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【目的】观察中药消瘀散结抑癌灌肠剂治疗晚期前列腺癌的临床疗效。【方法】根据自愿原则,将22例患者分为治疗组(15例)和对照组(7例)。对照组仅给予最大限度雄激素阻断治疗(MAB),治疗组在MAB治疗基础上给予消瘀散结抑癌灌肠剂(由山慈菇、夏枯草、莪术、虎杖、吴茱萸等组成)灌肠,隔天1次,2组疗程均为2个月。观察2组治疗前后前列腺体积、前列腺特异性抗原(PSA)、最大尿流率(MFR)等指标的变化。【结果】(1)在依从性方面,治疗组中有2例因不能耐受灌肠而退出研究,其他20例均获得随访2个月。(2)治疗后2组患者血清PSA水平均明显降低(与治疗前比较,P<0.01),但治疗组的降低作用明显优于对照组(P<0.05)。(3)治疗后2组患者前列腺的体积均有所缩小(与治疗前比较,P<0.05),分别缩小达到26.1%和26.2%。2组治疗后比较,差异无显著性意义(P>0.05),表明2组在缩小前列腺体积方面作用相似。(4)治疗后2组患者的MFR均明显改善(与治疗前比较,P<0.01)。2组治疗后比较,差异有显著性意义(P<0.05),表明治疗组在改善患者最大尿流率方面优于对照组。【结论】中药协同MAB治疗晚期前列腺癌作用优于单用MAB;灌肠给药是个很好的给药途径,可直达病所且副作用少、起效快。
【Objective】 To observe the clinical efficacy of traditional Chinese medicine Xiaoyu Sanjie suppository enema in the treatment of advanced prostate cancer. 【Methods】 According to the voluntary principle, 22 patients were divided into treatment group (15 cases) and control group (7 cases). The control group was given only maximal androgen blockade therapy (MAB). The treatment group was treated with MAB. The treatment group was given enema of Xiaoyasanjie Suppressing enema (composed of Shanzijiao, Prunella vulgaris, Curcuma rhizome, Polygonum cuspidatum, Fructus Evodiae) The next day, 2 groups of treatment are 2 months. The changes of prostate volume, prostate-specific antigen (PSA) and maximal flow rate (MFR) before and after treatment were observed in two groups. 【Results】 (1) In the aspect of compliance, two patients in the treatment group withdrew from the study because they could not tolerate the enema. The other 20 patients were followed up for 2 months. (2) After treatment, serum PSA levels of two groups were significantly decreased (P <0.01 compared with before treatment), but the reduction effect of the treatment group was significantly better than that of the control group (P <0.05). (3) After treatment, the volume of prostate in the two groups of patients decreased (P <0.05 compared with that before treatment), reaching 26.1% and 26.2% respectively. There was no significant difference between the two groups after treatment (P> 0.05), indicating that the two groups had similar effects in reducing the volume of the prostate. (4) The MFR of two groups of patients after treatment were significantly improved (compared with before treatment, P <0.01). The difference between the two groups after treatment was significant (P <0.05), indicating that the treatment group was superior to the control group in improving the maximum urinary flow rate in patients. 【Conclusion】 The combination of traditional Chinese medicine and MAB in the treatment of advanced prostate cancer is superior to MAB alone. Enema administration is a good route of administration, which can lead to the disease with less side effects and rapid onset of action.