时珍国医国药
時珍國醫國藥
시진국의국약
LISHIZHEN MEDICINE AND MATERIA MEDICA RESEARCH
2009年
11期
2754-2756
,共3页
邓宏%周宇姝%吴万垠%龙顺钦%郑剑霄%柴小姝%薛晓光%河文峰%蔡姣芝%张海波%孙良生
鄧宏%週宇姝%吳萬垠%龍順欽%鄭劍霄%柴小姝%薛曉光%河文峰%蔡姣芝%張海波%孫良生
산굉%주우주%오만은%룡순흠%정검소%시소주%설효광%하문봉%채교지%장해파%손량생
恶性胸腔积液%亚砷酸%体外高频热疗%胸腔内灌注
噁性胸腔積液%亞砷痠%體外高頻熱療%胸腔內灌註
악성흉강적액%아신산%체외고빈열료%흉강내관주
Malignant Pleural Effusion%Arsenic Trioxide%Extracorporeal High- frequency Hyperthermia%Pleural Infu-
目的 观察亚砷酸胸腔内灌注联合体外高频热疗对癌性胸水的疗效.方法 连续纳入45例癌性胸水病例,采用抽签法分为A、B、C 3组.所有患者均尽量引流胸水(至引流量小于150 ml/d),A组经导管向胸腔内灌注亚砷酸20 mg,后拔除导管并于当日行胸腔局部热疗1次,以后隔日热疗1次,连续4次;B组仅予胸腔内灌注亚砷酸20 mg并拔除导管;C组于胸水引净后拔除导管,并于当日行胸腔局部热疗1次,以后隔日热疗1次,连续4次.在拔管4周后复查胸水量,观察3种方法 对癌性胸水的疗效及毒性反应.结果 治疗后A、B、C 3组有效率分别为86.7%,62.5%和50.0%,A组胸水疗效优于B组和C组(P＜0.05).治疗后3组胸水LDH均较各组治疗前升高,均有显著性差异 (P＜0.01,P＜0.05),以A、B两组胸水LDH升高明显.治疗后A、B两组胸水CEA均较各组治疗前降低,均有显著性差异 (P＜0.01),以A组胸水CEA下降明显.治疗后3组患者均未出现血液学、心脏、肝脏、肾脏等毒性反应.结论 亚砷酸胸腔内灌注联合体外高频热疗控制癌性胸水具有协同增效作用,毒副反应小,患者易于耐受.
目的 觀察亞砷痠胸腔內灌註聯閤體外高頻熱療對癌性胸水的療效.方法 連續納入45例癌性胸水病例,採用抽籤法分為A、B、C 3組.所有患者均儘量引流胸水(至引流量小于150 ml/d),A組經導管嚮胸腔內灌註亞砷痠20 mg,後拔除導管併于噹日行胸腔跼部熱療1次,以後隔日熱療1次,連續4次;B組僅予胸腔內灌註亞砷痠20 mg併拔除導管;C組于胸水引淨後拔除導管,併于噹日行胸腔跼部熱療1次,以後隔日熱療1次,連續4次.在拔管4週後複查胸水量,觀察3種方法 對癌性胸水的療效及毒性反應.結果 治療後A、B、C 3組有效率分彆為86.7%,62.5%和50.0%,A組胸水療效優于B組和C組(P＜0.05).治療後3組胸水LDH均較各組治療前升高,均有顯著性差異 (P＜0.01,P＜0.05),以A、B兩組胸水LDH升高明顯.治療後A、B兩組胸水CEA均較各組治療前降低,均有顯著性差異 (P＜0.01),以A組胸水CEA下降明顯.治療後3組患者均未齣現血液學、心髒、肝髒、腎髒等毒性反應.結論 亞砷痠胸腔內灌註聯閤體外高頻熱療控製癌性胸水具有協同增效作用,毒副反應小,患者易于耐受.
목적 관찰아신산흉강내관주연합체외고빈열료대암성흉수적료효.방법 련속납입45례암성흉수병례,채용추첨법분위A、B、C 3조.소유환자균진량인류흉수(지인류량소우150 ml/d),A조경도관향흉강내관주아신산20 mg,후발제도관병우당일행흉강국부열료1차,이후격일열료1차,련속4차;B조부여흉강내관주아신산20 mg병발제도관;C조우흉수인정후발제도관,병우당일행흉강국부열료1차,이후격일열료1차,련속4차.재발관4주후복사흉수량,관찰3충방법 대암성흉수적료효급독성반응.결과 치료후A、B、C 3조유효솔분별위86.7%,62.5%화50.0%,A조흉수료효우우B조화C조(P＜0.05).치료후3조흉수LDH균교각조치료전승고,균유현저성차이 (P＜0.01,P＜0.05),이A、B량조흉수LDH승고명현.치료후A、B량조흉수CEA균교각조치료전강저,균유현저성차이 (P＜0.01),이A조흉수CEA하강명현.치료후3조환자균미출현혈액학、심장、간장、신장등독성반응.결론 아신산흉강내관주연합체외고빈열료공제암성흉수구유협동증효작용,독부반응소,환자역우내수.
Objective To observe the efficacy of extracorporeal high - frequency hyperthermia combined with pleural cavity infusion of Arsenic Trioxide in patients with malignant pleural effusion. Methods Forty - five patients with malignant pleural effusion were enrolled and divided into three arms by ballot; A, B and C. After the accumulation of pleural fluid had been adequately drained, Arm A received pleural cavity infusion of Arsenic Trioxide 20mg followed by extracorporeal high - frequency hyperthermia once every two days for four times. In Arm B, all patients were treated only with pleural cavity infusion of Arsenic Trioxide 20mg. In Arm C, patients were only given extracorporeal high - frequency hyperthermia once every two days for four times. The efficacy of pleural effusion and toxic reactions were recorded and compared after four weeks. Results The overall response rate of the three group were 86.7% ,62.5% ,50% respectively. And the efficacy of pleural effusion of A arm was better than B and C arms(P < 0.05 ). The levels of LDH in pleural effusion of post - treatment in three arms were all higher than those of prior - treatment. And there were statistically significant difference respectively between prior - treatment and post - treatment (P < 0.05, P < 0.01). Those of Arm A and Arm B increased significantly. The levels of CEA in pleural effusion of post - treatment in Arm A and Arm B were all lower than those of prior - treatment. And there were statistically significant difference respectively between prior - treatment and post - treatment( P <0.01). Those of Arm A reduced significantly. All the patients had no blood, heart, liver, kidney and other toxic reactions. Conclusion The efficacy to malignant pleural effusion of extracorporeal high - frequency hyperthermia combined with pleural cavity infusion of Arsenic Trioxide is better than those of the method of pleural cavity infusion of Arsenic Trioxide and high - frequency hyperthermia. The first method has combined synergies. The treatment is well tolerated with no adverse toxic reaction.
