Clinical Study Of Thermotherapy Combining With Infusing Kang-ai Injection Into Thorax For Malignant Pleural Effusion (MPE)

Malignant pleural effusion(MPE) is mainly clinical symptom of greatly part of the later period tumor sufferer, its creation and development influence the sufferer's living quality and existence period directly, the serious MPE even can endanger life, therefore, the treatment of MPE is very important in compositive treatment of tumor. Presciently, there are many methods treating MPE, but because of the poisonous side effect of the chemotherapy medicine and not subjecting the surgical operation etc. for the patient in later period. There are many methods of curing MPE with The Chinese medicine, but the study for Traditional Chinese differentiation of MPE is still little. The data expressed the infusion with Chinese herbal medicine product into thorax can raise curative effect of the chemotherapy medicine, and it can increase the immunity of patient, improving life quality, reducing the poison of chemotherapy. The heat physical therapy (heat infuses therapy, Thermotherapy) has applied in the treatment of MPE recently, it is a safe and effective treatment.Ⅰ. Relative Research between the Traditional Chinese Differentiations of MPE Caused by Lung Cancer and T lymphocyte Subsets, NnaturaI Killer Cells1. Objective To investigate the relation-ship between the Traditional Chinese differentiation in patients of MPE caused by lung cancer and the cell immunity function.2. Method To proceed diagnosis and differentiation in TCM, there are Qi stagnation and blood stasis, Accumulation of phlegm and stagnation, Accumulation of phlegm and heat in lung, Yin asthenia and virulent heat, Asthenia of both qi and yin, Asthenia of both lung and spleen, Asthenia of both lung and kidney. 72 cases of MPE caused by lung cancer were studied, and 147 cases of lung cancer which have no MPE were as control group. To analyze the T lymphocyte subsets (CD3~+,CD4~+,CD8~+,CD4~+/CD8~+) and CD(16＋56)~+ of NK cell for them. 3. Results CD3~+,CD4~+/CD8~+ ratio,CD(16＋56)~+ decreased significantly in MPE caused by lung cancer group as compared with normal group(P＜0.01 or P＜0.05). Compared with the control group, vvarious index were no difference (P＞0.05). CD3~+,CD4~+ decreased significantly in Asthenia syndrome of lung cancer group as compared with asthenia syndrome(P＜0.01). CD3~+ decreased significantly in Yin asthenia and virulent heat, Asthenia of both qi and yin, Asthenia of both lung and spleen, Asthenia of both lung and kidney syndrome of MPE caused by lung cancer as compared with Qi stagnation and blood stasis, Accumulation of phlegm and stagnation syndrome(P＜0.01 or P＜0.05). CD4~+ decreased significantly in Yin asthenia and virulent heat, Asthenia of both lung and kidney syndrome as compared with Qi stagnation and blood stasis (P＜0.05). CD4~+ decreased significantly in Yin asthenia and virulent heat as compared with Accumulation of phlegm and stagnation syndrome(P＜0.05). CD(16＋56)~+ increased significantly in Asthenia of both lung and kidney syndrome as compared with Qi stagnation and blood stasis, Accumulation of phlegm and stagnation syndrome (P＜0.05). CD3~+ increased significantly in MPE caused by lung cancer of KPS≧60 as compared with KPS＜60 group (P＜0.05). ZPS of MPE caused by lung cancer is more high, CD3~+ is more low (P＜0.05).4. Conclusion The Traditional Chinese differentiation and cell immunity function of MPE by lung cancer sufferer have relativity, the possibility provides more objective immunology index sign for the lung cancer clinical treatment based on syndrome differentiation.Ⅱ. A Clinical Study on TCM Syndrome Patterns of 102 oases of MPE1. Objective To observe the distributing rule and diagnosis criterion of TCM syndrome of MPE, to providing basis of standardization of syndrome differentiation of MPE.2. Methods Adopt the prospect method, to collect the clinic data of MPE in our hospital, setting up databases, to analyze the TCM syndrome based on the description covariance and clustering analysis method.3. Results 102 cases of MPE were observed, there are four TCM syndromes, which are Asthenia of both lung and spleen, Accumulation of phlegm and stagnation (n=54, 52.94%); Asthenia of both kidney and spleen, attack on the lung by retained fluid(n=29, 9.80%); Yin asthenia and heat, stagnation of virulent heat (n=10, 9.80%), Asthenia of both qi and yin, Accumulation of phlegm and heat in lung (n=9, 8.82%).4. Conclusion In this data, TCM syndrome of MPE have certain regulation, often mixing up Asthenia and asthenia syndrome, which is different from pleural effusion caused by infection. The research result can provide a certain basis of standardization of TCM syndrome differentiation of MPE.Ⅲ. Clinical study of thermotherapy combining with infusing Kang-ai injection into thorax for malignant pleural effusion1. Objective1. 1 To study the results of thermotherapy and side effects of thermotherapy combining with infusing Kang-ai injection into thorax for MPE.1.2 To Inquiry into the affection of thermotherapy to TCM syndrome differentiation of MPE; to study the relation-ship between the Traditional Chinese differentiation and the Curative effect.2. Methods To divide 55 patients with MPE into three groups at random. The three groups were respective given thermotherapy combining with infusing Kang-ai injection into thorax (therapeutic group, 21cases), the infusion of Kang-ai injection into thorax (control group 1, 14 cases), thermotherapy combining with intracavitary injection of Cisplati (control group 2, 20 cases). To study the results of thermotherapy and side effects of three groups.3. Results3.1 the results of thermotherapy: After four weeks treatment, The response rate of pleural effusion was 95.24% in therapeutic group(CR was 8 cases, PR was 12 cases, SD was 1 cases), 85.71% in control group 1 (CR was 3 cases, PR was 9cases, SD was 2 cases), 90% in control group 2 (CR was 10 cases, PR was 8 cases, SD was 1 case, PD was 1 case).3.2 side effects: WBC, WBC, PLT, the liver and kidney function have no variety in the before and in the after treatment(P＞0.05). there were 5 cases of patients having side effects in control group 2, 3 cases had digest symptom, such as disgusted, vomit; Marrow of 1 case were restrained, 1 case combined hemothorax. They had alleviated by treatment. 1 case had a fever in therapeutic group, which was a suspicious infection.3.3 the variety of TCM syndrome: There was no variety after treatment compared with before treatment in therapeutic group. 5 cases in control group 2 impaired yin, such as swallows dry.3.4 The quality of life: KPS oftherapeutic group increasing after treatment(P＜0.05).3.5 The relation-ship between the Traditional Chinese differentiation and the Curative effect. Efficient of Astheniaofboth lung and spleen, Asthenia of both kidney and spleen was better than Yin asthenia and heat, Asthenia of both qi and yin (P＜0.05).4. Conclusion The thermotherapy for MPE was a new, safe and effective treatment. It has affirmative curative effect, can improve the sufferer's existence quality, have little side effects. The initial research expresses that thermotherapy suits asthenia of both lung and spleen, asthenia of both kidney and spleen, this conclusion needs the larger sample quantity to confirm.