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地榆升白片治疗改良EOF方案化疗后骨髓抑制的疗效观察
http://www.100md.com 2011年3月25日 惠双 张成辉 仝运科 史晓丽
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     [摘要] 目的:观察地榆升白片防治晚期胃癌患者化疗后骨髓抑制的疗效及不良反应。方法:初治晚期胃癌患者80例采用表阿霉素+奥沙利铂+5-FU(CIV)方案(即改良EOF方案)化疗,随机分为试验组40例,采取改良EOF方案化疗同时联合地榆升白片治疗;对照组40例,仅采用改良EOF方案化疗,观察化疗期间两组白细胞的变化、粒细胞集落刺激因子(rhG-CSF)使用量及继发感染情况。结果:试验组在化疗期间有10例(25%)Ⅲ度以上白细胞下降,对照组有18例(45%)Ⅲ度以上白细胞下降,两组相比差异有统计学意义(P<0.05),粒细胞集落刺激因子(rhG-CSF)使用量及继发感染率均下降。结论:地榆升白片防治改良EOF方案化疗骨髓抑制疗效好,且安全性高,值得临床推广应用。

    [关键词] 地榆升白片;晚期胃癌;化疗;EOF方案;骨髓抑制

    [中图分类号] R735.2 [文献标识码]A [文章编号]1673-7210(2011)03(c)-074-02

    Observation on Diyushengbai tablets to treat myelosuppression in patients receiving chemotherapy of improved EOF regimen

    HUI Shuang, ZHANG Chenghui, TONG Yunke, SHI Xiaoli

    Oncology Three Ward, Central Hospital of Nanyang City, Nanyang 473009, China

    [Abstract] Objective: To observe clinical effects and adverse reactions of Diyushengbai tablets on treating myelosuppression in patients receiving chemotherapy of improved EOF regimen. Methods: Eighty cases of advanced gastric cancer were randomly divided into two groups. 40 patients in experimental group were treated by EOF regimen plus Diyushengbai tablets and 40 patients in control group were treated by EOF regimen only. Patients were evaluated by white blood cell count, the dose of rhG-CSF and the secondary infection rate associated with myelosuppression. Results: Grade Ⅲ and Ⅳ leukopenia occurred in 10 patients (25%) in the experimental group, whereas 18 patients(45%) in the control group. There was a significant difference between two groups (P<0.05). Conclusion: Diyushengbai tablet is an effective drug for treating myelosuppression in patients receiving chemotherapy of improved EOF regimen and deserved to apply popularly in the clinic.

    [Key words] Diyushengbai tablet; Advanced gastric cancer; Chemotherapy; EOF regimen; Myelosuppression

    我国胃癌患者确诊时大多为进展期或晚期,目前晚期胃癌规范化治疗多推荐以化疗为主的多种治疗手段综合应用。国外资料报告较多的ECF方案取得了良好疗效,但毒性大,耐受性差,用药疗程长;国内外学者将ECF方案改良为EOF,毒性下降,耐受性提高,但骨髓抑制仍较严重。我们观察化疗后Ⅲ/Ⅳ度白细胞下降发生率为29.1%[1]。为减少重度骨髓抑制发生率,初治晚期胃癌患者采用改良EOF方案同时联合地榆升白片化疗,观察对化疗后白细胞下降的预防情况,结果显示地榆升白片防治骨髓抑制疗效良好,现报道如下:

    1 对象与方法

    1.1 研究对象

    采用前瞻性随机对照的方法,入组自2008年3月~2010年3月完成,共80例资料完整晚期胃癌患者,均衡有可比性。所有病例为初治,经胃镜检查活检病理确诊为胃癌,且完善检查后行TNM分期列为晚期。试验入组条件:①胃镜活检病理学确诊的胃癌,分期为晚期的初治患者;②患者年龄大于18岁,小于75岁,KPS评分≥60分;③预计生存期超过3个月;④患者无同时患有另一种恶性肿瘤;⑤入组本试验之前无骨髓抑制病史 ......

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