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??OBJECTIVE To investigate the preventive effect of hepatoprotective agents against liver injury induced by initial chemotherapy in patients with acute myeloid leukemia (AML). METHODS A total of 128 patients with newly diagnosed AML in the department of hematology of one tertiary hospital who received IA regimen were enrolled into this study during the period of January 2012 to December 2015. Using a retrospective study design, differences were assessed between the group treated with hepatoprotective agents (experimental group; n=99) and that withou hepatoprotective agents (control group; n=29). The experimental group was further divided into four groups, ie, glutathione group, magnesium isoglycyrrhizinate group, glutathione combined with magnesium isoglycyrrhizinate group, and the other group. The patients in the experimental group were treated with hepatoprotective agents at the first time of inducing chemotherapy while the patients in the control group received inducing chemotherapy only. The biochemical indexes for liver function of all the patients were recorded. RESULTS There was no significant difference in the incidence of liver injury between the experimental group and control group (P>0.05),and the preventive effects in the three groups were similar (P>0.05). Cox regression analysis of the related factors of the occurrence of liver injury showed that there was no significant difference (P>0.05). CONCLUSION Prophylactic use of hepatoprotective agents does not reduce the incidence of liver injury among treatment-naive patients with AML who have received IA regimen.     

养肝化瘀法治疗HBsAg阳性肿瘤患者化疗肝损害

目的：观察养肝化瘀法治疗HBsAg阳性肿瘤患者化疗肝损害的临床疗效。方法：确诊为恶性肿瘤并接受化疗、出现肝功能损害的患者78例,随机分为治疗组40例与对照组38例,治疗组在常规西医保肝治疗的基础上加用中药养肝化瘀剂口服,比较两组患者治疗前后的临床症状体征、血清肝功能指标、患者KPS评分情况。结果：治疗组肝功能改善总有效率为87.5%,对照组为65.8%,对比显示治疗组在改善患者症状体征、降低血清转氨酶、胆红素,升高白球蛋白比例、提高患者KPS评分情况方面均优于对照组,差异具有显著性（P〈0.05）。结论：养肝化瘀法能有效治疗HBsAg阳性肿瘤患者化疗所致的肝损害。     

耳穴压豆治疗肺癌化疗所致恶心、呕吐临床观察

目的探讨肺癌患者在应用铂类化疗药物过程中,应用王不留行籽贴敷按摩在化疗所引起的恶心、呕吐中的疗效与安全性。方法选取2018年4月—2019年4月肿瘤科使用顺铂方案进行化疗的肺癌患者200例,根据患者化疗前预防性使用止吐药物及方法,按照病区分为对照组及试验组进行研究。对照组100例患者使用常规止吐药,试验组使用常规止吐药物配合使用王不留行籽耳部贴敷按摩的方法。观察2组患者在使用化疗药物0~72 h内的恶心呕吐的完全缓解(CR)率。结果试验组与对照组患者24 h内的CR率分别为84%(84/100)、76%(76/100),2组间差异无统计学意义(P=0.317);24~72 h内的CR率分别为36%(36/100)、20%(20/100),2组间差异无统计学意义(P=0.075)。试验组与对照组24 h内呕吐的CR率分别为94%(94/100)、84(84/100),2组间差异无统计学意义(P=0.110);王不留行籽组与对照组24~72 h内呕吐的CR率分别为84%(84/100)、52%(52/100),差异有统计学意义(P=0.001)。2组患者化疗过程中不良反应发生率基本相似,均为Ⅰ~Ⅱ度,患者可耐受。结论王不留行籽耳部穴位贴敷按摩对预防肺癌患者接受铂类化疗方案过程中24~72 h内所发生的恶心呕吐具有显著的疗效,且安全性良好,价格低廉,患者易于接受。     

真实世界阿帕替尼治疗乳腺癌的不良反应及危险因素分析

目的 评估真实世界乳腺癌患者使用阿帕替尼的安全性,分析使用阿帕替尼的患者发生药品不良反应的危险因素,为阿帕替尼在乳腺癌患者中的安全使用提供参考.方法 回顾性分析某院2016年3月～2020年3月接受阿帕替尼治疗的乳腺癌患者193例,收集患者的基本病例资料及不良反应,采用Logistic回归分析患者的临床特征与药品不良反...     

持续性药学服务在妇科肿瘤化疗患者中的应用实践

目的 建立妇科肿瘤化疗持续性药学服务路径并分析应用效果。方法 通过文献检索和北京妇产医院(以下简称我院)现状调研,建立妇科肿瘤化疗持续性药学服务路径,并以我院妇科肿瘤科2020年5月至2021年4月收入的173例化疗患者为研究对象进行效果观察,分为干预组和对照组。干预组按路径实施至少3个化疗疗程的持续性的药学服务,对照组实施常规用药指导及护理宣教。在第3程化疗当日采用问卷调查的方式比较两组患者对用药知识了解程度,采用床旁问诊和病历查询的方式获取患者药物不良反应(ADR)和用药错误(ME)发生情况并及时干预,用专用表格记录。结果 最终纳入干预组和对照组患者分别为66、72名,两组患者基线特征比较差异无统计学意义(P＞0.05);干预组患者对药物了解程度较对照组明显改善,总分[(14.121±1.398)∶(12.292±2.441)],F=25.734,P＜0.001,差异有统计学意义。干预组患者给药与监测环节中ME较对照组明显减少,[9.1%(6/66)比40.3%(29/72)],χ²=17.693,P＜0.001,差异有统计学意义。ME级别大多为B级和C级,但也有3例E级ME,需及时干预以避免对患者造成进一步危害。结论 妇科肿瘤化疗持续性药学服务路径的建立及应用有助于提高妇科肿瘤化疗患者对用药知识的了解程度,及时发现并干预ADR,预防ME。     

养正消积胶囊联合GP方案治疗晚期非小细胞肺癌对照观察

[目的]观察养正消积胶囊对晚期非小细胞肺癌(NSCLC)化疗的近期疗效、不良反应及生活质量的影响。[方法]将58例患者随机分为两组,治疗组29例采用养正消积胶囊配合GP方案治疗,对照组29例采用GP方案治疗,21天为1周期,完成2周期后评价疗效。[结果]治疗组和对照组的有效率分别为48.30%和44.80%,两组比较差异无显著性意义(P>0.05);治疗组主要毒副反应情况和生活质量情况分别与对照组比较,差异均有显著性意义(P<0.05)。[结论]养正消积胶囊联合化疗治疗晚期非小细胞肺癌可明显降低化疗不良反应发生率,提高患者生活质量。     

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??OBJECTIVE To analyze the usage of the adjuvant huoxuehuayu drugs in patients with acute coronary syndrome(ACS), observe the impact of the drugs on upper gastrointestinal haemorrhage(UGH),and provide a reference for the clinical rational use of the adjuvant huoxuehuayu drugs. METHODS The ACS patients were enrolled in our hospital during May to July 2016. And the patients were divided into four groups according to whether using the adjuvant huoxuehuayu drugs: not use, used one kind, used two kinds, used ??three kinds of huoxuehuayu drugs. Then we collected medical history, therapeutic measures and other baseline data, gathered the data of the usage of the adjuvant huoxuehuayu drugs, evaluated CRUSADE bleeding risk and analyzed frequency of occurrence of UGH. RESULTS Overall 503 ACS patients were enrolled, there was no significant differences among the four groups when the medical history, essential medicines and intervene frequency were compared respectively. On the other hand, the incidence rate of UGH increased significantly with CRUSADE bleeding risk rank increasing incrementally.For very low and low bleeding risk ACS patients, there were no significant differences in UGH incidence rate among the four groups; For moderate and high bleeding risk ACS patients, UGH incidence rate increased significantly in ACS patients using more than one kind of huoxuehuayu drugs compared with other two groups(P??0.05). For very high bleeding risk ACS patients, UGH incidence rate increased significantly in ACS patients using 2 and ??3 kinds of huoxuehuayu drugs compared with patients using one kind drug, P=0.009,0.025 respectively. CONCLUSION For moderate and high bleeding risk ACS patients, UGH incidence rate increase significantly in ACS patients using ??2 kinds of huoxuehuayu drugs. A significant increase in the incidence rate of UGH with CRUSADE bleeding risk rank increasing, the use of huoxuehuayu drugs shoud be controled strictly, especially for very high bleeding risk ACS patients.     

肿瘤病人服用甲地孕酮配合化疗36例疗效观察

目的观察肿甲地孕酮分散片辅助止吐30例疗效观察。方法将36例化疗晚期肿瘤患者随机分成对照组和观察组各18例。对照组单用化疗;治疗组化疗加甲地孕酮。化疗前1天开始服用甲地孕酮160mg,1次,天直至化疗结束后7天;对照组单用化疗,2个周期化疗后观察两组患者化疗后胃肠道反应、食欲、体重、骨髓抑制情况、karnofsky评分情况。结果经2个周期化疗后,观察组在胃肠道反应、食欲、体重、karnofsky评分方面均有明显改善。1例出现血糖升高,1例双下肢水肿,经对症处理症状均消失。结论甲地孕酮毒副反应轻,对化疗期间改善患者的生活质量、减少化疗毒副反应有明显帮助,值得临床推广运用。     

八珍汤加减对肺癌化疗后白细胞影响的疗效观察

[目的]观察中药八珍汤加减对肺癌化疗后白细胞影响的疗效观察。[方法]治疗组40例化疗前及化疗过程中,口服八珍汤加减方;对照组25例,按常规化疗,两组化疗方案相同,观察两组相同化疗后,白细胞减少的发生率。[结果]治疗组40例,白细胞减少症15例,发生率37.50%;对照组25例,白细胞减少症15例,发生率60.00%,经统计学处理P<0.05。[结论]八珍汤具有提高免疫机能、减少白细胞下降的作用。     

中药运用对膀胱癌介入化疗术后不良反应的影响

目的：探讨运用中药对膀胱癌介入化疗术后不良反应发生情况的影响。方法：将104例临床确诊并行膀胱癌介入化疗术结合经尿道电切术的患者随机分为实验组和对照组,每组57例。实验组于介入术后水化输液,并增加运用中药治疗,对照组于介入术后单纯水化输液治疗。比较两组患者术后不良反应发生率及发生持续时间。结果：实验组在发热、骨髓抑制、胃肠道副反应、肝肾功能损害、皮疹脱发、轻度心电图改变等不良反应发生率与对照组无显著差异（P〉0.05）,不良反应发生持续时间短,差异有显著统计学意义（P〈0.05）。结论：膀胱癌介入灌注化疗术后加用中药治疗能显著减少患者不良反应的持续时间,适合推广运用。