| This paper can be divided into two parts:literature review and clinical research:the first part is a literature review,which mainly introduces the understanding and research progress of traditional Chinese and Western medicine on myelosuppression after chemotherapy for cancer:The first part is the understanding and treatment methods of Western medicine on myelosuppression after chemotherapy,including the main pathogenesis,haematological changes,common chemotherapy drugs research and therapeutic measures.In the second review,the etiology and pathogenesis,syndrome differentiation and medication rule of cancer and myelosuppression after chemotherapy were analysed from the perspective of traditional Chinese medicine,and combined with previous clinical studies,the oral medication and external treatment of traditional Chinese medicine for myelosuppression were summarized.The second part is clinical study,observing the clinical effect of Shengbai Oral Solution in the treatment of bone marrow suppression after chemotherapy by self before and after study method.Objective:To investigate the efficacy and safety of Shengbai Oral Solution in the prevention and treatment of myelosuppression after chemotherapy,and to analyse the changes of peripheral blood cells and TCM syndrome in the treatment of myelosuppression after chemotherapy,so as to provide the basis for further clinical research.Methods:32 cases of cancer patients with myelosuppression after chemotherapy were studied by self before and after study method.Based on conventional Western medicine treatment,chemotherapy was given in the previous cycle,and Shengbai Oral Solution was taken 3 days before chemotherapy with the same regimen for continuous 14 days in the second cycle.No washout period was set between the two cycles of chemotherapy.peripheral blood cell values(WBC、NEUT、HB and PLT),myelosuppression score,KPS score and TCM symptom score were recorded in the 1 day before chemotherapy and the 1,7,14 and 21 days after chemotherapy.Observe whether there were allergic reactions,electrocardiogram change,abnormal liver and kidney function.Results:32 cases were observed at last.(1)Comparison of clinical efficacy:In the previous cycle,12 cases(37.50%)were significantly effective;1 case(3.13%)was effective;19 cases(59.38%)were invalid.The total effective rate was 40.63%.In the latter cycle,23 cases(9.38%)were significantly effective;0 cases(0.00%)was effective;9 cases(28.13%)were invalid;The total effective rates were 71.88%.By test,the clinical efficacy of the latter cycle was significantly better than that of the previous cycle(P<0.05).(2)Changes in peripheral blood cell values:The mean values of WBC and NEUT after two cycles of chemotherapy were compared,and the values of WBC and NEUT in the latter cycle were significantly higher than those in the previous cycle on the 7th day after chemotherapy(P<0.05);The difference values of WBC and NEUT in two cycles were compared with those before chemotherapy on day 7,day 14 and day 21,respectively.WBC and NEUT were significantly increased in the latter cycle,but significantly decreased in the previous cycle(P<0.05).Compared with the difference before and after two cycles of chemotherapy,the HB value of the latter cycle on the 14th and 21st day of chemotherapy was higher than that of the previous cycle,with statistical significance(P<0.05).The total effective rate of HB improvement in the latter cycle on the 21st day was higher than that of the previous cycle(P<0.05).There was no statistical significance of the PLT values before and after treatment in two cycles(P>0.05).(3)Comparison of the incidence of myelosuppression after chemotherapy:The incidence of myelosuppression on the 7th day of chemotherapy in the two cycles was compared.In the previous cycle,5 cases(15.63%)were without myelosuppression,and 27 cases(84.38%)with myelosuppression.In the latter cycle,12 cases(37.50%)were without myelosuppression,and 20 cases(62.50%)with myelosuppression.The incidence rates of grade Ⅰ/Ⅱ myelosuppression were 65.63%and 59.38%,respectively,and the incidence rates of grade Ⅲ/Ⅳmyelosuppression were 18.75%and 3.13%,respectively.Compared with the two chemotherapy cycles,the incidence of myelosuppression in the latter cycle was significantly lower than that in the previous cycle(P<0.05),especially the incidence of grade Ⅲ/Ⅳ myelosuppression.(4)Comparison of TCM symptom improvement:In the previous cycle,0 case(0.00%)was recovered;4 cases(12.50%)were significantly effective;1 0 cases(31.25%)were effective;18 cases(56.25%)were invalid;In the latter cycle,3 cases(9.38%)were recovered;10 cases(31.25%)were significantly effective;18 cases(56.25%)were effective.1 case(3.13%)was invalid;The overall apparent efficiencies were 12.50%and 40.63%,respectively,and the total effective rates were 43.75%and 96.88%,respectively.By test,the effective rate of TCM symptoms in the latter cycle was significantly higher than that in the previous cycle(P<0.001).Further comparison of the total score of TCM symptoms before and after two cycles of chemotherapy showed that the total score of the latter cycle after treatment was significantly lower than that of the previous cycle,and the change was more significant(P<0.001).The effective rate of single symptom in the latter period was significantly higher than that in the previous period,the difference was statistically significant(P<0.05).Further comparison of the main individual symptoms of traditional Chinese medicine before and after the treatment of changes found that in the "fatigue,fear of cold and limbs cold,waist and knee pain,little food,loose stool,dizziness,tinnitus,pale face,shortness of breath,frequent nocturnal urination"symptoms,the latter cycle significantly improved(P<0.001).(5)Comparison of KPS score changes:there were increased in 4 cases(12.50%),stabilized in 18 cases(56.25%),decreased in 10 cases(31.25%)after the previous cycle of chemotherapy,and the effective rate was 68.75%.In the latter cycle,19 cases(59.38%)were increased,10 cases(31.25%)were stabilized,and 3 cases(9.38%)were decreased.The effective rate was 90.63%.By test,the improvement of human function status in the latter cycle was significantly better than that in the previous cycle(P<0.001).(6)Changes in T lymphocyte subsets:As far as the Changes in CD3+T,CD4+T,CD8+T,CD4+T/CD8+T ratio are concerned,there was no statistical significance in posttreatment comparison between two cycles and changes before and after treatment(P>0.05).(7)Comparison of adverse reaction to chemotherapy:There was no statistical significance in digestive tract reaction,electrocardiogram,damage of liver and kidney function between the two cycles(P>0.05).Research conclusion1.Shengbai Oral Solution can improve the number of peripheral blood cells of patients with cancer after chemotherapy,and significantly increase the number of WBC and NEUT,preventing leukopenia after chemotherapy;At the same time,it was found that the treatment effect of haemoglobin and tumor-associated anemia was significantly improved on the 21st day of chemotherapy,which could be further studied in the later stage.2.Shengbai Oral Solution can significantly reduce the incidence of bone marrow suppression after degree Ⅲ/Ⅳ chemotherapy,especially reducing the incidence and degree of leukopenia and granulocytopenia.3.Shengbai Oral Solution can effectively improve the clinical symptoms of traditional Chinese medicine in patients with cancer after chemotherapy,such as " fatigue,fear of cold and limbs cold,waist and knee pain,little food,loose stool,dizziness,tinnitus,pale face,shortness of breath,frequent nocturnal urination " symptoms,Raising up the physical condition of patients and the quality of life.4.Chemotherapy can affect the level of T lymphocyte subsets in some cancer patients.Short-term oral administration of Shengbai Oral Solution can’t effectively improve the immune function and immune microenvironment of patients.5.Shengbai Oral Solution is safe in clinical use with no obvious adverse reactions. |
PDF Full Text Request