摘要
目的探讨蟾皮莪术汤辅助化疗治疗对胃癌(瘀毒内阻证)患者的临床疗效。方法选取2018年2月—2020年4月期间在驻马店市中心医院肿瘤一科进行新辅助化疗的胃癌(瘀毒内阻证)患者80例,采用随机数字表法分为对照组和试验组,每组各40例。对照组采用奥沙利铂联合替吉奥(SOX)化疗治疗;试验组在对照组基础上采用蟾皮莪术汤辅助治疗。治疗9周后,观察比较两组患者治疗前后中医证候积分,血清相关蛋白[血管内皮生长因子(Vascular endothelium growth factor,VEGF)、基质金属蛋白酶9(Matrix metalloproteinase 9,MMP-9)、内皮抑制素]水平,血清肿瘤标志物[癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原(Carbohydrate antigen199,CA199)、糖类抗原(Carbohydrate antigen 724,CA724)]含量及免疫功能[免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白M(Immunoglobulin M,IgM)]变化,近期疗效及不良反应情况。结果治疗后两组患者主、次症中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且试验组较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者血清VEGF、MMP-9及内皮抑制素含量均较治疗前明显降低,差异有统计学意义(P<0.05);且试验组较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者血清肿瘤标志物CEA、CA199含量均较治疗前明显降低,差异有统计学意义(P<0.05),且试验组较对照组明显降低,差异有统计学意义(P<0.05);两组患者血清CA724水平均较治疗前明显降低,差异有统计学意义(P<0.05),但两组间治疗后比较,差异无统计学意义(P>0.05)。治疗后两组患者血清IgA、IgG及IgM含量均较治疗前明显降低,差异有统计学意义(P<0.05);且试验组较对照组明显降低,差异有统计学意义(P<0.05)。治疗后试验组总有效率(RR)17.50%(7/40)、疾病控制率(DCR)77.50%(31/40),对照组总有效率(RR)5.13%(2/39)、疾病控制率(DCR)51.28%(20/39),两组比较,差异有统计学意义(P<0.05)。治疗后试验组不良反应发生率15.00%(6/40)明显低于对照组41.03%(16/39),两组比较,差异有统计学意义(P<0.05)。结论蟾皮莪术汤辅助化疗治疗可有效改善胃癌患者的中医证候积分、免疫功能及病情发展状况,具有良好的临床疗效及药物安全性。
Objective To analyze the efficacy of Chanpi Ezhu decoction and adjuvant chemotherapy on patients with gastric cancer(toxin stasis and internal resistance syndrome).Methods Eighty patients with gastric cancer(toxin stasis and internal resistance syndrome)who underwent neoadjuvant chemotherapy in the Department of Oncology,Zhumadian Central Hospital between February 2018 and April 2020.According to the random number table method,the patients were divided into control group and experimental group,with 40 cases in each group.Control group was treated with oxaliplatin combined with tegafur(SOX)chemotherapy,and experimental group was treated with Chanpi Zedoary decoction adjuvant therapy on the basis of control group.After 9 weeks of treatment,the TCM syndromes scores,serum-related proteins[vascular endothelial growth factor(VEGF),matrix metalloproteinase 9(MMP-9),endostatin],serum tumor markers[carcino-embryonic antigen(CEA),carbohydrate antigen(CA199),carbohydrate antigen(CA724)]and immune function[immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)]were compared between the two groups before and after of treatment.The short-term efficacy and adverse reactions during treatment were compared between the two groups after 9 weeks of treatment.Results After treatment,the scores of the primary and secondary TCM syndromes of the two groups of patients were significantly lower than before treatment,the difference was statistically significant(P<0.05);and the test group was significantly lower than the control group,the difference was statistically significant(P<0.05).After treatment,the serum VEGF,MMP-9 and endostatin levels of the two groups of patients were significantly lower than before treatment,the difference was statistically significant(P<0.05);and the test group was significantly lower than the control group,the difference was statistically significant(P<0.05).After treatment,the serum tumor markers CEA and CA199 levels of the two groups were significantly lower than before treatment,the difference was statistically significant(P<0.05),and the test group was significantly lower than the control group,the difference was statistically significant(P<0.05);The serum CA724 level of the two groups of patients was significantly lower than before treatment,the difference was statistically significant(P<0.05),but there was no statistically significant difference between the two groups(P>0.05).After treatment,the serum IgA,IgG and IgM levels of the two groups of patients were significantly lower than before treatment,the difference was statistically significant(P<0.05);and the test group was significantly lower than the control group,the difference was statistically significant(P<0.05).After treatment,the total effective rate(RR)of the test group was 17.50%(7/40),the disease control rate(DCR)was 77.50%(31/40),and the total effective rate(RR)of the control group was 5.13%(2/39)and the disease control The rate(DCR)was 51.28%(20/39),and the difference between the two groups was statistically significant(P<0.05).After treatment,the adverse reaction rate of 15.00%(6/40)in the experimental group was significantly lower than 41.03%(16/39)in the control group.The difference between the two groups was statistically significant(P<0.05).Conclusion Chanpi Ezhu Decoction adjuvant chemotherapy can effectively improve the TCM syndromes scores,immune function and disease development of patients with gastric cancer,and has good clinical efficacy and drug safety.
作者
高冬冬
张静
李华华
GAO Dong-dong;ZHANG Jing;LI Hua-hua(Department of Oncology,Zhumadian Central Hospital,Zhumadian Henan 463000;Department of Academic Affairs,Huanghuai University School of Medicine,Zhumadian City,Zhumadian Henan 463000;Department of Integrated Traditional Chinese and Western Medicine,Henan Cancer Hospital,Zhengzhou Henan 450000)
出处
《世界中西医结合杂志》
2021年第12期2329-2333,2337,共6页
World Journal of Integrated Traditional and Western Medicine
基金
2020年河南省中医药科学研究专项课题(20-21ZY2310)。
关键词
蟾皮莪术汤
新辅助化疗
肿瘤标志物
Chanpi Ezhu Decoction
Neoadjuvant Chemotherapy
Tumor Markers
