To Explore The Clinical Efficacy Of "Spleen And Dampness And Removing Phlegm Method" Combined With Abiraterone Acetate In The Treatment Of Metastatic Castration-resistant Prostate Cancer Based On The Theory Of "Chuzhuo Peiben"

1.Objective:Based on the theory of "Chuzhuo Peiben",to explore the clinical efficacy of "spleen and dampness and removing phlegm method" combined with a new endocrine drug(abiraterone acetate)plus prednisone in the treatment of metastatic castration-resistant prostate cancer.The effect of the spleen and dampness and removing phlegm method combined with the new endocrine therapy to reduce toxicity and increase efficacy.2.Method:According to the inclusion and exclusion criteria established by this research,m CRPC patients who were diagnosed and treated in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and Tianjin Medical University General Hospital from October 2018 to August 2020 were randomly divided into the control group using a random number table method.(Abiraterone acetate plus prednisone),observation group("Jianpi Lishi Huayu Recipe" combined with abiraterone acetate plus prednisone),the control group received abiraterone acetate(trade name: Zeke,Xi’an Janssen,specification: 250mg/tablet),4tablets each time,once a day,orally;prednisone acetate tablets(trade name: prednisone acetate tablets,Lisheng Pharmaceutical,specification: 5mg/tablet)1 tablet each time,Take it orally twice a day.Based on the control group,the observation group was given oral "Jianpi Lishi Huayu Decoction",150 ml each time,once in the morning and evening.Every 4 weeks is an observation period,and each observation period is followed up once for a total of 6observation periods.The main observation indicators are short-term efficacy(objective remission rate,disease control rate)and TCM clinical symptom score;secondary observation indicators are t-PSA,f-PSA,IPSS score,bone pain score,quality of life(FACT-P)And adverse reactions.3.Results:A total of 66 m CRPC patients who met the criteria for inclusion and exclusion were included,and 4 people were eliminated during the follow-up process(withdrawal from the experiment due to personal reasons),of which 2 were eliminated in the observation group,2were eliminated in the control group,and 62 people completed the entire experiment.There were 33 cases in the group and 29 cases in the control group.The objective response rate(ORR)of patients with "spleen and dampness and removing phlegm method" combined with new endocrine therapy was 45.45%,which was higher than 37.93% of the control group;the disease control rate(DCR)of the observation group was 72.73%,which was higher than that of the control group 65.52%(P>0.05).The clinical symptom scores of traditional Chinese medicine in the observation group and the control group improved after treatment(P<0.05);and compared with the control group,The observation group declined more significantly(P<0.05).The clinical symptoms of the observation group were reduced after treatment.The improvement rate is better(P<0.05).The IPSS scores of the observation group and the control group improved after treatment(P<0.05);The observation group declined more significantly(P<0.05).After treatment,the IPSS scores of the observation group were improved(P<0.05).The effective rate is higher(P<0.05).After treatment,the quality of life of the observation group and the control group improved(P<0.05),The observation group improved significantly(P<0.05).In terms of PSA improvement,the two groups were able to effectively reduce the levels of t PSA and f PSA compared with before treatment(P<0.05),After treatment,the degree of decline in the observation group was more obvious(P<0.05).Traditional Chinese medicine has its specific advantages in reducing bone pain and adverse reactions.After treatment,the bone pain of the observation group and the control group were relieved(P<0.05),The observation group declined more significantly(P<0.05);two None of the groups had serious adverse reactions leading to drug withdrawal.After symptomatic treatment,the corresponding adverse reactions were improved.The observation group showed advantages in improving patient fatigue,and the difference was statistically significant(P<0.05).4.Conclusion:"spleen and dampness and removing phlegm method" combined with abiraterone acetate plus prednisone treatment can improve the clinical efficacy,reduce toxins and increase efficacy,and reduce PSA levels.The addition and subtraction of "Jianpi Lishi Huayu Recipe" can improve the clinical symptoms of patients in traditional Chinese medicine,and has obvious advantages."spleen and dampness and removing phlegm method" combined with abiraterone acetate and prednisone can better alleviate the clinical symptoms of prostate cancer,relieve bone pain and improve the quality of life of patients.