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Article(id=1322923516198269078, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.05.015, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339144992, onlineDateStr=2026-10-30, pubDate=1746806400000, pubDateStr=2025-05-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339144992, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339144992, creator=13701087609, updateTime=1793339144992, updator=13701087609, issue=Issue{id=1322923490592043032, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='5', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1746806400000', pubDateStr='2025-05-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339138887, creator='13701087609', updateTime=1793340572227, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322929502539612595, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322929502539612596, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322923490592043032, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=66, endPage=69, ext={EN=ArticleExt(id=1322923516491870359, articleId=1322923516198269078, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Effects of Shengyu Decoction（圣愈汤）and Zengye Decoction（增液汤）Combined with Recombinant Human Granulocyte Colony-Stimulating Factor on Myelosuppression after Chemotherapy for Epithelial Ovarian Cancer, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the effects of Shengyu Decoction（圣愈汤）and Zengye Decoction（增液汤）combined with recombinant human granulocyte colony-stimulating factor on myelosuppression and peripheral blood image after chemotherapy for epithelial ovarian cancer.

Methods

All 75 patients were randomly divided into treatment group and control group according to the order of enrollment for epithelial ovarian cancer，35 cases in each group. The control group was prophylactically treated with pegylated recombinant human granulocyte colony stimulating factor（PEG-rhG-CSF）or recombinant human granulocyte colony stimulating factor（rhG-CSF）after chemotherapy. The treatment group was treated with Shengyu Decoction and Zengye decoction orally in addition to the treatment of the control group. The degree of myelosuppression after chemotherapy and peripheral blood images were observed at 1 day before chemotherapy，1，2 and 3 courses after chemotherapy.

Results

The incidence of myelosuppression in the treatment group after 1，2 and 3 courses was significantly lower than that in the control group，and the difference was statistically significant（P<0.05）. There was no statistically significant difference in the levels of white blood cells，neutrophils，platelets or hemoglobin between the two groups before treatment（P>0.05）. The above indexes were both decreased after treatment and the decrease degree in the control group was significantly greater than that in the treatment group，and the difference was statistically significant（P<0.05）.

Conclusion

Shengyu Decoction and Zengye Decoction combined with recombinant human granulocyte colony-stimulating factor can reduce myelosuppression in patients with epithelial ovarian cancer，improve the decline of peripheral blood cells and promote the recovery of blood cell levels after chemotherapy.

, authors=An LI1, Danmiao SUN2, Lulu ZHANG1, authorsList=An LI, Danmiao SUN, Lulu ZHANG, authorCompany=null, correspAuthors=null, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322923519323025570, articleId=1322923516198269078, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=圣愈汤合增液汤联合重组人粒细胞集落刺激因子对上皮性卵巢癌化疗后骨髓抑制的影响, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

探讨圣愈汤合增液汤联合重组人粒细胞集落刺激因子（recombinant human granulocyte colony-stimulatingfactor，rhG-CSF）对上皮性卵巢癌化疗后骨髓抑制及外周血象影响。

方法

选取上皮性卵巢癌患者70例，按入组先后顺序随机分为治疗组和对照组，每组35例，对照组化疗后预防性应用聚乙二醇化重组人粒细胞集落刺激因子（pegylated recombinant humangranulocyte colony-stimulating factor，PEG-rhG-CSF）或rhG-CSF治疗，治疗组患者加用圣愈汤合增液汤口服治疗，观察患者化疗后骨髓抑制程度及化疗前1 d、1个疗程、2个疗程、3个疗程结束时外周血象。

结果

治疗组1个疗程、2个疗程、3个疗程后骨髓抑制发生率明显低于对照组，差异有统计学意义（P<0.05）；白细胞、中性粒细胞、血小板及血红蛋白水平，两组患者治疗前比较差异无统计学意义（P>0.05），治疗后均下降，且对照组下降程度明显大于治疗组，差异有统计学意义（P<0.05）。

结论

圣愈汤合增液汤联合rhG-CSF能够降低上皮性卵巢癌患者化疗后骨髓抑制发生，改善化疗后外周血细胞下降情况，促进血细胞水平的恢复。

, authors=李安1, 孙丹邈2, 张璐璐1, authorsList=李安, 孙丹邈, 张璐璐, authorCompany=null, correspAuthors=null, authorNote=

李安（1986-），女（瑶族），广东从化人，主治医师，硕士，研究方向：中医药防治妇科肿瘤。

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李安（1986-），女（瑶族），广东从化人，主治医师，硕士，研究方向：中医药防治妇科肿瘤。

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李安（1986-），女（瑶族），广东从化人，主治医师，硕士，研究方向：中医药防治妇科肿瘤。

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journalId=1255847919539208197, articleId=1322923516198269078, doi=null, pmid=null, pmcid=null, year=2022, volume=53, issue=23, pageStart=7613, pageEnd=7623, url=null, language=null, rfNumber=［24］, rfOrder=23, authorNames=徐世一, 刘秀波, 陆佳欣, journalName=中草药, refType=null, unstructuredReference=徐世一，刘秀波，陆佳欣，等. 黄芪活性成分抗肿瘤作用机制的研究进展［J］. 中草药，2022，53（23）：7613-7623., articleTitle=黄芪活性成分抗肿瘤作用机制的研究进展, refAbstract=null), Reference(id=1322923527606776043, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, doi=null, pmid=null, pmcid=null, year=2022, volume=50, issue=1, pageStart=111, pageEnd=114, url=null, language=null, rfNumber=［25］, rfOrder=24, authorNames=马艳春, 吴文轩, 胡建辉, journalName=中医药学报, refType=null, unstructuredReference=马艳春，吴文轩，胡建辉，等. 当归的化学成分及药理作用研究进展［J］. 中医药学报，2022，50（1）：111-114., articleTitle=当归的化学成分及药理作用研究进展, refAbstract=null), Reference(id=1322923527678079212, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, 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组别1个疗程2个疗程3个疗程
0级Ⅰ级Ⅱ级Ⅲ级Ⅳ级0级Ⅰ级Ⅱ级Ⅲ级Ⅳ级0级Ⅰ级Ⅱ级Ⅲ级Ⅳ级
对照组350（0.00）11（31.43）12（34.29）7（20.00）5（14.29）8（22.86）7（20）10（28.57）6（17.14）4（11.43）8（22.86）16（45.71）6（17.14）3（8.57）2（5.71）
治疗组350（0.00）21（60.00）8（22.86）4（11.43）2（5.71）11（31.43）17（48.57）4（11.43）2（5.71）1（2.86）13（37.14）19（54.29）3（8.57）0（0.00）0（0.00）
Z值2.3843.0642.230
P值0.0170.0020.026
), ArticleFig(id=1322923523202756808, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, language=CN, label=表1, caption=

两组上皮性卵巢癌患者骨髓抑制情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别1个疗程2个疗程3个疗程
0级Ⅰ级Ⅱ级Ⅲ级Ⅳ级0级Ⅰ级Ⅱ级Ⅲ级Ⅳ级0级Ⅰ级Ⅱ级Ⅲ级Ⅳ级
对照组350（0.00）11（31.43）12（34.29）7（20.00）5（14.29）8（22.86）7（20）10（28.57）6（17.14）4（11.43）8（22.86）16（45.71）6（17.14）3（8.57）2（5.71）
治疗组350（0.00）21（60.00）8（22.86）4（11.43）2（5.71）11（31.43）17（48.57）4（11.43）2（5.71）1（2.86）13（37.14）19（54.29）3（8.57）0（0.00）0（0.00）
Z值2.3843.0642.230
P值0.0170.0020.026
), ArticleFig(id=1322923523274059977, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前1个疗程2个疗程3个疗程F值P值
对照组356.78±0.944.16±0.824.52±0.855.32±0.8378.855<0.001
治疗组356.80±0.915.24±0.785.53±0.746.02±0.7554.567<0.001
t值0.0905.6465.3023.702
P值0.928<0.001<0.001<0.001
), ArticleFig(id=1322923523345363146, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, language=CN, label=表2, caption=

两组上皮性卵巢癌患者治疗前后白细胞水平比较（±s，×109/L）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前1个疗程2个疗程3个疗程F值P值
对照组356.78±0.944.16±0.824.52±0.855.32±0.8378.855<0.001
治疗组356.80±0.915.24±0.785.53±0.746.02±0.7554.567<0.001
t值0.0905.6465.3023.702
P值0.928<0.001<0.001<0.001
), ArticleFig(id=1322923523420860619, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数治疗前1个疗程2个疗程3个疗程F值P值
对照组353.92±0.543.04±0.533.23±0.563.96±0.5230.473<0.001
治疗组353.88±0.573.56±0.504.11±0.585.33±0.5722.195<0.001
t值0.3014.2226.45710.505
P值0.764<0.001<0.001<0.001
), ArticleFig(id=1322923523496358092, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322923516198269078, language=CN, label=表3, caption=

两组上皮性卵巢癌患者治疗前后中性粒细胞水平比较（±s，×109/L）

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组别例数治疗前1个疗程2个疗程3个疗程F值P值
对照组353.92±0.543.04±0.533.23±0.563.96±0.5230.473<0.001
治疗组353.88±0.573.56±0.504.11±0.585.33±0.5722.195<0.001
t值0.3014.2226.45710.505
P值0.764<0.001<0.001<0.001
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组别例数治疗前1个疗程2个疗程3个疗程F值P值
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治疗组35197.60±32.58157.64±26.81136.86±24.76167.97±26.7154.281<0.001
t值0.2244.4273.7834.815
P值0.823<0.001<0.001<0.001
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两组上皮性卵巢癌患者治疗前后血小板水平比较（±s，×109/L）

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治疗组35197.60±32.58157.64±26.81136.86±24.76167.97±26.7154.281<0.001
t值0.2244.4273.7834.815
P值0.823<0.001<0.001<0.001
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组别例数治疗前1个疗程2个疗程3个疗程F值P值
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治疗组35120.22±23.35118.34±12.11115.44±10.96112.10±10.329.497<0.001
t值0.0652.7152.8103.372
P值0.9490.0080.0070.001
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两组上皮性卵巢癌患者治疗前后血红蛋白水平比较（±s）

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治疗组35120.22±23.35118.34±12.11115.44±10.96112.10±10.329.497<0.001
t值0.0652.7152.8103.372
P值0.9490.0080.0070.001
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圣愈汤合增液汤联合重组人粒细胞集落刺激因子对上皮性卵巢癌化疗后骨髓抑制的影响
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李安 1 , 孙丹邈 2 , 张璐璐 1
中华中医药学刊 | 国家项目点击 2025,43(5): 66-69
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中华中医药学刊 |国家项目点击 2025 , 43 (5) : 66 -69
圣愈汤合增液汤联合重组人粒细胞集落刺激因子对上皮性卵巢癌化疗后骨髓抑制的影响
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李安（1986-），女（瑶族），广东从化人，主治医师，硕士，研究方向：中医药防治妇科肿瘤。

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李安（1986-），女（瑶族），广东从化人，主治医师，硕士，研究方向：中医药防治妇科肿瘤。

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李安1, 孙丹邈2, 张璐璐1
作者信息
  • 1.广州中医药大学第一附属医院，广东 广州 510000
  • 2.丹邈医疗门诊部，广东 广州 510000
作者简介:

李安（1986-），女（瑶族），广东从化人，主治医师，硕士，研究方向：中医药防治妇科肿瘤。

Effects of Shengyu Decoction（圣愈汤）and Zengye Decoction（增液汤）Combined with Recombinant Human Granulocyte Colony-Stimulating Factor on Myelosuppression after Chemotherapy for Epithelial Ovarian Cancer
An LI1, Danmiao SUN2, Lulu ZHANG1
Affiliations
  • 1.First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine，Guangzhou 510000，Guangdong，China
  • 2.General Department of Danmiao Medical Outpatient Department，Guangzhou 510000，Guangdong，China
出版时间: 2025-05-10 doi: 10.13193/j.issn.1673-7717.2025.05.015
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摘要
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目的

探讨圣愈汤合增液汤联合重组人粒细胞集落刺激因子（recombinant human granulocyte colony-stimulatingfactor，rhG-CSF）对上皮性卵巢癌化疗后骨髓抑制及外周血象影响。

方法

选取上皮性卵巢癌患者70例，按入组先后顺序随机分为治疗组和对照组，每组35例，对照组化疗后预防性应用聚乙二醇化重组人粒细胞集落刺激因子（pegylated recombinant humangranulocyte colony-stimulating factor，PEG-rhG-CSF）或rhG-CSF治疗，治疗组患者加用圣愈汤合增液汤口服治疗，观察患者化疗后骨髓抑制程度及化疗前1 d、1个疗程、2个疗程、3个疗程结束时外周血象。

结果

治疗组1个疗程、2个疗程、3个疗程后骨髓抑制发生率明显低于对照组，差异有统计学意义（P<0.05）；白细胞、中性粒细胞、血小板及血红蛋白水平，两组患者治疗前比较差异无统计学意义（P>0.05），治疗后均下降，且对照组下降程度明显大于治疗组，差异有统计学意义（P<0.05）。

结论

圣愈汤合增液汤联合rhG-CSF能够降低上皮性卵巢癌患者化疗后骨髓抑制发生，改善化疗后外周血细胞下降情况，促进血细胞水平的恢复。

圣愈汤  /  增液汤  /  重组人粒细胞集落刺激因子  /  上皮性卵巢癌  /  骨髓抑制  /  外周血象  /  化疗
Objective

To investigate the effects of Shengyu Decoction（圣愈汤）and Zengye Decoction（增液汤）combined with recombinant human granulocyte colony-stimulating factor on myelosuppression and peripheral blood image after chemotherapy for epithelial ovarian cancer.

Methods

All 75 patients were randomly divided into treatment group and control group according to the order of enrollment for epithelial ovarian cancer，35 cases in each group. The control group was prophylactically treated with pegylated recombinant human granulocyte colony stimulating factor（PEG-rhG-CSF）or recombinant human granulocyte colony stimulating factor（rhG-CSF）after chemotherapy. The treatment group was treated with Shengyu Decoction and Zengye decoction orally in addition to the treatment of the control group. The degree of myelosuppression after chemotherapy and peripheral blood images were observed at 1 day before chemotherapy，1，2 and 3 courses after chemotherapy.

Results

The incidence of myelosuppression in the treatment group after 1，2 and 3 courses was significantly lower than that in the control group，and the difference was statistically significant（P<0.05）. There was no statistically significant difference in the levels of white blood cells，neutrophils，platelets or hemoglobin between the two groups before treatment（P>0.05）. The above indexes were both decreased after treatment and the decrease degree in the control group was significantly greater than that in the treatment group，and the difference was statistically significant（P<0.05）.

Conclusion

Shengyu Decoction and Zengye Decoction combined with recombinant human granulocyte colony-stimulating factor can reduce myelosuppression in patients with epithelial ovarian cancer，improve the decline of peripheral blood cells and promote the recovery of blood cell levels after chemotherapy.

Shengyu Decoction（圣愈汤）  /  Zengye Decoction（增液汤）  /  recombinant human granulocyte colony-stimulating factor  /  epithelial ovarian cancer  /  myelosuppression  /  peripheral blood image  /  chemotherapy
李安, 孙丹邈, 张璐璐. 圣愈汤合增液汤联合重组人粒细胞集落刺激因子对上皮性卵巢癌化疗后骨髓抑制的影响. 中华中医药学刊, 2025 , 43 (5) : 66 -69 . DOI: 10.13193/j.issn.1673-7717.2025.05.015
An LI, Danmiao SUN, Lulu ZHANG. Effects of Shengyu Decoction（圣愈汤）and Zengye Decoction（增液汤）Combined with Recombinant Human Granulocyte Colony-Stimulating Factor on Myelosuppression after Chemotherapy for Epithelial Ovarian Cancer[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (5) : 66 -69 . DOI: 10.13193/j.issn.1673-7717.2025.05.015
正文
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卵巢癌是女性常见的生殖系统恶性肿瘤之一，在世界范围内每年发病患者超过20万，死亡率位居妇科恶性肿瘤首位[1-2]，已经成为严重危害女性身体健康的疾病之一。卵巢癌的发病率、死亡率等与其组织学类型有明显关系[2-3]，不同组织学类型的卵巢癌患者发病率及预后明显不同。上皮性卵巢癌（epithelial ovarian cancer，EOC）占卵巢恶性肿瘤的85% ～90%，发病年龄以中老年女性为主，其起病较为隐匿，发病后进展速度较快，大部分患者确诊时已经处于病情中晚期，为了延缓患者生命，可采取标准的肿瘤细胞减灭术＋铂类为主的联合化疗一线治疗方案[2]，但是化疗药物在杀伤肿瘤细胞的同时会同时杀伤正常细胞，尤其是影响到骨髓造血细胞，引发骨髓抑制[4-6]，而骨髓抑制又会反过来影响到后期化疗疗程的完成，甚至于导致化疗疗程中断。重组人粒细胞集落刺激因子（recombinant human granulocyte colony-stimulatingfactor，rhGCSF）是临床上常用的治疗骨髓抑制的药物，具有促进中性粒细胞增殖、分化等作用，疗效良好[7-8]。中医学上并无“卵巢癌”“上皮性卵巢癌”“骨髓抑制”等病名，但根据其临床症状表现可将“卵巢癌”“上皮性卵巢癌”归纳到“癥瘕”“积聚”等范畴，“骨髓抑制”则可归纳到“虚劳”“内伤发热”“血虚”等范畴。近年来相关临床研究证实，中医药用于改善化疗后骨髓抑制有独特的优势[9-10]，文献报道显示圣愈汤及增液汤治疗化疗后骨髓抑制有良好的效果[11]，同时还能降低其他化疗后并发症。为此我院近年来对上皮性卵巢癌化疗后骨髓抑制患者采取圣愈汤合增液汤联合rhG-CSF治疗，取得了良好的效果，现将圣愈汤合增液汤联合rhG-CSF对上皮性卵巢癌化疗后骨髓抑制及外周血象影响的相关研究结果报道如下。
1　资料与方法
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1.1　一般资料
选取2021年1月—2023年8月我院住院治疗的上皮性卵巢癌患者70例为研究对象。（1）患者均符合上皮性卵巢癌诊断[12]，病理诊断明确。（2）中医诊断“癥瘕”，中医证型为脾肾亏虚、气血不足证[13]。（3）需行紫杉醇和卡铂联合化疗（TC）方案静脉化疗4～6个疗程，首次接受化疗治疗或距离上次化疗时间超过1个月。（4）年龄30～70岁。（5）卡氏评分≥60分，预计生存期≥3个月。（6）开始化疗前肝肾功能、血常规检查未发现异常。排除标准：（1）合并有其他恶性肿瘤。（2）对本研究所用的化疗药物及中成药药物有过敏史者。（3）化疗前合并机体心脑等重要脏器功能障碍性疾病。（4）有精神疾病史或精神障碍性疾病。（5）妊娠期、哺乳期患者。（6）目前不配合治疗，存在无法坚持完成化疗疗程风险者。将符合纳入研究的患者按入组先后顺序随机分为治疗组和对照组，每组35例。对照组年龄31～70岁，平均（53.15±8.56）岁，体质量指数（body mass index，BMI）18.61～26.42 kg/m2，平均（24.32±3.07）kg/m2，病理类型：浆液性腺癌20例、黏液性腺癌10例、子宫内膜样癌5例，临床分期：Ⅲ期22例、Ⅳ期13例。治疗组年龄33～68岁，平均（53.23±8.80）岁，BMI 18.35～26.70 kg/m2，平均（24.35±3.11）kg/m2，病理类型：浆液性腺癌22例、黏液性腺癌9例、子宫内膜样癌4例，临床分期：Ⅲ期21例、Ⅳ期14例。两组患者的年龄、BMI及病理类型、临床类型等资料比较差异均无统计学意义（P>0.05）。本研究取得患者知情同意，并且签署知情同意书，通过医院伦理委员会审核通过。
1.2　方法
本研究为化疗后预防性应用聚乙二醇化重组人粒细胞集落刺激因子（pegylated recombinant humangranulocyte colony-stimulating factor，PEG-rhG-CSF）或rhG-CSF。患者化疗后24 h后给予100μg/kg的PEG-rhG-CS皮下注射，患者化疗结束后每3 d监测静脉血常规，患者如出现2～4度中性粒细胞减少，此时给予5μg/kg的rhG-CSF皮下注射，至外周血中性粒细胞绝对值（absolute neutrophil count，ANC）从最低点升高到≥2.0×10 9/L的水平后停止用药。治疗组患者在上述用药基础上加用圣愈汤合增液汤口服治疗，组方：熟地黄12～15 g，生地黄12～15 g，党参12～15 g，玄参12～15 g，白芍9～12 g，川芎9～12 g，当归9～12 g，黄芪30 g，麦门冬20 g；1剂/d，水煎2次后共取汁200 mL，每日少量频服，在每次化疗开始前的1周服用，1个疗程9剂，至少服用3个疗程。
1.3　观察指标
（1）骨髓抑制程度[13]：在患者进行治疗3个疗程后根据抗肿瘤药物急性或亚急性反应分度标准对骨髓抑制程度进行分级，统计骨髓抑制率，骨髓抑制率可分为0级、Ⅰ级、Ⅱ级、Ⅲ级、Ⅳ级；（2）外周血象：抽取患者每次化疗前1 d、1个疗程、2个疗程、3个疗程结束时的空腹外周静脉血，检测血常规，监测白细胞、中性粒细胞、血小板、血红蛋白水平变化。
1.4　统计学方法
采用SPSS 22.0统计软件处理分析数据。计量资料以（）表示，符合正态分布的采用t检验，其中组间予独立样本t检验，组内治疗前后多次检测数据给予重复测量方差分析；计数资料采用率表示，等级资料给予秩和检验，非等级资料行卡方检验；P<0.05表示差异具有统计学意义。
2　结果
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2.1　骨髓抑制情况比较
治疗组1个疗程、2个疗程、3个疗程后骨髓抑制发生率明显低于对照组，差异有统计学意义（P<0.05），见表1。
2.2　治疗前后外周血象比较
白细胞、中性粒细胞、血小板及血红蛋白水平，两组患者治疗前比较差异无统计学意义（P>0.05），治疗后均下降，且对照组下降程度明显大于治疗组，差异有统计学意义（P<0.05），见表2-表5。
3　讨论
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上皮性卵巢癌是卵巢癌最常见的病理类型，其恶性程度高，患者预后一般较差。上皮性卵巢癌对化疗相对敏感，对无法手术的患者已经行肿瘤减灭术治疗的患者术后化疗，能在一定程度上延长患者生命，提高生存率。目前推荐的化疗是以铂类为基础的化疗方案，其中TC方案是上皮性卵巢癌化疗的一线方案，但是上述方案治疗后最主要的不良反应就是血液毒性反应，患者因为药物的影响化疗患者往往会出现不同程度的骨髓抑制，影响到患者化疗疗程的完成，同时还会增加继发性感染等风险。化疗导致骨髓抑制的机制如下[14]：主要是因为化疗药物会损伤造血干细胞及基质细胞，导致造血干细胞生成各种血细胞的能力下降，因此外周血中各类血细胞水平会明显下降，其机制是化疗药物杀灭肿瘤细胞后肿瘤细胞凋亡时释放的化学因子也会对骨髓干细胞形成损伤，导致骨髓造血功能进一步下降，另外化疗药物缺乏细胞选择性，同时会杀伤正常细胞，特别是增殖旺盛的造血干细胞、子宫内膜、消化道黏膜等受损更为严重，多重因素的共同影响最终会导致造血干细胞损伤，其自我复制、增殖、更新、分化功能发生障碍，骨髓造血功能不及血细胞破坏速度，化疗患者出现骨髓抑制现象。
目前，对化疗后骨髓抑制的治疗主要采取药物治疗，可通过口服单药（如利可君片、盐酸小檗胺片等）、皮下注射粒细胞集落刺激因子（G-CSF）或粒细胞-巨隨细胞集落刺激因子（ranulocyte macrophage colony-stimulating factor，GM-CSF）、抗感染、成分输血等治疗措施治疗，对于I～Ⅱ度白细胞的减少主要采取升白药物状况，但是在提高骨髓造血功能的同时还会出现头晕、皮疹、胃肠反应等不良反应。G-CSF是中性粒细胞发育分化的重要调控因子，rhG-CSF是大肠埃希菌植入G-CSF后并经过DNA技术提取而来，其作用是刺激粒细胞系祖细胞的增殖、分化及成熟过程，促进干细胞及中性粒细胞进入外周血，起到提高外周血细胞水平的作用。rhG-CSF和PEG-rhG-CSF是目前临床常用的G-CSF，可用于化疗治疗后的中性粒细胞减少预防及治疗，主要用于化疗后中性粒细胞减少的预防。rhG-CSF需要皮下注射，PEG-rhG-CSF通过偶联PEG和rhG-CSF而成，药物半衰期长因此无须连续多日给药，可单次给药，疗效也相对较好。
中医学上将“卵巢癌”“上皮性卵巢癌”归纳到“癥瘕”“积聚”“肠蕈”等范畴，《素问·骨空论篇》中有“任脉为病……女子带下瘕聚”的记载，这是“瘕聚”的最早文献记载。《诸病源候论》云：“若积引岁月，人即柴瘦，腹转大，遂致死。”《妇人大全良方》曰：“夫妇人疝瘕之病者，……此为妇人胞中绝伤有恶血，久则结成癥也。”可见古人对卵巢癌早已有认识。古代医家认为此病时正气不足、邪气滞留导致，《灵枢·水胀》中有“肠覃何如？……寒气客于肠外，与卫气相搏，气不得荣，固有所系，癖而内著，恶气乃起，瘪肉乃生……”的记载，认为寒邪侵袭，瘀阻冲任是致病原因。《医宗必读卷七》中有“女子癥瘕，多因产后恶露未净，凝结于冲任之中，而流走之新血，又日凝滞其上以附益之，逐渐积而为癥瘕矣……”的描述，也进一步对卵巢癌的发病机制进行了论述。综合古今医家观点，卵巢癌的病因病机主要是情志失常、饮食失调等因素引起正气亏虚、未外不固，加之外感六邪，邪毒侵犯冲任，脏腑功能失常，最终气机内阻形成瘀血、痰饮、湿浊等，积聚于胞宫，日久成瘕[15-18]。化疗导致的骨髓抑制在古籍中并无记载，但是根据症状可归纳在“虚劳”“血虚”等范畴，诸多医家认为此病是脾肾虚及阴阳俱损所致[19-20]，同时药毒、癌毒、情志不畅等共同作用导致，虚证贯穿始终。
临床上目前中医药辅助治疗卵巢癌及化疗后骨髓抑制优势越来越明显[15，17-18]，辨证施治，不仅能提高患者化疗疗效，同时还会增强机体免疫功能，减少化疗后不良反应的发生[15，17-18]。根据卵巢癌及化疗后骨髓抑制的病因病机，对患者中医药治疗可从脾肾虚及气血亏虚入手。圣愈汤合增液汤中的生地黄有清热凉血、养阴生津功效，熟地黄则滋阴、补血、补肾，玄参可滋阴降火、解毒散结，党参健脾益肺、养血生津，当归补血、活血，白芍养血、收敛阴液，川芎则活血、行气，黄芪益气固表、利水消肿、托毒排脓，麦门冬养阴生津、润肺清心。各药配伍，起到补肝肾、补益气血、滋阴生津之效，且补而不滞，补而不腻，补血活血而不耗血。研究表明[11]，圣愈汤合增液汤可减轻化疗药物所致的骨髓抑制，降低骨髓抑制导致的不良反应及并发症，从而间接提高化疗药物的疗效。刘开心等研究显示圣愈汤中的梓醇、川芎内酯A、芒柄花素、阿魏酸、毛蕊异黄酮、黄芪甲苷等26个原型及20个代谢产物入血后会对造血系统形成影响[21-22]，可多途径对抗骨髓抑制，同时促进骨髓造血功能的活性，增加骨髓抑制大鼠的体质量、血红蛋白、红细胞计数、血小板计数。现代医学研究显示黄芪、当归具有抗肿瘤、调节免疫、抗疲劳等作用[23-26]。本研究对圣愈汤合增液汤联合rhG-CSF对上皮性卵巢癌化疗后骨髓抑制及外周血象影响进行了研究，结果显示采用圣愈汤合增液汤治疗的治疗组患者骨髓抑制率明显低于对照组，同时外周血象中血小板水平也明显高于对照组，圣愈汤合增液汤的应用有助于减轻患者化疗后骨髓抑制损伤，与上述相关研究结果一致[11]。
综上所述，圣愈汤合增液汤联合rhG-CSF能够降低上皮性卵巢癌患者化疗后骨髓抑制发生，改善化疗后外周血细胞下降情况，促进血细胞水平的恢复。
基金
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  • 国家中医药管理局中医药科学技术研究专项(2022ZX987)
  • 广东省中医药局科研项目(20222051)
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2025年第43卷第5期
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doi: 10.13193/j.issn.1673-7717.2025.05.015
  • 首发时间：2026-10-30
  • 出版时间：2025-05-10
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国家中医药管理局中医药科学技术研究专项(2022ZX987)
广东省中医药局科研项目(20222051)
作者信息
    1.广州中医药大学第一附属医院，广东 广州 510000
    2.丹邈医疗门诊部，广东 广州 510000
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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