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对症处理联合中药治疗对胰腺癌化疗后骨髓抑制的效果

Effect of symptomatic treatment combined traditional Chinese medicine in treating bone marrow suppression after chemotherapy for pancreatic cancer

    摘要
  • 摘要:
    目的 探讨中药治疗对胰腺癌化疗所致骨髓抑制的效果。
    方法 回顾性分析2024年1—8月于复旦大学附属肿瘤医院化疗并出现骨髓抑制的53例胰腺癌患者的临床资料。患者均在常规化疗第1~3个周期出现不同程度骨髓抑制。化疗第4个周期联合中药治疗, 观察中药治疗后患者骨髓抑制改善情况。
    结果 化疗第1个周期后患者均出现不同程度的骨髓抑制，包括白细胞减少、血小板减少、中性粒细胞减少和血红蛋白减少。与联合中药治疗前比较，骨髓抑制分级≥Ⅱ级患者中，联合中药治疗1个月后白细胞减少患者占比降低，差异有统计学意义(P=0.019), 血小板减少患者占比也降低，但差异无统计学意义(P=0.066)。联合中药治疗前后中性粒细胞减少患者占比差异无统计学意义(P=0.231)。患者联合中药治疗1个月后，白细胞计数、血红蛋白水平及血小板计数较联合中药治疗前升高，差异有统计学意义(P=0.006、P=0.011、P < 0.001)。联合中药治疗1个月后，重组人粒细胞集落刺激因子和重组人血小板生成素使用平均次数分别为(2.8±1.9)次/周期和(3.1±1.2)次/周期，少于联合中药治疗前的(4.5±1.7)次/周期和(4.5±1.3)次/周期，差异有统计学意义(P=0.002、0.038)。
    结论 中药联合治疗可改善胰腺癌化疗后骨髓抑制不良反应，提升白细胞计数及血红蛋白水平。

     

    Abstract:
    Objective To investigate the application effect of traditional Chinese medicine (TCM) in treating bone marrow suppression induced by chemotherapy for pancreatic cancer.
    Methods A retrospective analysis was conducted on the clinical data of 53 pancreatic cancer patients who underwent chemotherapy induced bone marrow suppression at Fudan University Shanghai Cancer Center between January and August 2024. All patients developed varying degrees of bone marrow suppression during the first to third cycles of conventional chemotherapy. In the fourth cycle of chemotherapy, TCM was added, and the improvement in bone marrow suppression after TCM treatment was observed.
    Results After thefirst cycle of chemotherapy, all patients exhibited different degrees of bone marrow suppression, including leukopenia, thrombocytopenia, neutropenia, and anemia. Compared with combined TCM treatment before, among patients with bone marrow suppression of grade Ⅱ and above, the proportion of those with leukopenia decreased significantly after one month of TCM treatment (P=0.019), and the proportion of those with thrombocytopenia also decreased, but the difference was not statistically significant (P=0.066). There was no statistically significant difference in the proportion of patients with neutropenia before and after TCM treatment (P=0.231). One month after TCM treatment, the white blood cell count, hemoglobin level, and platelet count of the patientsincreased comparedto before combined treatment (P=0.006, P=0.011, P < 0.001). One month after TCM treatment, the average number of use of recombinant human granulocyte colony-stimulating factor and recombinant human thrombopoietin were (2.8±1.9) times/cycle and (3.1±1.2) times/cycle, respectively, which were less than those before combined TCM treatment (4.5±1.7) times/cycle and (4.5±1.3) times/cycle (P=0.002, 0.038).
    Conclusion Combined TCM treatment can improve adverse reactions of bone marrow suppression after chemotherapy for pancreatic cancer and increase white blood cell count and hemoglobin level.

     

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