消瘤方加减治疗化疗后正虚痰凝型弥漫大B细胞淋巴瘤60例临床观察

目的观察消瘤方加减对化疗后正虚痰凝型弥漫大B细胞淋巴瘤(DLBCL)患者生活质量、肿瘤负荷情况及机体免疫的影响。方法收集化疗4~6个疗程结束临床评估为完全缓解或不确定的完全缓解的DLBCL患者60例,随机分为对照组与治疗组各30例。两组患者均遵医嘱随访观察定期复查,入组后每个月进行1次随访。治疗组在此基础上予消瘤方加减口服,2周为1个疗程,共治疗6个疗程。对比两组患者治疗前后中医症状积分、生活质量(EORTC-QLQ-C30)评分、KPS评分、肿瘤负荷指标包括乳酸脱氢酶(LDH)、β2-微球蛋白(β2-MG)]、免疫球蛋白包括免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]水平,并判定中医证候疗效、生活质量疗效,计算复发率。结果治疗组中医证候疗效总有效率为96.67%,明显优于对照组的33.3%,差异有统计学意义(P<0.05)。治疗组无复发,对照组复发率为16.67%,差异有统计学意义(P<0.05)。治疗组生活质量疗效中好转率(80.00%)高于对照组(13.33%),治疗组恶化率(0)低于对照组(6.67%,P<0.01)。与本组治疗前比较,治疗后治疗组疲倦、恶心呕吐、气促、失眠、食欲不振、便秘评分,中医症状积分,LDH、β2-MG水平均明显降低,社会功能、情绪功能、躯体功能、角色功能、总体健康状况评分,IgA、IgG、IgM水平均明显升高(P<0.05);对照组中医症状积分明显降低(P<0.05),其余指标差异均无统计学意义(P>0.05),两组各指标差值比较差异均有统计学意义(P<0.05)。结论消瘤方加减可以有效改善化疗后正虚痰凝型DLBCL患者中医证候,提高生活质量及机体免疫力,有效降低肿瘤负荷指标,并可减少复发。

Modified Xiaoliu Formula (消瘤方) for Treatment of 60 Cases of Diffuse Large B-cell Lymphoma after Chemotherapy with Healthy Qi Deficiency and Phlegm Coagulation Pattern

Objective To observe the effect of Modified Xiaoliu Formula(消瘤方)on quality of life,tumor burden and body immunity of diffuse large B-cell lymphoma(DLBCL)patients with healthy qi deficiency and phlegm coagulation pattern after chemotherapy.Methods Sixty DLBCL patients who have been evaluated as complete remission(CR)or uncertain complete remission(CRU)after chemotherapy(4 to 6 treatment courses)were randomly divided into control group and MXF group,with 30 cases in each group.All the patients were required to take follow-up appointment once a month after enrollment.In addition,the patients in the treatment group were given Xiaoliu Formula orally,for six courses with two weeks as a course.The traditional Chinese medicine(TCM)symptoms scores,European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC-QLQ-C30)scores,Karnofsky performance status(KPS)scores,tumor burden indicators including lactate dehydrogenase(LDH),β2-microglobulin(β2-MG),and immunoglobulin levels including immunoglobulin M(IgM),immunoglobulin G(IgG),immunoglobulin A(IgA)were measured before and after the treatment and compared between groups;the effective rates regarding TCM symptoms and quality of life,as well as the recurrence rate were assessed.Results The effective rate regarding TCM symptoms in the MXF group was 96.67%,significantly better than 33.3%in the control group,with significant differences(P<0.05).No patient relaps in the treatment group,while the recurrence rate was16.67%in the control group(P<0.05).The improvement rate regarding quality of life was 80.00%in the treatment group,higher than 13.33%in the control group;and the deterioration rate was 0.00%,lower than 6.67%of the control group(P<0.01).After treatment,scores of fatigue,nausea,vomiting,shortness of breath,insomnia,loss of appetite and constipation,level of LDH andβ2-MG decreased significantly,while scores of social function,emotional funtion,physical function,role function and overall health status,as well as level of IgA,IgG,IgM increased significantly(P<0.05).In the control group,scores of TCM symptom decreased after treatment(P<0.05),while changes of other indexes was not significant(P>0.05),and the differences within each group was significantly different(P<0.05).Conclusion Xiaoliu Formula can effectively improve the TCM symptoms,quality of life,and body immunity of DLBCL patients with healthy qi deficiency and phlegm coagulation pattern after chemotherapy,and can reduce tumor burden indicators and recurrence of DLBCL.