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[目的]观察葶苈大枣泻肺汤合香附旋覆花汤联合顺铂治疗恶性胸水疗效。[方法]使用随机平行对照方法,将72例住院患者按病志号抽签方法随机分为两组。大量胸腔积液局麻行患侧腋中线第7、8肋间留置胸腔闭式引流管,连接水封瓶,逐日放胸水到胸水引流干净(每天放液总量<2000m L);中等量胸水常规行胸腔穿刺抽取胸水,每次尽量抽尽。对照组36例顺铂50mg,1~2次/周。治疗组36例葶苈大枣泻肺汤合香附旋覆花汤(葶苈子、大枣、香附、旋覆花、苏子、陈皮各15g,杏仁12g,半夏9g,茯苓15g,薏米仁30g),1剂/d,水煎300m L,早晚口服;顺铂治疗同对照组。连续治疗4周为1疗程。观测临床症状、胸水、不良反应。连续治疗1疗程,判定疗效。[结果]治疗组CR12例,PR20例,NR4例,总有效率88.80%。对照组CR7例,PR15例,NR14例,总有效率61.10%。治疗组疗效优于对照组(P<0.01)。[结论]葶苈大枣泻肺汤合香附旋覆花汤联合顺铂治疗恶性胸水,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of Jujube Jujube Xiefei Decoction combined with Cyperus rotundus Decoction combined with cisplatin in the treatment of malignant pleural effusion. [Methods] Using randomized parallel control method, 72 inpatients were randomly divided into two groups according to the method of lottery of the disease index. A large number of pleural effusion local anesthesia ipsilateral axillary midline 7,8 intercostal indwelling thoracic closed drainage tube connected to the water bottle, daily discharge of pleural effusion to the pleural effusion (total daily excretion <2000m L); moderate amount of pleural effusion Conventional thoracentesis extraction pleural effusion, as far as possible pumping exhausted. Control group, 36 cases of cisplatin 50mg, 1 ~ 2 times / week. The treatment group of 36 cases of Jiaozuo jujube Xiefei soup combined with Cyperus rotundus decoction (Emu son, jujube, incense, Inula, Suzi, Citrus each 15g, almond 12g, Pinellia 9g, Poria 15g, barley kernel 30g), 1 / d, decoction 300m L, morning and evening oral; cisplatin treatment with the control group. Continuous treatment for 4 weeks for a course of treatment. Observation of clinical symptoms, pleural effusion, adverse reactions. Continuous treatment of a course of treatment to determine the efficacy. [Results] The treatment group CR12 cases, PR20 cases, NR4 cases, the total effective rate was 88.80%. Control group CR7 cases, PR15 cases, NR14 cases, the total effective rate was 61.10%. The treatment group than the control group (P <0.01). [Conclusion] Jiaozuo Jujube Xiefei Decoction combined with Cyperus rotundus Decoction combined with cisplatin in the treatment of malignant pleural effusion has satisfactory curative effect and no serious adverse reactions, so it is worth popularizing.