| Research backgroundMalignant pleural effusion is caused by malignant tumors, which originated from the pleura or transferred from other parts of the body. Lung cancer is the most common reason causing malignant pleural effusion.accounting for1/3. The most common pathological type is metastatic adenocarcinoma. The pleural effusion causing by lung cancer has a strong impact on cardiopulmonary function in patients, survival time and quality of life. It leads to the rapid depletion of the patient’s body functions, even causes death in a short time. Advanced lung cancer patients, because of chronic illness consuming Promordial Qi, and anti-tumor therapy consunming vital qi,turn up cancer cachexia, which is a severe stage of cancer. Majority of patients can not tolerate the treatment of pleural effusion by repeatedly invasive puncture and tapping. The primary purposes of treating pleural effusion causing by lung cancer are controlling the pleural effusion effectively, relieving clinical symptoms, improving quality of life and prolonging survival time. As a consequence, seeking highly efficient and non-invasive methods of treating pleural effusion causing by lung cancer is a clinically urgent problemThe reserch that treating pleural effusion causing by lung cancer by traditional chinese medicine is growing rise, but is still in the development stage, yet there is not a standard and widely accepted theory method. The pleural effusion causing by lung cancer belongs to traditional chinese medicine "suspending fluid"," cornering drink " category. In traditional chinese medicine theory, lung cancer usually caused by deficiency of vital qi first, invasion of evil qi then, causing Canopy closure of lung qi, impairment of purifying and descending function of the lung, endogeny of Phlegm turbid. Advanced lung cancer patients’ spleen and stomach are decline, that can’t transpor liquid water, causing running sluggish, then stop the phlegm, made for suspending fluid.Traditional chinese medicine accumulated a wealth of experience to treat suspending fluid and the main therapeutic principle is disinhibitting water. Especially for external using, the method is effective, safe and reliable, little or no side effects, clinical reports a lot. Since the topical treatment of traditional Chinese medicine for suspending fluid is safe, effective, easy to operate. On the premise of without safe and effective treatments in Western medicine, it is worth to try to use. And the results can also provide reference of assessment for further clinical trials of the efficacy for pleural effusion causing by lung cancer Removing retained water plaster is made up of Poria cocos, Atractylodes, daphne genkwa, Euphorbia pekinensis, Euphorbia kansui, hirudo, glycyrrhiza. It is developed by Professor Chen Gaofeng, according to traditional chinese medicine" treat an internal illness by external treatment " theory, combined with years of clinical experience in the treatment of malignant effusions. Combination with acupoint sticking, it can stimulate acupoints, promote blood circulation to remove blood stasis, get throngh water path, then eliminate the pleural effusion. The topical treatment is not easy to damage vital qi,the most patients can tolerate, and is easy to use, easy to be acceptted by patients.Research purposeTo observe the clinical efficacy of removing retained water plaster sticking points to spleen-deficiency and phlegm-turbid stagnation type of pleural effusion causing by lung cancer. Explore the feasible and special traditiongal chainese medicine treatment to pleural effusion causing by advanced lung cancer. Improve the traditional chinese medicine theory of "get throngh water path and remove retained water" acupoints external application to treat pleural effusion causing by lung cancer lung cancer. Analyze the significance and feasibility of removing retained water plaster using for external application in the treatment of pleural effusion causing by lung cancer. And provide a reference for further basic and applied researchResearch methodsProspective randomized single-blind controlled study, the establishment of diagnostic criteria sample, inclusion criteria, exclusion cri teria and exit criteria. Observed72cases of hospitalized patients were randomly assigned to a treatment group of36patients in the control group of36patients. Patients after admission to the blood, urine, stool, liver function, kidney function, blood clotting function, electrocardiogram and other routine examination. After the B-positioning, thoracentesis catheter, catheter daily pleural fluid extraction (for the first time less than1000ml, after a. day of. not more than1500ml), pleural fluid extraction is completed after the start of the following treatment:treatment group to DDP60mg+0.9%chloride sodium100ml pleural perfusion (once a week, a total of4times)in Feishu, pishu, shenshu, Yin Ling Quan, shuifen, shuidao sticking point by removing retained water paster, a paster daily, each affixed duration4-6hours continuous sticking four weeks. The control group DDP60mg+0.9%NaCl100ml pleural infusion (once a week for a total of4times).Resarch ResultsThe complete remission were6cases,23cases were partial remission, and the effective rate was82.9%. The contrast group of complete remission were4cases, partial remission were14cases, the total effective rate was57.1%.After treatment, the total effective rate was compared by rank-sum test, Z=-2.098, P=0.0361＜0.05, so the difference was statistically significant, indicating that the two groups on the treatment of pleural effusion causing by lung cancer total efficacy rate difference was statistically significant. Before and after treatment by B-ultrasonic measurement hydrothorax biggest diameter, the treatment group compared with control group after treatment, the rank and inspection, Z=5.526, P<0.05, hydrothorax reduction compared two groups, the rank and inspection, Z=2.640, P<0.05, suggesting that the two methods can reduce the water, but the reduction in treatment group than in the control group. Between the treatment group and contrast group improvement of symptoms, Karnofsky score were significantly different by the statistical analyzes(P<0.05), indicating that the treatment group was superior to the control group. The occurrence of adverse reactions were not statistically significant (P>0.05) between the two groups by statistical test, indicating that the treatment is safe and reliable.Research conclusionApplication acupoints with removing retained water plaster is a effective mean to control spleen-deficiency and phlegm-turbid stagnation pleural effusion causing by lung cancer. On the basis of conventional Western medicine treatment, it can significantly enhance the efficacy of treatment and improve the quality of life of patients, and without obvious adverse reactions. Therefore application acupoints with removing retained water plaster can be one means of treating pleural effusion causing by lung cancer as a clinical treatment. And application acupoints with removing retained water plaster is simple, easy to use, safe and reliable, worthy of further clinical application. |
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