摘要:目的：觀察復(fù)方苦參注射液配合化療治療晚期胃癌的臨床療效。方法：將60例晚期胃癌患者分為兩組,兩組均采用FOLFOX方案化療,21天為1個(gè)周期；2個(gè)周期評(píng)價(jià)效療。治療組30例加用復(fù)方苦參注射液治療,14天為1療程,2個(gè)療程評(píng)價(jià)療效。觀察近期療效及臨床證候變化、生存質(zhì)量及毒副反應(yīng)變化。結(jié)果:兩組近期療效比較,治療組與對(duì)照組總緩解率分別為433%和400%（P＞005）；兩組臨床證候變化比較,治療組與對(duì)照組總改善率分別為800%和600%（P＜005）；兩組生存質(zhì)量變化比較,治療組與對(duì)照組提高穩(wěn)定率分別為867%和567%（P＜005）；中位生存期分別為8個(gè)月和5個(gè)月；兩組毒副反應(yīng)比較,治療組毒副反應(yīng)明顯低于對(duì)照組（P＜005）。結(jié)論:復(fù)方苦參注射液配合化療治療晚期胃癌具有一定抗腫瘤作用,能緩解疼痛癥狀及臨床癥狀,減輕化療毒副反應(yīng),提高生活質(zhì)量,延長(zhǎng)生存期。Abstract: Objective: To study the effect of combination FuFang Ku Shen Zhusheye and chemotherapy for treatment of advanced gastric cancer. Methods: Sixty patientswith advanced gastric cancer were divided into two groups, all used with FOLFOXregimen, 21 days a cycle; twocycle assessment of treatment effect. The treatment group were treated with the FuFang Ku Shen Zhusheye plus treatment, a course of treatment for 14 days, the effect were evaluated after two courses. The clinical symptoms and living quality, toxicity were dynamically observed. Results: Both shortterm effect of comparison, the overall response rates of the treatment group and the control group were 433% and 400% (P＞005); The rates of clinical symptoms of the treatment group and the controlgroup were 800% and 600% respectively (P＜005); the rates of increasing of living quality were respectively 867% and 567% (P＜005); the median survival time was 8 months and 5 months; the toxicity of the treatment group was significantly lower than that of the control group (P ＜005).Conclusion: Treating advanced gastric cancer by use of FuFang Ku Shen Zhusheye combination with chemotherapy is helpful to reducing the pain symptoms, promoting the clinical symptoms, reducing the chemotherapy side effects, improving quality of life and prolonging the survival time.
目的 總結(jié)腹腔鏡輔助結(jié)腸次全切除聯(lián)合改良Duhamel術(shù)治療重度功能性便秘（SFC）的近期療效、手術(shù)并發(fā)癥及相關(guān)手術(shù)經(jīng)驗(yàn)。方法 回顧性分析2010年3月至2011年8月期間我科行腹腔鏡輔助結(jié)腸次全切除聯(lián)合改良Duhamel術(shù)治療的15例經(jīng)保守治療無效的SFC患者的臨床資料，比較SFC患者術(shù)前1d及術(shù)后1個(gè)月的胃腸生活質(zhì)量評(píng)分及便秘癥狀改善情況。結(jié)果 15例SFC患者手術(shù)均獲得成功，手術(shù)時(shí)間為（247.33±55.10） min，術(shù)中出血量為（107.33±45.59） ml，手術(shù)切口長(zhǎng)度為（8.40±2.41） cm，術(shù)后離床活動(dòng)時(shí)間為（2.27±1.28） d，術(shù)后肛門排氣時(shí)間為（2.60±1.89） d，術(shù)后排便時(shí)間為（2.87±2.50） d，術(shù)后進(jìn)食時(shí)間為（3.07±1.16） d，術(shù)后住院時(shí)間為（12.64±2.37） d。術(shù)后3～4d出現(xiàn)腹瀉患者10例，藥物控制良好；術(shù)后8d出現(xiàn)腸梗阻1例，經(jīng)保守治療痊愈；術(shù)后9d出現(xiàn)吻合口漏并發(fā)深部感染患者1例，經(jīng)保守治療痊愈。術(shù)后1個(gè)月胃腸生活質(zhì)量總評(píng)分較術(shù)前明顯改善〔（121.80±4.72）分比（90.80±7.24）分，P=0.000〕，便秘癥狀改善度為（0.81±0.56）%。結(jié)論 從本組有限的病例資料看，腹腔鏡輔助結(jié)腸次全切除聯(lián)合改良Duhamel手術(shù)治療SFC近期療效良好、安全性確切，具有出血少、創(chuàng)傷小、術(shù)后恢復(fù)快的特點(diǎn)。