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目的观察加味五参四苓汤联合逐饮散敷贴配合顺铂胸腔化疗对癌性胸水的影响。方法 65例恶性胸腔积液患者分为实验组35例,对照组30例。实验组在胸腔抽液后向胸腔内注入顺铂注射液30mg,并予以中药加味五参四苓汤煎服和逐饮散外敷;对照组在抽取胸腔积液后仅向胸腔内注入顺铂注射液30mg;两组均每周两次。比较两组胸水控制疗效,检测胸水肿瘤标志物CEA、CA125、CA153、CYFRA21-1、NSE下降程度和外周血免疫指标T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+变化情况以及观察对生活质量(KPS评分)和不良反应发生的影响。结果实验组控制胸腔积液总有效率85.71%,对照组控制胸腔积液总有效率63.33%(P<0.05);实验组CEA、CA125、CA153、CYFRA21-1和NSE下降程度高于对照组(统计学意义不明显,P>0.05);实验组CD3+、CD4+和CD4+/CD8+比值较本组治疗前明显增高而CD8+下降(P<0.05),并且CD3+、CD4+和CD4+/CD8+比值较对照组也明显增高而CD8+下降(P<0.05);治疗后实验组KPS评分上升例数多于对照组,有效率分别是80.00%和53.33%(P<0.05);两组不良反应比较实验组明显少于对照组。结论加味五参四苓汤联合逐饮散敷贴配合顺铂化疗能有效控制患者胸腔积液,能改善患者的免疫功能和提高生活质量,比单用顺铂治疗癌性胸水患者疗效好。
Objective To observe the effect of Modified Wushen Siling Decoction combined with Cisplatin and Cisplatin on malignant pleural effusion. Methods Sixty-five patients with malignant pleural effusion were divided into experimental group (35 cases) and control group (30 cases). The experimental group in the chest after pumping liquid into the thoracic cavity injection of cisplatin 30mg, and to be treated with five Senate Siling Decoction decoction and by drink Yin external application; the control group after pleural effusion was drawn only to the intrathoracic injection of cisplatin Liquid 30mg; two groups were twice a week. The curative effect of pleural effusion was compared between the two groups. The decrease of CEA, CA125, CA153, CYFRA21-1, NSE and the change of T lymphocyte subsets CD3 +, CD4 +, CD8 + and CD4 + / CD8 + in peripheral blood were observed. Quality (KPS score) and the impact of adverse reactions. Results The total effective rate of control group was 85.71% in control group and 63.33% in control group (P <0.05). The decrease of CEA, CA125, CA153, CYFRA21-1 and NSE in experimental group was higher than that in control group (P <0.05). The ratio of CD3 +, CD4 + and CD4 + / CD8 + in the experimental group was significantly higher than that before treatment and CD8 + in the experimental group was significantly lower than that in the control group (P <0.05). After treatment, the number of KPS in experimental group increased more than that in control group, and the effective rates were 80.00% and 53.33% respectively (P <0.05). The adverse reactions in two groups were significantly less than those in experimental group Control group. Conclusions Modified Wushen-Siling Decoction combined with Cisplatin and Cisplatin Chemotherapy can effectively control pleural effusion, improve immune function and improve quality of life of patients, which is more effective than cisplatin in treating patients with cancerous pleural effusion.