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目的:探讨中西医结合治疗去势抵抗性前列腺癌(CRPC)的疗效。方法:54例CRPC患者随机均分为对照组和治疗组。对照组应用内分泌治疗(口服比卡鲁胺50 mg/d,每4周皮下注射戈舍瑞林3.6 mg)+化疗(每3周静脉滴注多西他赛75 mg/m2+口服泼尼松5 mg,早晚各1次),治疗组在其基础上加用扶阳化瘀方每日1剂,分早晚服,疗程均为24周。观察两组患者治疗前、治疗12及24周后血清前列腺特异抗原(PSA)水平、体力状况(Karnosky评分)、生活质量(FACT-P)及中医症状评分的变化。结果:治疗12周后,对照组与治疗组的血清PSA值分别由治疗前的(25.9±39.3)μg/L、(22.1±33.9)μg/L下降至(20.0±21.1)μg/L、(17.9±19.1)μg/L,两组较治疗前均有统计学差异(P<0.05),两组间相比无统计学差异(P>0.05)。治疗24周后,对照组与治疗组血清PSA较治疗3个月后分别小幅上升至(23.1±28.4)μg/L、(19.6±23.5)μg/L,但均无统计学差异(P>0.05)。治疗组在治疗12周后体力状况、生活质量、中医症状评分均得到改善,较治疗前均有统计学差异(P<0.05),治疗24周时较治疗12周时保持稳定;但对照组治疗12周、24周后体力状况、生活质量、中医症状评分均无明显改善(P>0.05)。结论:扶阳益阴、解毒化瘀方联合化疗对CRPC具有一定的临床疗效,值得临床推广。
Objective: To investigate the curative effect of traditional Chinese medicine and western medicine on the treatment of castration resistant prostate cancer (CRPC). Methods: 54 patients with CRPC were randomly divided into control group and treatment group. The control group was treated with endocrine therapy (oral bicalutamide 50 mg / d, subcutaneous goserelin 3.6 mg every 4 weeks) plus chemotherapy (docetaxel 75 mg / m2 every 3 weeks + oral prednisone 5 mg, morning and evening 1), the treatment group on the basis of Fuyang Huayu side with a daily dose of points morning and evening clothes, treatment were 24 weeks. The changes of serum PSA, Karnosky score, quality of life (FACT-P) and symptom score of TCM were observed before and 12 and 24 weeks after treatment. Results: After 12 weeks of treatment, the serum PSA levels of the control group and the treatment group decreased from (25.9 ± 39.3) μg / L and (22.1 ± 33.9) μg / L to (20.0 ± 21.1) μg / L and 17.9 ± 19.1) μg / L respectively. There was a significant difference between the two groups before treatment (P <0.05). There was no significant difference between the two groups (P> 0.05). After 24 weeks of treatment, serum PSA in control group and treatment group increased slightly to (23.1 ± 28.4) μg / L and (19.6 ± 23.5) μg / L respectively after 3 months of treatment, but no significant difference was found ). After 12 weeks of treatment, the physical condition, quality of life and TCM symptom scores of the treatment group improved significantly compared with that before treatment (P <0.05), and remained stable at 24 weeks after treatment, but the control group No significant improvement was found in physical status, quality of life and symptom scores of TCM after 12 weeks and 24 weeks (P> 0.05). Conclusion: Fuyang Yiyin and Jiedu Huayu Recipe combined with chemotherapy have certain clinical effect on CRPC, which is worthy of clinical promotion.