消痰散结方为基础的中药辨证治疗对中晚期胃癌生存质量的影响

目的 探讨消痰散结方对中晚期胃癌患者生存质量的影响.方法 采用非随机同期对照试验方法,根据自愿原则,将患者分为中药组(消痰散结方治疗组)和化疗组.中药组根据辨证,以消痰散结方为基础,随证加减,每日1剂,晚期胃癌患者至少连续服用3个月,胃癌根治术患者至少连续服用6个月;化疗组采用氟尿嘧啶类化疗药物进行化疗,疗程为3～6个周期.测定患者的生存质量调查问卷(QLQ-C30)评分、卡氏(KPS)评分、体质量变化及毒性反应情况.结果 中药组患者的生存质量优于化疗组,在缓解疲倦、失眠、食欲不振、恶心呕吐,以及情绪等方面差异有统计学意义(P＜0.05);中药组的治疗费用也较化疗组低(P＜0.05),未增加患者的经济负担;中药组的总体健康状况也优于化疗组(P＜0.05).中药组患者KPS评分以及体质量管理均优于化疗组(P＜0.05),中药组的毒性反应轻于化疗组(P＜0.05).结论 消痰散结方可以改善中晚期胃癌患者的生存质量,维持体能状态和体质量,且毒性反应轻微.

Effect of Xiaotan Sanjie Decoction treatment based on syndrome differentiation on quality of life of patients with intermediate and advanced gastric cancer

Objective To explore the effect of the Xiaotan Sanjie (XTSJ) Decoction on quality of life of patients with intermediate and advanced gastric cancer. Methods Non-randomized controlled trial was used in the present study, and the patients were divided into XTSJ group and chemotherapy group according to the voluntary principle. The patients in XTSJ group were treated with XTSJ Decoction based on syndrome differentiation (one dose daily, reduce or increase with the severity of symptoms) with patients having advanced gastric cancer taking for at least 3 months and those receiving radical resection taking for at least 6 months. The patients in chemotherapy group were treated with chemotherapy drug fluorouracil for 3 to 6 cycles. The quality of life of patients in the two groups was evaluated by measuring the quality of life questionnaire (QLQ-C30) scores, Karnofsky performance status (KPS) scale, body weight, and the toxicity. Results The quality of life of patients in XTSJ group was significantly improved than that in the chemotherapy group. The XTSJ group was superior to chemotherapy group in improving the fatigue, insomnia, loss of appetite, nausea and vomiting, and emotional symptoms (P<0.05). In addition, the cost of treatment of XTSJ group was significantly lower than that of chemotherapy group (P<0.05), causing no economic burden increase to the family. The overall health statuses were also significantly different between the two groups (P<0.05). The KPS score and body weight managent in the XTSJ group were significantly improved than those in the chemotherapy group (P<0.05). Moreover, the toxic effect of the XTSJ group was significantly lower than that in chemotherapy group (P<0.05). Conclusion Treatment with XTSJ Decoction can improve the quality of life of the patients with intermediate and advanced gastric cancer by maintaining physical condition and body weight and causing milder adverse reaction.