CAJ | 학술논문

目的：探讨华蟾素注射液腹腔灌注治疗恶性腹水的临床效果和安全性。方法回顾性分析北京中医药大学东方医院肿瘤科2010年1月~2013年12月收治的102例恶性腹水患者应用华蟾素注射液腹腔灌注治疗的临床资料。观察1个疗程后(每周给予药物灌注2次,每2周为1个疗程),患者腹水量、腹水质(腹水红细胞、乳酸脱氢酶、肿瘤标志物水平)、中医症状积分以及卡氏评分(KPS评分)的变化,根据此变化评价疗效。分层观察消化系统恶性腹水与非消化系统恶性腹水、局部辨证湿热毒证与寒湿毒证的疗效差异。结果腹水量的有效率为65.7%,腹水中红细胞水平下降逸25%者占61.8%,乳酸脱氢酶下降逸25%者占63.7%、肿瘤标志物下降逸25%者占57.8%。治疗后中医临床症状积分较治疗前明显下降,KPS评分较治疗前明显升高。分层统计显示消化系统恶性腹水疗效优于非消化系统恶性腹水(P<0.05或P<0.01),局部辨证湿热毒证者优于寒湿毒证者(P<0.05或P<0.01)。102例患者治疗过程中均未发生严重的不良反应。结论华蟾素注射液腹腔灌注治疗是一种安全有效、副作用低、中晚期肿瘤患者接受度好的治疗方法,尤其对消化系统恶性腹水以及局部辨证为湿热毒者疗效更佳,值得进一步推广和研究。
목적：탐토화섬소주사액복강관주치료악성복수적림상효과화안전성。방법회고성분석북경중의약대학동방의원종류과2010년1월~2013년12월수치적102례악성복수환자응용화섬소주사액복강관주치료적림상자료。관찰1개료정후(매주급여약물관주2차,매2주위1개료정),환자복수량、복수질(복수홍세포、유산탈경매、종류표지물수평)、중의증상적분이급잡씨평분(KPS평분)적변화,근거차변화평개료효。분층관찰소화계통악성복수여비소화계통악성복수、국부변증습열독증여한습독증적료효차이。결과복수량적유효솔위65.7%,복수중홍세포수평하강일25%자점61.8%,유산탈경매하강일25%자점63.7%、종류표지물하강일25%자점57.8%。치료후중의림상증상적분교치료전명현하강,KPS평분교치료전명현승고。분층통계현시소화계통악성복수료효우우비소화계통악성복수(P<0.05혹P<0.01),국부변증습열독증자우우한습독증자(P<0.05혹P<0.01)。102례환자치료과정중균미발생엄중적불량반응。결론화섬소주사액복강관주치료시일충안전유효、부작용저、중만기종류환자접수도호적치료방법,우기대소화계통악성복수이급국부변증위습열독자료효경가,치득진일보추엄화연구。
Objective To explore the clinical efficacy and safety of Cinobufacini Injection intraperitoneal perfusion treatment of malignant ascites. Methods The clinical data of 102 patients who were given Cinobufacini Injection in-traperitoneal perfusion treatment from January 2010 to December 2013 in Oncology of Dongfang Hospital of Beijing U-niversity of Chinese Medicine was analyzed retrospectively. After 1 course of treatment (twice a week, every two weeks as a course of treatment), according to the changes of quantity and quality(red blood cells, lactate dehydrogenase, tumor markers) of malignant ascites, and the symptom integral and karnofsky, curative effect was judged. The curative effect difference between digestive system malignant ascites and non digestive system malignant ascites and the curative effect difference between local dialectical damp-heat toxin syndrome and cold-damp toxin syndrome were observed respec-tively. Results The efficiency of quantity of malignant ascites was 65.7%, the level of red blood cells decreased ≥25% accounted for 61.8%, the level of lactate dehydrogenase decreased≥ 25% accounted for 63.7%, the level of tu-mor markers decreased≥ 25% accounted for 57.8%. After treatment, the clinical symptom score was significantly low-er than that before treatment, the KPS score was signifi-cantly higher than the pre-treatment. The study showed that the curative effect of Cinobufacini Injection in-traperitoneal perfusion treatment in digestive system ma-lignant ascites was better than that of non digestive sys-tem malignant ascites (P < 0.05 or P < 0.01), and in damp-heat toxin syndrome malignant ascites was better than that of cold-damp toxin syndrome malignant ascites (P < 0.05 or P < 0.01). In the course of treatment, 102 patients had no serious adverse reactions. Conclusion Cinobufacini Injection intraperitoneal perfusion treatment is a good method of treatment, which is safe and effective, with low side effect, wide indications, middle-late tumor patients can accept, especially for the digestive system malignant ascites, and damp-heat toxin syndrome malignant ascites has a better effect, which deserves further promotion and research.