Low-Frequency Sonophoresis of Chinese Medicine Formula Improves Efficacy of Malignant Pleural Effusion Treatment

Objective: To evaluate whether low-frequency ultrasound-facilitated transdermal delivery of a Chinese medicine (CM) formula could improve the efficacy of intrapleural administration of interleukin-2 (IL-2) in treatment of malignant pleural effusion (MPE). Methods: A total of 110 eligible participants were randomized into the low-frequency sonophoresis (LFS) of CM (LSF/CM) group (55 cases) and the control group (55 cases) by simple randomization using a random number table. The control group was treated with an intrapleural administration of IL-2; and the LFS/CM group was treated with LFS of a CM gel formulation, combined with the same IL-2 injection as in the control group. The CM formula consisted of Semen Lepidii, Semen Sinapis, Ramulus Cinnamomi, Poriacocos, Herba Lycopi, and Radix Paeoniae Rubra. After 2-week treatment, the therapeutic outcome was determined by the change of the amount of MPE, which was evaluated by B-scan ultrasound and/or chest X-ray, and the change of quality of life (QOL) scores, which were evaluated by the Eastern Cooperative Oncology Group (ECOG) performance status. Results: A significantly higher objective remission rate (ORR) was obtained with intrapleural IL-2 plus LFS/CM than IL-2 treatment alone (P=0.049). In addition, more patients in the LFS/CM group than in the control group had an improved QOL score (P=0.048), and no patients in the LFS/CM group had a reduced QOL. Conclusion: LFS of CM formulation could effectively alleviate MPE and improve the QOL of cancer patients.     

Chinese Medicine Herbal Treatment Based on Syndrome Differentiation Improves the Overall Survival of Patients with Unresectable Hepatocellular Carcinoma

Objective:To investigate the effects of Chinese medicine(CM) herbal treatment based on syndrome differentiation on patients with unresectable hepatocellular carcinoma(HCC).Methods:A total of 94 patients with unresectable HCC were reviewed between June 2008 and June 2011.Survival analysis was performed between patients who received CM with/without non-curative antitumor treatments of Western medicine(WM)(CM group,30cases) and patients who were not treated with CM but with non-curative antitumor treatments of WM or supportive treatment alone(non-CM group,64 cases).Then,survival analysis was performed between patients treated with CM combined with non-curative antitumor treatments of WM(combination therapy group,25 cases) and patients with non-curative antitumor treatments of WM alone(non-curative antitumor treatments group of WM,52 cases).The survival analysis was performed by Kaplan-Meier method and prognostic factors for overall survival(OS) were assessed by the Cox proportional hazards regression model.Results:The median survival time(MST),1- and 2-year survival rates of the CM group and the non-CM group were 36 months,76.7%,56.1%and 12 months,48.4%,26.6%,respectively.The Log-rank test revealed significant difference between the two groups in OS(P<0.01).Cox proportional multivariate analysis revealed that CM was an independent favorable prognostic factor for OS.The MST,1- and 2-year survival rates of combination therapy group and non-curative antitumor treatments group of WM were 36 months,76.0%,55.5%and 13 months,55.8%,30.8%,respectively.There was significant difference in OS between the two groups(P=0.004).Conclusions:CM herbs based on syndrome differentiation have positive effects on survival of patients with unresectable HCC.Furthermore,combination therapy of CM and WM are recommended in HCC treatment.     

~(153)Sm-EDTMP治疗乳腺癌骨转移骨痛

目的:评价153Sm-EDTMP治疗乳腺癌骨转移骨痛的临床价值。方法:对51例临床确诊为乳腺癌多发骨转移伴骨痛患者进行治疗,153Sm-EDTMP按18.5MBq/kg体重剂量静脉注射给药。治疗前患者白细胞≥3.5×109/L,血红蛋白≥90g/L,血小板≥9.0×1010/L。结果:依据疼痛、活动能力及止痛药物用量的增减进行疗效评价,骨痛缓解总有效率86.3%,其中显效39.2%(20例),有效47.1%(24例),无效13.7%(7例);其中18例治疗后骨显像示骨转移灶减少。结论:用153Sm-EDTMP治疗乳腺癌骨转移骨痛疗效明显,可改善患者生活质量,骨髓毒性主要是白细胞、血小板降低,但均轻微、短暂,可自行恢复,可多次重复使用。     

80岁以上老年人食管癌放射治疗临床分析

目的探讨80岁以上老年人食管癌放疗疗效,毒副反应及耐受性。方法回顾性分析2004年8月-2011年12月在放疗科完成根治性放射治疗的73例80岁以上食管癌患者。结果全组有效率为65.8%,随访1年、3年、5年生存率分别为80.8%、16.4%、6.8%。主要死亡原因为局部未控或复发,共22例,占49%。主要毒副反应为放射性食管炎及骨髓抑制,大部分患者能耐受。结论对于高龄食管癌患者,放射治疗仍为一种安全有效的治疗手段,年龄不是放疗达根治性剂量的限制性因素。     

前列腺癌的现代中医药治疗策略探讨

分析近年来前列腺癌的中医药治疗思路,提出前列腺癌分期论治的现代中医药治疗策略。认为在前列腺癌的手术后期、放射治疗期、内分泌治疗期和化学治疗期等不同阶段,中医药干预可分别从改善患者尿失禁、减轻放化疗毒副反应、预防肿瘤复发转移、改善肿瘤相关并发症和提高生活质量等方面入手,提高前列腺癌的治疗效果;并指出当前应用中医药治疗前列腺癌,应慎用破血消癥或毒性较强的中药,以及慎用或不用补肾(阳)中药。     

基于神经网络分析方法探索类风湿关节炎证病信息对疗效的预测作用

目的:利用神经网络模型分析方法探索类风湿性关节炎(rheumatoidarthritis,RA)证候疾病信息对疗效的预测作用。方法:397例确诊为活动期RA的病例来自9个临床中心,随机分成中药治疗组203例和西药治疗组194例。西药治疗方案包括非甾体抗炎药和慢作用药,中药治疗包括基础治疗和辨证用药。治疗前后收集患者中医四诊信息和西医疾病诊查指标,治疗效果用美国风湿病学会20%改善标准(theAmericanCollegeofRheu-matology20,ACR20)判断,抽取患者初诊时的信息进行分析,分析方法在SAS8.2上实施。通过单因素探索性分析,计算疗效与变量的比数比,以P<0.2作为入选模型的标准;采用神经网络模型进行数据分析,以疗效为分层变量,随机将数据集分为训练集(占75%)和验证集(占25%),对分析方法进行验证。结果:数据分析模型中,中药治疗组共纳入18个变量,西药治疗组纳入24个变量。中药治疗组中,晨僵、关节肿胀数、免疫球蛋白M、关节压痛数、关节压痛、类风湿因子、C反应蛋白和关节疼痛等与疗效正相关,病程和夜尿多与疗效呈负相关。西药治疗组中,血沉、腰膝酸软、苔白、关节疼痛、屈伸不利和关节肿胀等与疗效呈正相关,苔黄、舌红、白细胞检测与疗效呈负相关。在随机选取的验证集患者中,神经网络模型的预测作用表现为:RA中药治疗方案使用中,可预测20%患者有效率达到90%;RA西药治疗方案使用中,可预测20%患者有效率达到100%。结论:根据证候疾病信息与中西医疗法疗效的临床数据所建立的神经网络模型,能够显示证病信息对疗效的预测作用。     

类风湿关节炎寒热属性分类及其对中西药疗效的影响

目的:探讨类风湿关节炎(RA)患者寒热属性分类规律及其对中、西药疗效的影响。方法:397例来自多中心的RA随机对照临床研究病例,随机分为中药组203例和西药组194例,西药治疗方案包括非甾体抗炎药和慢作用药,中药治疗包括基础治疗和辨证用药。按ACR20标准评价治疗3个月和6个月的疗效。观察患者初诊时寒热相关症状和舌象13项,采用因子分析方法将患者分为寒证和热证,分类结果与中医师辨证结果进行对比分析,并比较寒、热证患者的疗效差异。结果:因子分析分类结果与医生辨证的结果一致。西药组3个月疗效中寒证患者有效率51.67%,热证为29.09%;6个月疗效中寒证有效率为88.52%,热证为55.36%,寒证疗效均高于热证,差异有显著性(P<0.05)。结论:依据中医理论对疾病再分类有利于提高治疗方案的针对性。     

中西医结合治疗晚期结肠癌的临床疗效

目的 探讨中西医结合治疗晚期结肠癌的临床疗效及生活质量研究.方法 选取在本院住院治疗的经病理检查确诊的晚期结肠癌患者73例,根据治疗方案随机分为中西医结合组(n=38)接受扶正消积汤联合XELOX方案(卡培他滨+奥沙利铂)治疗和西医组(n=35)单纯接受XELOX方案治疗,比较两组患者治疗后近期疗效、治疗前后中医症状积分、肿瘤标志物、免疫细胞水平以及生活质量的差异.结果 中西医结合组总的中医症状积分高于西医组(P<0.05);中西医结合组治疗后的癌胚抗原(CEA)低于西医组和治疗前(P<0.05);中西医结合组治疗后的CD4+、CD8+高于西医组(P<0.05),与治疗前比无差异(P>0.05).结论 中西医结合治疗晚期结肠癌的近期疗效,降低中医症状积分,提高生活质量方面均好于单独西医治疗,且对免疫系统的影响较小.     

中医在临床肿瘤学中的角色

Chinese Medicine（CM）has been used for several thousand years,playing an important role in the prevention and treatment of diseases including cancer.In the recent four decades,a number of CM herbs have aroused extreme interest in the world-isolating anticancer components from medicinal herbs,using them as biological response modifiers,and most recently as angiogenesis inhibitors.The present review reports both the experimental and clinical results obtained in the field of clinical oncology,especially conducted by our group.The review also presents the possible future of integration of CM and modern medicine in basic research and clinical practice,especially when CM used as adjuvant and maintenance therapy.     

中西医疗效评价方法在进展期胃癌中的比较研究

[目的]比较中医及西医两种疗效评价方法在进展期胃癌治疗应用中的差异。[方法]收集3个分中心进展期胃癌患者215例,分为2组:中药组115例采用中药注射剂联合辩证论治汤剂治疗,化疗组100例采用国际通用的胃癌OFL化疗方案治疗,疗程均为6周。以包含临床症状、瘤体、卡氏评分、体重、免疫功能评价的"中医治疗进展期胃癌患者临床受益(疗效)评定标准"和WHO实体瘤疗效评价标准同步进行疗效观察。[结果]按照"WHO实体瘤疗效评价标准"评价,化疗组疗效明显优于中药组(P<0.01);按照"中医治疗进展期胃癌患者临床受益(疗效)评定标准"评价,中药组疗效优于化疗组,两组比较差异有统计学意义(P<0.05)。[结论]"中医治疗进展期胃癌患者临床受益(疗效)评定标准"与"WHO实体瘤疗效评价标准"两种评价方法得出的结论存在差异,两者相比,前者更能反映中医药治疗肿瘤的特色与优势,具有进一步研究的价值。     

同步放化疗与单纯放疗治疗中晚期宫颈癌的临床疗效比较

目的:对比研究同步放化疗与单纯放疗治疗中晚期宫颈癌的临床疗效和毒副作用。方法:选择经病理确认为Ⅱb～Ⅳ期的宫颈癌患者46例,随机分为同步放化疗组23例和单纯放疗组23例。两组放疗方法及放疗剂量均相同,同步放化疗组在此基础上再采用静脉点滴的方法给予顺铂化疗,每4周进行一次,共进行3次,比较两组患者的近期、远期治疗效果和毒副作用。结果:同步放化疗组的近期有效率为95.23%(22/23),显著高于单纯放疗组的69.20%(16/23)(P<0.05);同步放化疗组的3年和5年生存率分别为86.96%、65.22%,显著高于单纯放疗组的60.87%、43.48%(P<0.05);同步放化疗组的毒副反应和放射性损伤等不良反应显著高于单纯放疗组(P<0.05),但经治疗后均能耐受。结论:同步放化疗法比单纯放疗对治疗中晚期宫颈癌具有较好的临床疗效,虽然其毒副反应较单纯放疗较高,但经治疗后均能耐受,不影响治疗。     

抗癌中药对肺癌标记物表达的影响及其疗效分析

目的：分析检测血液中癌胚抗原CEA mRNA、缓解率的变化，评价抗癌中药注射液对肺癌的疗效。方法：以肺癌（40例实验组、40例对照组）为对象，应用半巢式-聚合酶链反应技术检测患者注射抗癌中药前后血CEAmRNA水平、CR＋PR＋SD率。结果：治疗后，实验组CEAmRNA阳性结果为22.5％（9例），低于对照组的45％（18例）（B〈0.05）；CR＋PR＋SD率上升达80.0％（P〈0.05）。结论：抗癌中药可有效治疗肺癌，CEAmRNA阳性例数减少，提高了临床有效率。     

中西药联用直肠滴入法治疗轻中度溃疡性结肠炎的疗效研究

目的：观察中西药联用直肠滴入法对轻中度溃疡性结肠炎的疗效。方法：将39例轻中度溃疡性结肠炎患者分为3组，分别用中药、西药、中西药联合直肠滴入，每晚一次，15d为一疗程。结果：中西药联合组的治愈率、总有效率及血清IgG的降低均明显优于中药组和西药组（P＜0．01或P＜0．05）。其症状平均改善的时间也短于中药组和西药组。结论：中西药联用直肠滴入法疗效显著，副作用少，是门诊治疗轻中度溃疡型结肠炎的理想方法。     

盐酸拓扑替康治疗小细胞肺癌临床研究

目的探讨盐酸拓扑替康(TPT)在治疗小细胞肺癌中的临床疗效和不良反应.方法 36例小细胞肺癌患者接受TPT治疗.分二组.A组32例,TPT 1.2mg/m2,静脉滴注30min,连用5d(第1～5天),21d为1周期,连用2周期;B组4例,TPT用法同前,联合顺铂60mg/m2,第1天静脉滴注,水化3d,21d为1周期,连用2周期.结果可评价疗效30例,其中A组26例,B组4例.总有效率A组46.2%,B组25.0%.中位生存期A组48.2周,B组26周.1年生存率A组初治58.8%,复治42.8%(B组例数少无法评价).可评价不良反应36例,主要有骨髓抑制(Ⅲ、Ⅳ度中性粒细胞下降,血小板降低)、恶心、呕吐、腹泻、脱发、乏力等,对心、肝、肾功能均无影响.结论 TPT是对小细胞肺癌有较好治疗作用的药物,剂量限制性毒性为骨髓抑制.前景为继续探讨在小细胞肺癌治疗中适宜的剂量和联合使用其他抗肿瘤药物的有效剂量,并进一步减轻不良反应;探讨TPT在非小细胞肺癌中的治疗作用、适宜的剂量、疗效及不良反应.     

中西医结合治疗躁狂症36例疗效观察

目的探讨中药癫狂梦醒汤合并西药碳酸锂对躁狂症的临床疗效.方法符合CCMD-2-R躁狂症诊断标准的36例患者,应用我院自拟中药癫狂梦醒汤,每日一剂,水煎2次服,合并西药碳酸锂1g/日,治疗8周.于治疗前及治疗后2、4、6、8周用BRMS、CGI、TESS量表评定.结果中西医结合、单纯西药治疗躁狂症总有效率分别为86%、80%.两组疗效差异无显著性(P＞0.05),西药副作用大于中西医结合,两组治疗药物副作用发生频度比较差异有非常显著性意义(P＜0.01).结论中西医结合治疗躁狂症安全有效,且副作用少.     

硫酸吗啡控释片治疗晚期癌症疼痛的临床疗效分析

【目的】观察硫酸吗啡控释片对晚期癌症患者中度疼痛的临床疗效及其安全性研究。【方法】选取64例男性中度癌痛患者,口服美施康定片（每片含盐酸硫酸吗啡15mg）止疼治疗,初始剂量每12h为15mg,根据患者的疼痛情况调整用药剂量,直至患者无痛或基本无痛,连续治疗14d,治疗期间进行疼痛强度、生活质量的评分及不良反应的观察并记录结果。【结果】口服美施康定片（以每片含15mg硫酸吗啡计算）的最终滴定剂量为：≤30mg／d的30例（46．87％）,31—45mg／d的22例（34．38％）,46～60mg／cl的8例（12．50％）,61～75mg／d的2例（3．13％）,≥75mg／d的2例（3．13％）,总疼痛有效率96．87％。有轻度头痛、头晕、嗜睡、恶心、呕吐、便秘及皮肤瘙痒等不良反应,但发生率较低。【结论】硫酸吗啡控释片片控制中度癌性疼痛效果显著,不良反应较轻,能很好的改善患者的生活质量。     

中药内服结合外敷治疗黄褐斑78例

目的:临床观察中药内服结合外敷治疗黄褐斑的疗效。方法:将符合诊断标准的78例患者随机分成两组,治疗组40例,口服中药桃红四物汤辨证加味结合五白散局部外敷治疗,对照组38例,只予以口服中药桃红四物汤辨证加味治疗,两组观察周期为3个月。结果:治疗组总有效率为90.24%,疗效明显优于对照组。结论:中药内服结合外敷治疗黄褐斑能够明显提高临床疗效。     

中药蜈蚣汤与甲氨蝶呤治疗非破裂型输卵管妊娠的对照研究

目的对比观察中药蜈蚣汤与甲氨蝶呤治疗非破裂型输卵管妊娠的疗效及不良反应。方法收集保守治疗的非破裂型输卵管妊娠患者72例,分别用蜈蚣汤口服(A组,37例)和甲氨蝶呤50mg/m2单次肌注(B组,35例)治疗,比较其疗效及不良反应。结果 A组治愈率(86.5%)和B组治愈率(88.6%)比较,差异无统计学意义(P>0.05),两组在1周内血β-hCG下降>15%例数、2周内盆腔包块缩小≥30%例数、血β-hCG转阴时间、住院治疗时间等方面比较差异无统计学意义(P>0.05),但A组的胃肠道不良反应明显低于B组(P<0.05)。结论两种方法治疗非破裂型输卵管妊娠均有较好的疗效,疗效相同,但中药治疗有活血化淤作用,促进包块吸收,不良反应少,是一种安全有效的药物治疗方法,值得临床推广。     

Effectiveness and Safety Evaluation of Chinese Medicine in Treatment of Metastatic Colorectal Cancer after Chemotherapy Failure: Protocol of a Prospective Multicenter Cohort Study

Background: Colorectal cancer (CRC) is the second most common cause of cancer-related deaths and has the third highest incidence in the world. Almost half of the patients with CRC have metastases at the time of diagnosis. However, the treatment for patients with metastatic CRC that progresses after approved conventional chemotherapy is still controversial. Chinese medicine (CM) has unique characteristics and advantages in treating metastatic CRC. Objective: To assess the effectiveness and safety of CM in patients with metastatic CRC after failure of conventional chemotherapy. Methods: The study is a multicenter prospective cohort study. A total of 384 patients with documented metastatic CRC after failure of conventional chemotherapy will be included from 9 hospitals at Beijing, Shanghai, Nanjing, and Guizhou, and assigned to three groups according to paitents'' wishes: (1) integrated Chinese and Western medicine (ICM) group receiving CM herbal treatment combined with Western medicine (WM) anti-tumor therapy, (2) Chinese medicine (CM) group receiving only CM herbal treatment, and (3) WM group receiving only WM anti-tumor therapy. The primary endpoint is the overall survival (OS). Secondary endpoints include the progression free survival (PFS), quality of life (QOL) assessed by the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) questionnaire, tumor control, and CM symptom score. Discussion: This prospective study will assess the effectiveness and safety of CM in treating metastatic CRC after conventional chemotherapy failure. Patients in the ICM group will be compared with those in the WM group and CM group. If certified to be effective, national provision of CM treatment in metastatic CRC will probably be advised. (Registration No. NCT02923622)