养阴散结法和化痰祛瘀法辅助化疗治疗胃癌60例临床观察  

Clinical Observation on Yin-Nourishing Masses-Resolving and Phlegm-Transforming Stasis-Removing Therapy Combined with Chemotherapy for 60 Cases of Gastric Cancer

作　　者：卫蓉[1] 杨柱[1] 刘华蓉[1] 李鑫[1] 张书国[1] 

机构地区：[1]贵阳中医学院第一附属医院,贵州省贵阳市宝山北路71号550001

出　　处：《中医杂志》2014年第21期1849-1852,共4页Journal of Traditional Chinese Medicine

基　　金：贵阳市科技计划资助项目[筑科合同(2011103)31号]

摘　　要：目的观察养阴散结法、化痰祛瘀法辅助化疗分别治疗胃癌阴虚、痰瘀互结证的临床疗效。方法将60例胃癌患者根据中医辨证分为阴虚组(给予化疗及养阴散结方加减)及痰瘀交阻组(给予化疗及化痰祛瘀方加减),每组30例,化疗每28天为1个周期,共治疗两个周期,中药每个疗程21天,共治疗4个疗程。观察两组患者治疗前后卡氏评分判定临床疗效,记录体重增减情况判定体重疗效,检测T细胞亚群,NK细胞,肿瘤标志物CA199、CA724、CA125,癌胚抗原(CEA)及血管内皮生长因子(VEGF)水平的变化。结果两组患者临床疗效比较,阴虚组总有效率78.33%,痰瘀交阻组总有效率76.67%;两组患者体重疗效比较,阴虚组体重增加及稳定率80.00%,痰瘀交阻组体重增加及稳定率83.33%,两组比较差异均无统计学意义(P>0.05)。两组患者治疗后CD4+、CD4+/CD8+及NK细胞均较治疗前明显增高(P<0.05或P<0.01),CD8+较治疗前明显降低(P<0.05)。两组患者治疗后肿瘤标志物CA199、CA724、CA125、CEA及VEGF水平均较治疗前明显降低(P<0.05或P<0.01)。治疗后阴虚组CD4+、CA125及VEGF较痰瘀交阻组升高(均P<0.05),其余指标差异均无统计学意义(P>0.05)。结论养阴散结法、化痰祛瘀法辅助化疗分别治疗胃癌证属中医阴虚、痰瘀互结者均有确切疗效。Objective To observe the efficacy of yin-nourishing masses-resolving and phlegm-transforming stasisremoving therapy in treating gastric cancer with yin-deficiency and phlegm-stasis obstruction. Methods Totally 60 gastric cancer patients were grouped into yin-defieiency group （30 cases, chemotherapy combined with modified yinnourishing masses-resolving formula） and phlegm-stasis obstruction group （30 cases, chemotherapy combined with modified phlegm-transforming stasis-removing formula） according to TCM syndrome differentiation. The treatment lasted for 4 courses （each course lasted for 21 days）. The Karnofsky scores, weight changes, T-cell subset, NK cell, tumor marker CA199, CA724 and CA125, carcinoembryonic antigen （CEA） and vascular endothelial growth factor （VEGF） in both groups were observed in both groups before and after treatment. The drug safety was evaluated. Results The total effective rate of yin-deficiency group and phlegm-stasis obstruction group was 78.33% and 76.67% respectively. The rates of weight gain and stability in yin-deficiency group and phlegm-stasis obstruction group were 80. 00% and 83.33% respectively, with no significant difference between groups （P 〉 0. 05 ）, After treatment, the levels of CD4＋ , CD4＋/CD8＋ and NK cell were obviously increased in both gorups （ P 〈 0. 05 or P 〈 0. 01 ） but the level of CD8＋ was obviously decreased （P 〈0. 05 ）. The levels of tumor marker CA199, CA724 and CA125 and levels of CEA and VEGF were obviously decreased in both groups after treatment （P 〈 0. 05 or P 〈 0. 01 ）. After treatment, the levels of CD4＋ , CA125 and VEGF in yin deficiency group was significantly higher than phlegm-stasis obstruction group （P 〈 0. 05 ）. Three was no significant difference between groups in other indexes. Conclusion Yin-nourishing masses-resolving and phlegm-transforming stasis-removing therapy combined with chemotherapy has a definite therapeutic effect on gastric cancer with yin-deficiency and phlegm-stasis

关 键 词：胃癌 养阴散结 化痰祛瘀 肿瘤标志物 

分 类 号：R273[医药卫生—中西医结合]