参苓白术散在局部晚期宫颈癌根治性放疗联合铂类药物化疗中的临床意义  

Clinical significance of Shenling Baizhu San in locally advanced cervical cancer patients during concurrent radiochemotherapy

作　　者：罗爱华[1] 张高锋 

机构地区：[1]三峡大学第二人民医院肿瘤放化疗科,湖北宜昌443000 [2]湖北省宜昌市中医医院内分泌科,湖北宜昌443003

出　　处：《中国现代医学杂志》2016年第17期125-129,共5页China Journal of Modern Medicine

基　　金：湖北省宜昌市科技局2014年医疗卫生科研项目(No:A14301-31)

摘　　要：目的观察参苓白术散对宫颈癌同步放化疗后放射性肠炎（RE）的预防和治疗作用。观察参苓白术散对宫颈癌患者放化疗程中血红蛋白水平的影响；观察参芩白术散对人低氧诱导因子1d（HIF-1a）表达水平的影响；观察参芩白术散对宫颈癌同步放化疗疗效的影响。方法纳入58例局部晚期宫颈癌患者，按随机数表法将其分为对照组和参苓白术散组。对照组接受盆腔外照射同时予以顺铂[40mg／（mz·周）]治疗，并给予后装治疗，A点剂量80～86Gy，B点剂量45～50Gy。参芩白术散组接受盆腔外照射同时予以顺铂[40mg／（m2·周）]治疗，并给予后装治疗，A点剂量80～86Gy，B点剂量45—50Gy，放疗同期给予参芩白术散口服。免疫组织化学法检测HIF-1a表达水平。核磁共振评价放化疗疗效。结果两组患者年龄、国际妇产科协会分期、病理类型、分化程度、治疗前Karnofsky评分比较，差异无统计学意义。放疗后参芩白术散组RE的发生率低于对照组：参芩白术散组患者血红蛋白水平高于对照组。对照组HIF-1a表达阳性率高于参芩白术散组。对照组治疗后临床完全缓解率为69％，参芩白术散组治疗结束后临床完全缓解率为79％。结论放疗同时使用参苓白术散可以降低RE和贫血的发生率，提高氧饱和度，降低肿瘤组织缺氧的程度，从而提高同期放化疗疗效。Objective To observe the preventive and therapeutic effects of Shenling Baizhu San on radia- tion enteritis, and its influence on the levels of hemoglobin and human hypoxia inducible factor 1 （HIF-la） and radiochemotherapy efficacy in cervical cancer patients receiving concurrent radiochemotherapy. Methods Random allocation was taken to averagely divide 58 patients into two groups： control group and Shenling Baizhu San group. The control group received external pelvic beam radiotherapy plus Cisplatin （40 mg/m2） weekly and after-loading therapy with the dose of 80-86 Gy at point A and 45-50 Gy at point B. The Shen- ling Baizhu San group was given oral administration of Senling Baizhu San in addition to the treatment for the control group. The expression of HIF-1a was detected by immunohistochemical method in the 58 cases with cervical cancer. MRI was used to assess the effect of the radiochemotherapy. Results The incidence of radiation enteritis in the Sbenling Baizhu San group was obviously lower than that in the control group afterradiotherapy. The hemoglobin level of the Shenling Baizhu San group was obviously higher than that of the control group. The level of HIF-1a in the control group was higher than that in the Shenling Baizhu San group. The clinical complete response （CR） rate was 69% in the control group and 79% in the Shenling Baizhu San group after treatment. Conclusions Shenling Baizhu San used during concurrent radiochemotherapy can significantly reduce the incidence of radiation enteritis and anemia, increase oxygen saturation, alleviate the degree of hypoxia in tumor and improve the efficacy of radiotherapy.

关 键 词：宫颈癌 参芩白术散 放射性肠炎 缺氧诱导因子1Α 

分 类 号：R737.33[医药卫生—肿瘤]