复方苦参注射液联合顺铂治疗恶性胸腔积液疗效及不良反应观察

目的：比较复方苦参注射液联合顺铂及顺铂单药胸腔灌注后对肺癌致恶性胸腔积液的近期疗效及不良反应。方法：将2012年6月－2015年6月确诊为肺癌所致恶性胸腔积液患者共60例随机分为两组，各30例。治疗组：复方苦参注射液20ml，溶解于50ml 生理盐水的40mg 顺铂注入胸腔内，同时注入地塞米松10mg。对照组：将顺铂40mg 溶解于50ml 生理盐水中注入胸腔内，同时注入地塞米松10mg。每周1次，连用4次后评价疗效。结果：治疗组完全缓解13例，部分缓解11例，无效6例，有效率为80．00％。对照组完全缓解7例，部分缓解9例，无效14例，有效率为53．33％，两组间有效率比较差异有统计学意义（P ＜0．05）。治疗组患者生活质量改善率（76．67％）明显高于对照组（50．00％），两组比较差异有统计学意义（P ＜0．05）。治疗组消化道反应（多为Ⅰ－Ⅱ度）发生率较对照组低（16．67％ vs 43．33％），差异有统计学意义（P ＜0．05），两组中性粒细胞计数下降发生率比较（20．00％ vs 46．67％），差异有统计学意义（P ＜0．05）。两组均无明显的肝肾功能损害及心脏毒性。结论：在肺癌并发的恶性胸腔积液治疗中，复方苦参联合顺铂治疗有效率高，不良反应少，且患者可耐受，可继续行临床研究。

Effects and safety of compound Kushen injection combined with cisplatin on malignant pleural effusion

Objective:To evaluate the efficacy and adverse reactions of compound Kushen injection combined with cisplatin for malignant pleural effusion caused by lung cancer compared with cisplatin regimen alone.Methods:With randomized and controlled method,the patients who were diagnosed as malignant pleural effusion were divided into treatment group and control group.Treatment group:Compound Kushen injection 20mg and cisplatin 40mg dissolved in saline 50ml injection into the chest,while the subsequent injection of dexamethasone 10mg once a week for 4 times.Control group:Cisplatin 40mg dissolved in saline 50ml injection into the chest,while the subsequent injection of dexamethasone 10mg once a week for 4 times.Results:The total effective rate was 80.00% in treatment group(com-plete remission in 13 cases and partial remission in 11 cases)and it was statistically different compared with control group that was 53.33%(complete remission in 7 cases and partial remission in 9 cases)(P <0.05).Quality of life improvement rate of treatment group was higher than the control group(76.67% vs 50.00%,P <0.05).The inci-dence of gastrointestinal reactions of treated patients was lower than the control group (16.67% vs 43.33%,P <0.05).The incidence of neutrophils decrease of treatment group was lower than the control group (20.00% vs 46.67%,P <0.05).Both groups showed no apparent function of liver and kidney damage and cardiac toxicity.Con-clusion:Compound Kushen injection combined with cisplatin has good curative effects,low side effects,and patients can be tolerated.