杨雪圆;陈其华;蔡宛灵;朱文雄;杨华.中医药治疗前列腺癌的临床研究进展[J].中医药信息,2023,40(10):71-76 |
中医药治疗前列腺癌的临床研究进展 |
Clinical Research Progress of Traditional Chinese Medicine in Treating Prostate Cancer |
投稿时间:2023-03-28 录用日期:2023-05-10 |
DOI:10.19656/j.cnki.1002-2406.20231013 |
中文关键词: 前列腺癌 中医药 研究进展 |
英文关键词: Prostate cancer Traditional Chinese medicine Research progress |
基金项目:湖南省中医药科研计划重点项目(E2022009);陈其华全国名老中医药专家传承工作室建设项目;湖南中医药大学研究生创新课题项目(2022CX36);2022年代谢性疾病中医药调控四川省重点实验室开放基金项目(SZKF202208);湖南省自然科学基金青年基金项目(2022JJ40335)湖南省卫生健康委科研计划项目(B202304058417);湖南省中医药科研计划项目(B2023096) |
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中文摘要: |
目前前列腺癌(PCa)发病率逐年攀升,而且病死率居男性肿瘤第五位,对于PCa的治疗主要采用手术及放化疗为主,同时联合内分泌、中医药治疗等方式的综合性诊治模式必将成为PCa临床医学干预的未来趋势。本文系统梳理了中医药对于PCa的临床诊疗用药、取穴配伍规律,详细阐述了近10年来中医药在PCa领域的临床研究现状及进展。通过归纳整理133篇临床相关文献发现,PCa的病因主要为脾肾亏虚,外感湿热、痰毒,搏结气血,瘀毒顽痼留于下焦;在临床诊断方面,多采用各类指南及教材为主,评估指标多为有效率、尿失禁评分、中医证候评分、生活质量评分、骨转移疼痛评分、最大尿流率、残余尿量、肿瘤标志物、卡氏评分等多个临床疗效指标组合评价。试验组干预措施主要以中药、针灸联合内分泌或联合化疗治疗PCa;在针灸治疗方面,主要以足三里、关元、三阴交、气海穴居多,涉及的经脉以任脉、足太阳膀胱经、足太阴脾经为主,在特定穴中的选择以交会穴、五输穴为多;在中药选择方面,主要以补气药(黄芪)、补血药(熟地黄)和利水消肿药(茯苓)使用频次最高;在安全性及随访方面,主要涉及消化道不良反应、免疫功能情况、生存率及复发情况等;在纳入的临床文献中,明确说明为随机数字表法的文献超过半数,但也有一部分仅提及随机字样,未明确指出采用何种随机方法。 |
英文摘要: |
At present, the incidence of prostate cancer(PCa) is increasing year by year, and the fatality rate ranks fifth among male tumors. The treatment of PCa is mainly based on surgery, radiotherapy and chemotherapy, and the comprehensive diagnosis and treatment mode combined with endocrine and traditional Chinese medicine(TCM) treatment will become the future trend of PCa clinical medical intervention. This paper systematically combed the clinical diagnosis and treatment of PCa and the rules of acupoint selection and compatibility of Chinese medicine(CM), and elaborated the current situation and progress of clinical research of CM in the field of PCa in recent 10 years. After summarizing 133 relevant clinical literatures, we found that the main pathogenesis of PCa are associated with spleen and kidney deficiency and exogenous damp heat or phlegm toxin contraction bound with qi and blood, and then static toxin retains in the lower energizer. In terms of diagnosis, various guidelines and textbooks are used to give proper clinical diagnosis, and the evaluation indices are the combination of efficiency, urinary incontinence score, TCM syndrome score, quality of life score, bone metastasis pain score, maximum urinary flow rate, residual urine volume, tumor markers, Karl Fischer score, etc. The intervention measures of the experimental group were mainly to treat PCa with CM, acupuncture and moxibustion combined with endocrinology or combined with chemotherapy. In acupuncture and moxibustion treatment, Zusanli(ST36), Guanyuan(CV4), Sanyinjiao(SP6) and Qihai(CV6) were mainly employed. The involved meridians were mainly conception vessel, bladder meridian and spleen meridian. The specific points were mainly confluence acupoints and five transport points. The most frequently used drugs were qi tonifying medicinals(such as astragalus membranaceus), blood tonifying medicinals(such as rehmannia glutinosa) and water-draining and swelling-dispersing medicinal(such as poria cocos). In terms of safety and follow-up, the medicinals mainly involve adverse reactions of digestive tract, immune function, survival rate and recurrence. More than half of the literatures explicitly stated that the random number table method was used, but some of them only used the word “random” and did not clearly indicate what kind of random method was used. This article aims to provide objective evidence support for the clinical treatment of PCa. |
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