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分析

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[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。 [Objective] To investigate the therapeutic effect of Zhiqi Capsule combined with intraperitoneal infusion of mitomycin in patients with rectal cancer and malignant pleural effusion. [Methods] Eighty-two patients with advanced rectal cancer complicated with malignant pleural effusion were selected and randomly divided into observation group and control group. The patients in the control group were given intraperitoneal infusion of mitomycin C. The observation group was additionally given orally Zhizhi capsules on the basis of the treatment in the control group. After the end of treatment, the evaluation of ascites control efficacy was evaluated; before the treatment, after the treatment, on the first week, the second week, the third week and the fourth week, the Kart score was evaluated; before and after the treatment, the patients had nausea and vomiting, abdominal pain, and reduced urine output. The symptoms of dyspnea and bloating were evaluated; the levels of T lymphocyte subsets such as CD3+, CD4+, CD8+, and CD19+ were detected before and after treatment; CYFRA21 and NSE in the patient’s pleural effusion were measured before and after treatment. , CEA and LDH content. Observe the occurrence of adverse reactions during treatment of all patients. [Results] The total effective rate of the observation group was 86.8%, which was significantly higher than that of the control group (71.8%) (P=0.043); the KPS scores of the observation group after treatment were significantly higher than that of the control group (P<0.05); after treatment, the observation group patients The scores for nausea and vomiting, abdominal pain, decreased urine output, dyspnea, and abdominal distension were (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), respectively. The scores were all significantly lower than those in the control group (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 contents of CYFRA21, NSE, CEA and LDH in the effusion were significantly lower than those in the control group (P<0.05). No adverse reactions occurred in all patients during the treatment period. There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). ). [Conclusion] Zhiqi capsule combined with peritoneal infusion of mitomycin C is effective in the treatment of advanced rectal cancer with malignant pleural effusion and is worthy of further study.
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