归脾汤防治老年胃癌化疗相关疲乏的临床研究

目的]观察归脾汤防治老年胃癌化疗相关疲乏的临床疗效。方法]84例老年胃癌患者随机分为治疗组(给予替吉奥化疗联合归脾汤治疗)42例,对照组(替吉奥化疗联合最佳支持治疗)42例,观察两组治疗前后疲乏程度、化疗相关不良反应、体质量以及老年抑郁程度等变化情况。结果]化疗后治疗组重度疲乏发生率2.3%(1例),明显低于对照组的16%(7例),差异具有统计学意义(P0.05);对照组体质量较治疗组减轻4.06 kg,差异具有统计学意义(P0.05);中重度抑郁发生率2%(1例),明显低于对照组14%(6例),差异具有统计学意义(P0.05)。化疗后治疗组未见3/4级胃肠道不良反应,且1/2级胃肠道不良反应明显少于对照组(P0.01)。血液学毒性方面,治疗组未见3/4度骨髓抑制,且1/2度骨髓抑制的发生率较低。结论]归脾汤通过明显缓解老年替吉奥单药化疗患者的血液学及胃肠道不良反应,改善抑郁状态,增强老年患者体力达到预防患者化疗相关疲乏的目的,且改善疲乏效果明显。

Clinical study on treatment of senile gastric cancer chemotherapy related fatigue with Guipi decoction

Objective] To observe the clinical effect of Guipi decoction in treatment of senile gastric cancer with chemotherapy related fa-tigue. Methods] The 84 cases of patients were randomly divided into the treatment group with 42 cases(S-1 combined with Guipi decoc-tion), 42 patients in the control group (chemotherapy with S-1 plus best supportive treatment), observe fatigue of two groups before and af-ter treatment, chemotherapy related side effects, weight and elderly depression degree. Results] After chemotherapy, occurrence rate of fatigue was 2.3%in treatment group (1 cases), significantly lower than those in control group (7 cases). In weight after chemotherapy, the control group was significantly lower than that in the treatment group (4.06 kg). The difference was statistically significant (P=0.024). The incidence of severe depression was 14%(6 case), and the difference was statistically significant (P=0.044) with 2% (1 cases) in the treat-ment group. After chemotherapy, no adverse reaction of 3/4 grade was found in the treatment group, and the adverse reaction of gastroin-testinal tract in grade 1/2 was significantly less than that of the control group (P=0.001). There was no side effect of 3/4 in the treatment group, and the side effect of 1/2 in the treatment group was less than that in control group (hypoleucocytosis 19%, anemia 12%, thrombo-cytopenia 5%). Conclusion] Guipi decoction by significantly alleviate the elderly S-1 single agent chemotherapy in patients with blood and gastrointestinal side effects, to improve depression, elderly patients physical enhancement to prevent patients with chemotherapy re-lated fatigue and improve of fatigue effect is obvious.