文章摘要
中医分阶段辨治联合中药外洗治疗EGFR-TKIs相关皮疹的临床研究
Clinical Study on Treatment of EGFR-TKIs Related Rash by TCM Staged Differentiation and Treatment Combined with External Washing of Traditional Chinese Medicine
投稿时间:2019-06-17  修订日期:2019-06-17
DOI:
中文关键词: 非小细胞肺癌  皮疹  EGFR-TKIs  外治疗法  辨证论治
英文关键词: Non-small cell lung cancer  Rash  EGFR-TKIs  External treatment  Treatment based on differentiation of symptoms and signs
基金项目:浙江省中医药科技项目
作者单位E-mail
黄挺 杭州市中医院 yzf2011@163.com 
叶知锋 杭州市中医院 yzf2011@163.com 
杨雪飞 杭州市中医院  
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中文摘要:
      摘要:目的:观察中医辨证论治联合中药外洗治疗EGFR-TKIs相关皮疹的临床疗效。方法:入组出现EGFR-TKI相关皮疹的晚期非小细胞肺癌患者63例,随机分为中医治疗组32例和对照组31例,中医治疗组根据皮疹发展的不同阶段及表现,中医辨证分为风热型(初期)、湿热型(中期)、阴虚型(晚期),分别予消风散、萆薢渗湿汤、沙参麦冬汤内服 1剂/日,同时予中药外洗 2次/日;对照组予红霉素软膏外用 2次/日,合并感染予米诺环素100mg 2次/日口服;治疗疗程为6周。观察治疗前后皮疹分级与中医临床症状的变化。结果:中医治疗组有效25例,稳定4例,无效3例,有效率78.13%;对照组有效7例,稳定11例,无效13例,有效率22.6%,中医治疗组较对照组EGFR-TKIs相关皮疹改善明显(P<0.05),有统计学差异。中医治疗组与对照组治疗前肺癌中医症状评分分别为35.38±3.69与34.38±4.21,无统计学差异(P>0.05);中医治疗组治疗后中医症状评分为29.59±3.06,较治疗前有统计学差异(P<0.05);对照组治疗后中医症状评分为,较治疗前无统计学差异(P>0.05);治疗后中医治疗组与对照组中医症状评分33.29±4.08,有统计学差异(P<0.05)。结论:中医分阶段辨证治疗联合中药外洗能显著改善晚期非小细胞肺癌患者EGFR-TKIs治疗相关皮疹,改善患者的中医临床症状。
英文摘要:
      Abstract: Objective: To observe the clinical efficacy of TCM syndrome differentiation and treatment combined with external washing of traditional Chinese medicine in the treatment of skin rash associated with EGFR-TKIs. Methods: A total of 63 patients with advanced non-small cell lung cancer (NSCLC) who developed skin rash related to EGFR-TKI were randomly divided into the treatment group (n = 32) and the control group (n = 31). According to the different stages and manifestations of skin rash development, the treatment group was divided into wind-heat type (initial stage), damp-heat type (middle stage) and yin-deficiency type (late stage). Xiaofengsan, Bixingyishen Decoction and Shashen Ophiopogon Decoction were given orally 1 dosage per day, and Chinese medicine was given external washing 2 times per day;The control group was given erythromycin ointment for external use twice a day and minocycline 100 mg twice a day with infection;The course of treatment was 6 weeks.Before and after treatment, the grade of skin rash and the changes of clinical symptoms of traditional Chinese medicine were observed. Results: In TCM treatment group, 25 cases were effective, 4 cases stable, 3 cases ineffective, the effective rate was 78.13%;In the control group, 7 cases were effective, 11 cases were stable, 13 cases were ineffective, and the effective rate was 22.6%. Compared with the control group, the TCM treatment group was significantly improved in skin rash related to EGFR-TKIs (P < 0.05). The TCM symptom score of lung cancer before treatment in the TCM treatment group and the control group was 35.38 ± 3.69 and 34.38 ± 4.21, respectively, with no significant difference (P > 0.05);The symptom score of TCM group was 29.59 ± 3.06 after treatment, which was significantly different from that before treatment (P < 0.05). In the control group, the scores of TCM symptoms after treatment were not significantly different from those before treatment (P > 0.05);After treatment, the TCM symptom score of the treatment group and the control group was 33.29 ± 4.08, there was significant difference (P < 0.05). Conclusion: TCM staged treatment combined with external washing can significantly improve the treatment of advanced non-small cell lung cancer patients with EGFR-TKIs related rash, improve the clinical symptoms of patients with TCM.
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