世界中医药

目的：探讨温阳利水方外敷对晚期肿瘤恶性腹水患者免疫功能的影响。方法：选取2015年3月至2017年4月新疆医科大学第四附属医院收治的晚期肿瘤恶性腹水患者86例作为研究对象，按照随机数字表法分为对照组和观察组，每组43例。对照组采用腹腔灌注化疗，观察组在此基础上给予温阳利水方外敷治疗，2组均连续治疗3个月。比较2组患者治疗后临床疗效、治疗前后中医症状改善情况及免疫功能变化。结果：治疗后观察组总缓解率（ORR）为83.72%，明显高于对照组的67.44%,差异有统计学意义（P<0.05）。与治疗前比较，治疗后2组患者腹痛、腹胀、食少、纳呆、乏力、水肿评分明显降低,差异有统计学意义（P<0.05），且观察组明显低于对照组,差异有统计学意义（P<0.05）。与治疗前比较，治疗后2组患者腹围及最大液性暗区均明显减小，体质量明显下降，且观察组明显小于/低于对照组,差异有统计学意义（P<0.05）；2组患者1周后尿量均明显增加，且观察组明显高于对照组,差异有统计学意义（P<0.05）。与治疗前比较，治疗后对照组患者全血CD3+比例及观察组CD3+、CD4+比例和CD4+/CD8+明显升高，且观察组明显高于对照组,差异有统计学意义（P<0.05）；观察组患者全血CD8+比例明显降低，且明显低于对照组，差异有统计学意义（P<0.05）。观察组不良反应发生率明显低于对照组,差异有统计学意义（P<0.05）。结论：温阳利水方外敷治疗晚期肿瘤恶性腹水患者可明显提高机体免疫功能，改善中医症状及腹水情况，提高整体治疗效果，安全性高。

English Summary:

To investigate the effects of external application of Wenyang Lishui Recipe on immune function of patients with advanced tumor malignant ascites.Methods:A total of 86 cases of patients with advanced tumor malignant ascites in Fourth Affiliated Hospital of Xinjiang Medical University from March 2015 to April 2017 were selected and divided into an observation group and a control group according to the random number table method, with 43 cases in each groups.The control group was treated with intraperitoneal infusion chemotherapy, and the observation group was added Wenyang Lishui Recipe on the basis of the control group.Both groups were treated continuously for 3 months.The clinical efficacy, the improvement of traditional Chinese medicine(TCM)symptoms and the changes of immune function before and after treatment were compared between the 2 groups.Results:After treatment, the ORR of the observation group was 83.72%, which was significantly higher than 67.44% of the control group(P<0.05).Compared with before treatment, the scores of abdominal pain, abdominal distension, food intake, poor appetite, fatigue and edema after treatment in the 2 groups significantly decreased(P<0.01), and the observation group was significantly lower than the control group(P<0.01).Compared with before treatment, the abdominal circumference and the maximum liquid dark area after treatment in the 2 groups significantly reduced, and the body weight significantly decreased.The observation group was significantly smaller/lower than the control group(P<0.05 or P<0.01); the amount of urine 1 week after treatment in the 2 groups significantly increased, and the observation group was significantly higher than the control group(P<0.01).Compared with before treatment, the proportion of CD3+ in the whole blood of the patients in the control group and the CD3+, CD4+ ratio and CD4+/CD8+ in the observation group significantly increased, and the observation group was significantly higher than the control group(P<0.05 or P<0.01); the proportion of CD8+ in the whole blood of the patients in the observation group significantly decreased, and was significantly lower than the control group(P<0.01).The incidence of total adverse reactions in the observation group was significantly lower than that of the control group(P<0.01).Conclusion:External application of Wenyang Lishui Recipe in treatment of advanced tumor malignant ascites can significantly enhance the immune function of patients, improve the TCM symptoms and the condition of ascites, improve the overall treatment efficacy.It has high safety, and it is worthy of clinical promotion.

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