本文選題：疏肝養(yǎng)心法 + 惡性腫瘤��； 參考：《中國(guó)老年學(xué)雜志》2017年06期

【摘要】：目的探討甘麥大棗湯疏肝養(yǎng)心法對(duì)惡性腫瘤抑郁患者免疫狀態(tài)、抑郁狀態(tài)及生活質(zhì)量的影響。方法選取老年惡性腫瘤抑郁患者100例,根據(jù)隨機(jī)數(shù)字表法將患者隨機(jī)分為對(duì)照組和觀察組各50例,對(duì)照組予以常規(guī)治療,觀察組在對(duì)照組基礎(chǔ)上予以服用中藥加味甘麥大棗湯,測(cè)量治療前后兩組患者的血清免疫球蛋白(IgA、IgG、IgM)、T細(xì)胞亞群(CD3~+、CD4~+、CD8~+、CD4~+/CD8~+)、NK細(xì)胞等免疫指標(biāo),同時(shí)采用抑郁自評(píng)量表評(píng)分及漢密頓抑郁量表對(duì)患者的心理狀態(tài)進(jìn)行評(píng)價(jià),采用癌癥患者生活質(zhì)量問(wèn)卷(QLQ-C30)對(duì)患者的生活質(zhì)量進(jìn)行評(píng)價(jià),并比較兩組患者的近期療效及不良反應(yīng)等。結(jié)果治療后,對(duì)照組IgA、IgG、IgM水平與治療前比較明顯降低(P0.05),觀察組患者的IgA、IgG、IgM水平明顯高于治療前及對(duì)照組(均P0.05)。觀察組患者的CD3~+細(xì)胞治療后與治療前比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);而對(duì)照組患者的CD3~+細(xì)胞治療后水平明顯低于治療前(P0.05)。療程結(jié)束后兩組患者CD4~+指標(biāo)均有所下降,其中以對(duì)照組更為明顯(P0.05);與治療前相比觀察組CD8~+指標(biāo)顯著降低,而對(duì)照組指標(biāo)則較治療前有所升高(P0.05),治療后兩組對(duì)比差異顯著(P0.05)。治療前后CD4~+/CD8~+值兩組并無(wú)顯著差異(P0.05)。對(duì)照組的NK細(xì)胞絕對(duì)數(shù)水平與治療前比較明顯降低(P0.05),觀察組患者的NK細(xì)胞絕對(duì)數(shù)水平明顯高于治療前及對(duì)照組(P0.05)。治療后對(duì)照組的SDS、HAMD評(píng)分與治療前比較明顯升高(P0.05);而觀察組患者對(duì)應(yīng)的SDS與HAMD評(píng)分則有所降低,且與對(duì)照組相比亦顯著偏低(均P0.05)。兩組患者健康狀況評(píng)分比較之下觀察組顯著優(yōu)于對(duì)照組(P0.05);兩組患者的功能量表各維度得分比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);癥狀領(lǐng)域方面,觀察組患者的惡心嘔吐、乏力、納差、便秘得分明顯高于對(duì)照組(均P0.05);兩組患者的呼吸困難、疼痛、失眠、腹瀉、經(jīng)濟(jì)困難維度得分比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組疾病控制率(DCR)為90.00%,明顯高于對(duì)照組(80.00%,P0.05);觀察組客觀有效率(ORR)為58.00%,明顯高于對(duì)照組(44.00%,P0.05)。結(jié)論在老年惡性腫瘤抑郁患者中應(yīng)用加味甘麥大棗湯加減疏肝養(yǎng)心法能有效改善患者的抑郁癥狀,提高患者的免疫狀態(tài)及生活質(zhì)量。
[Abstract]:Objective to investigate the effect of Gan Mai Da zizzao Decoction on the immune state, depression and quality of life of the patients with malignant tumor depression. Methods 100 patients with malignant tumor and depression were selected and randomly divided into control group and 50 cases in the observation group according to the random digital table method. The control group was treated with routine treatment, and the observation group was based on the control group. Taking Chinese traditional Chinese medicine plus flavored jujube soup, the serum immunoglobulin (IgA, IgG, IgM), T cell subgroup (CD3~+, CD4~+, CD8~+, CD4~+/CD8~+) and NK cells were measured before and after treatment in two groups, and the psychological state of the patients was evaluated by the self rating depression scale and Hamilton Depression scale, and the patients were born with cancer. The living quality questionnaire (QLQ-C30) was used to evaluate the quality of life of the patients and to compare the short-term effect and adverse reaction of the two groups. Results after treatment, the level of IgA, IgG, IgM in the control group was significantly lower than that before treatment (P0.05). The level of IgA, IgG, IgM in the observation group was significantly higher than that before and in the control group (all P0.05). The CD3~+ of the patients in the observation group was CD3~+. Compared with before treatment, the difference was not statistically significant (P0.05), but the level of CD3~+ cells in the control group was significantly lower than that before treatment (P0.05). After the treatment, the CD4~+ indexes of the two groups were all decreased, and the control group was more obvious (P0.05). Compared with the control group, the CD8~+ index was significantly lower than the control group, and the control group was compared with the control group. The index was higher than that before treatment (P0.05), and there was significant difference between the two groups after treatment (P0.05). There was no significant difference between the two groups of CD4~+/CD8~+ values before and after treatment (P0.05). The absolute number of NK cells in the control group was significantly lower than that before the treatment (P0.05). The absolute number of NK cells in the observation group was significantly higher than that before the treatment and the control group (P0.05). After treatment, the SDS and HAMD scores in the control group were significantly higher than before the treatment (P0.05), while the corresponding SDS and HAMD scores in the observation group were significantly lower than those in the control group (P0.05). The two groups of patients were significantly better than the control group (P0.05) compared with the control group (P0.05); the scores of the functional scales in the two groups were scored. There was no statistically significant difference (P0.05), and the scores of nausea and vomiting, fatigue, nausea and constipation in the observation group were significantly higher than those in the control group (P0.05); the scores of dyspnea, pain, insomnia, diarrhea, and economic difficulties in the two groups were not statistically significant (P0.05). The rate of disease control (DCR) in the observation group was 90%. It was significantly higher than the control group (80%, P0.05), and the objective effective rate (ORR) of the observation group was 58%, which was significantly higher than that of the control group (44%, P0.05). Conclusion the added flavored jujube zizzao Decoction plus subtraction of liver and nourishing heart can effectively improve the depressive symptoms and improve the immune status and quality of life of the elderly patients with malignant tumor.
【作者單位】： 遼寧中醫(yī)藥大學(xué)附屬醫(yī)院藥劑科;深圳市蛇口人民醫(yī)院;
【分類號(hào)】：R730.5;R749.4

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