治疗前后分别检测患者胸腹腔积液中CYFRA21，NSE，CEA及LDH的含量。观察所有患者治疗期间不良反应发生情况。［结果］ 观察组总有效率为86.8%，明显高于对照组的71.8%（P=0.043）；治疗后观察组KPS评分均明显高于对照组（P<0.05）；治疗后，观察组患者恶心呕吐、腹痛、尿量减少、呼吸困难及腹胀等评分分别为（1.11±0.19）分、（0.97±0.16）分、（0.87±0.15）分、（0.92±0.21）分及（1.13±0.27）分，均明显低于对照组（P均<0.05）；观察组CD3+、CD4+、CD8+及CD19+水平均明显高于对照组（均P<0.05）；观察组胸腹腔积液中CYFRA21，NSE，CEA及LDH的含量均明显低于对照组（P均<0.05）；所有患者治疗期间均未发生严重不良反应，两组不良反应发生率无显著性差异（P>0.05）。［结论］ 志苓胶囊联合丝裂霉素腹腔灌注治疗晚期直肠癌合并恶性胸腹腔积液疗效确切，值得深入研究。
Abstract: [Objective] To investigate the curative effect of Zhiling Capsule and mitomycin C intraperitoneal perfusion on patients with rectal cancer complicated with malignant pleural effusion. [Methods] 82 patients with malignant pleural effusion and peritoneal effusion who had undergone advanced rectal cancer were randomly divided into observation group and control group. Patients in the control group were treated with intraperitoneal infusion of mitomycin, and the observation group was treated with Zhiling capsule orally on the basis of the control group. The curative effect of ascites was evaluated after the treatment was finished. The Karnofsky scores before treatment, 1st week, 2nd week, 3rd week and 4th week after treatment were analyzed. Before and after treatment, the patients’ nausea and vomiting, abdominal pain and urine output were decreased, Dyspnea, bloating and other symptoms were evaluated before and after treatment. The levels of CD3 +, CD4 +, CD8 + and CD19 + T-lymphocyte subsets were detected before and after treatment. The levels of CYFRA21, NSE, CEA and LDH in pleural and peritoneal effusion were measured before and after treatment. All patients observed during treatment of adverse reactions. [Results] The total effective rate in the observation group was 86.8%, which was significantly higher than 71.8% in the control group (P = 0.043). After treatment, the KPS scores in the observation group were significantly higher than those in the control group (P <0.05) (1.11 ± 0.19) points, (0.97 ± 0.16) points, (0.87 ± 0.15) points, (0.92 ± 0.21) points and (1.13 ± 0.27) points, respectively. The scores of nausea and vomiting, abdominal pain, decreased urine output, (P <0.05). The levels of CD3 +, CD4 +, CD8 + and CD19 + in the observation group were significantly higher than those in the control group (all P <0.05). The levels of CYFRA21, NSE, CEA and LDH were significantly lower than those in the control group (all P <0.05). No serious adverse reactions occurred in all the patients during the treatment period. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). [Conclusion] The combination of Zhiling capsule and mitomycin C peritoneal perfusion in the treatment of advanced rectal cancer with malignant pleural effusion is effective and deserves further study.