Therapeutic Effect of Jinlongshe Granule (金龙蛇颗粒) on Quality of Life of Stage Ⅳ Gastric Cancer Patients Using EORTC QLQ-C30: A Double-Blind Placebo-Controlled Clinical Trial

Objective: To evaluate the impact of Jinlongshe Granule (金龙蛇颗粒, JLSG) on quality of life (QOL) of stage Ⅳ gastric cancer patients. Methods: This randomized, double-blind and placebo-controlled clinical trial included 50 patients with advanced gastric cancer. They were equally randomized into a JLSG group and a placebo group. Patients in both groups received routine Chinese herbal decoctions according to Chinese medicine (CM) treatment based on syndrome differentiation. Patients in JLSG group received additional JLSG, and those in the placebo group received an additional placebo. In the JLSG group, 19 patients who completed the study were used for analysis. In the placebo group, finally the data of 20 patients who completed the study were used for analysis. The treatment course was at least 3 months, and the follow-up duration was at least 6 months in 5 interviews. Repeated measurements of the subscale items and individual items in European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire C30 (EORTC QLQ-C30) obtained at the 5 interviews were compared using different patient groups, changes over time and changes within one group over time independently to observe the tendency of changes in the scores. Results: Using time as the variant, there was significant difference in 4 functional scales (physical, role, emotional and social, P<0.05), 3 symptom scales (fatigue, nausea and vomiting and pain, P<0.05) and a global health status/QOL scale (P<0.05) and 6 single symptoms dyspnoea (P>0.05), insomnia (P<0.05), appetite loss (P<0.05), constipation (P<0.05), diarrhea (P>0.05) and financial difficulties (P<0.05). There was also significant difference in these items between the two groups when the placebo group and group over time were used as variants (P<0.05 or P<0.01). Conclusion: Additional use of JLSG on the basis of routine CM treatment could improve the somatic function, role function, emotional function, social function, cognitive function and general QOL of patients with advanced gastric cancer, and relieve the symptoms of fatigue, nausea and vomiting, pain, loss of appetite and constipation.     

从痰论治癌痛的思考

癌痛是恶性肿瘤最常见、最痛苦的症状之一,受到全球医学界的广泛关注。尽管目前"三阶梯止痛方案"在一定程度上可减轻癌痛,但政策法规、社会人文因素等使癌痛的控制仍不理想。中医外治通过施药于外而作用于内,与化学药止痛相比具有疗效可靠、使用安全、无成瘾性及戒断性等优点。在中医痰证理论指导下,结合癌痛临床症状,本文提出"消痰止痛"为其主要治法,治疗效果满意。     

颈内静脉置管在恶性肿瘤化疗中的应用

颈内静脉穿刺置管是目前采取最多的中心静脉通路之一,随着人们的认识及操作熟练性不断提高,其应用得到极大推广,颈内静脉穿刺留置导管,在恶性肿瘤病人内科治疗中,因可避免化疗药物的强刺激性和反复穿刺而造成的外周浅静脉严重损伤甚至不可逆损伤,减轻患者痛苦,提高患者生活质量,使肿瘤治疗能顺利进行.     

中医经典系列课程教学的整合优化与实践

构建实施以5门中医经典课程为核心,整合优化其他中医学课程的教改方案,按照4个步骤实施教学:分阶段以经典课程统领基础及临床课程;根据学员认知规律和经典课程教学目标,理论教学和专题教学相结合;在增设经典课程实践教学和设立经典带教门诊基础上,实现医学生培养全过程的"识训结合";针对基层需求,在经典教学中重视中医简便廉验的实用技术培训。由此切实增强学员为军服务能力,提高学员运用中医理论的能力,增强学员进入部队后的适应性。     

中医肿瘤病学科的内涵与外延初探

中医肿瘤病学科建设经历了"启动、摸索"阶段,进入了"发展"阶段,通过对中医肿瘤病学科的发展进行梳理,思考学科建设方向和内容,对学科的内涵与外延做了初步界定,将有助于推动中医肿瘤病学科建设的发展。     

消痰散结方对MKN-45人胃癌裸鼠原位移植瘤微卫星不稳定的抑制作用观察

目的观察消痰散结方对MKN-45人胃癌裸鼠原位移植瘤微卫星不稳定的抑制作用。方法采用MKN-45人胃癌细胞株建立裸鼠皮下瘤模型皮下传3代作为实验模型的瘤源,采用OB胶粘合法建立人胃癌裸鼠原位移植瘤模型。30只模型裸鼠分为模型组、中药组和化疗组,每组10只。中药组给予消痰散结方（0.4 mL/天）灌胃,化疗组给予喃氟啶0.4 mL/天灌胃,模型组无干预措施。用药6周后,测瘤质量、计算抑瘤率,检测5个微卫星不稳定位点（D17S250、D2S123、D5 S346、Bat-25和BAT26）的大小、峰高度及峰面积。结果中药组抑瘤率为40.84%,中药组的瘤质量明显低于模型组（P〈0.01）,与化疗组比较,差异无统计学意义（P〉0.05）。模型组高度微卫显不稳定发生率为70%,低度微卫星不稳定发生率为30%,使用消痰散结方治疗6周后,微卫星位点趋于稳定,均表现为微卫星稳定。结论消痰散结方对微卫星不稳定MKN-45人胃癌裸鼠原位移植瘤有抑制作用。     

硬膜外镇痛用于经尿道前列腺等离子体气化电切术临床观察

目的 探讨硬膜外镇痛用于经尿道前列腺等离子体气化电切术术后镇痛的效果.方法 选择经尿道前列腺等离子体气化电切术患者90例,随机分为两组,A组41例,术后未行硬膜外镇痛.B组49例,术后行硬膜外镇痛.结果 A组患者回病房后,1～2 h后均出现不同程度下腹痛,尿意和肛门坠胀感明显,膀胱痉挛疼痛,患者血压波动大,呼吸浅快,血氧饱和度低于术前(P＜0.05)B组术后下腹无痛,膀胱痉挛消失,1例患者术后尿管被血块堵塞膀胱冲洗液集聚导致膀胱胀大引起疼痛,更换尿管后,疼痛消失,术后患者血压、心率、呼吸、血氧饱和度(SpO2)与术前相近(P＞0.05).结论 硬膜外镇痛用于经尿道前列腺等离子体气化电切术的患者能起到明显的解痉镇痛作用,减轻术后应激反应及并发症.     

胃癌同证型中肿瘤转移相关基因蛋白的表达

目的:从基因蛋白表达层次探索胃癌中医证本质. 方法:从第二军医大学长征医院普外科收集术前胃癌患者, 并按中医辨证分型标准将其归属;取术后肿瘤标本,用免疫组化方法检测胃癌肿瘤中E-Cadherin、C-erbB-2、P53、nm23、ICAM-1、VEGF、KDR、MMP-2、TIMP- 29种基因蛋白表达情况. 结果:每个证型中的9个基因蛋白之间均有不同表达,统计学分析表明6证型的9个基因蛋白表达均有显著性差异P=0.0 001,进一步两两比较示同一证型内部多组基因都存在表达差异性;VEGF、E-cad、nm23表达率较高,分别为94%、90%、92%.痰湿凝结型中E-cad的蛋白表达最高,以平均秩和表示为:63.09,肝胃不和、瘀毒内阻两型E-cad表达较低. 结论:肝胃不和、瘀毒内阻两型胃癌发生转移可能主要与E-cad的缺失有关,但内部既有癌基因的高表达亦有抑癌基因高表达.     

消痰散结方药物血清对人胃癌MKN-45细胞增殖和凋亡的影响

目的：观察消痰散结方药物血清对人胃癌MKN-45细胞生长和凋亡的影响。方法：采用低、中、高浓度消痰散结方药物血清处理MKN-45细胞后,倒置相差显微镜下观察MKN-45细胞的形态学变化,血球计数盘计数细胞,细胞活性计数试剂盒检测消痰散结方药物血清对MKN-45细胞增殖的影响;Annexin V-异硫氰酸荧光素（{luorescein isothiocyanate,FITC）／碘化丙啶（propidiumiodide,PI）双标记法流式细胞术检测消痰散结方药物血清诱导MKN-45细胞后细胞凋亡的情况。结果：低、中、高浓度消痰散结方药物血清均能不同程度地抑制人胃癌MKN-45细胞的增殖,细胞发生了脱落、变圆、折光率下降等形态学变化;Annexin V-FITC／PI双标记法检测显示消痰散结方药物血清可诱导细胞发生凋亡,其中中、高剂量的效果有高于低剂量的趋势。结论：消痰散结方药物血清可抑制人胃癌MKN-45细胞的增殖,促进其凋亡。     

魏品康从痰论治胃癌的经验

“痰”字始见于《神农本草经》中“巴豆”条，言其能治“留饮痰游”。中医所论之痰既是病理产物，又是致病因素，是重要的病因病机之一。“痰生百病”，“怪病责之于痰”，痰与肿瘤等多种疑难重病的发生发展密切相关。远在《黄帝内经》中对痰与肿瘤的关系已有初步的认识，《灵枢·刺节真邪》中指出“有所结，气归之，津液留之，邪气中之，