机构地区:[1]陕西省西安高新医院妇科,710000 [2]陕西省西安高新医院中医科,710000
出 处:《国际中医中药杂志》2019年第10期1043-1048,共6页International Journal of Traditional Chinese Medicine
基 金:陕西省教育厅自然科学研究项目(2013JK0782)。
摘 要:目的评价自拟抗癌固本消癥汤辅助化疗治疗老年Ⅳ期卵巢癌的疗效.方法将符合入选标准的218例Ⅳ期卵巢癌患者采用随机数字表法分为2组,每组109例.对照组采用TP化疗方案,观察组在对照组基础上加服自拟抗癌固本消癥汤.2组均3周为1个周期,共治疗4个周期,随访2年.采用卵巢癌特异性量表(Functional Assessment of Cancer Therapy-Ovarycancer V4.0,FACT-OV4)评价生存质量,采用ELISA法检测肿瘤标志物含量,包括整合素连接激酶(integrim linked kinase,ILK)、缺氧诱导因子-α(hypoxia inducible factor-α,HIF-α)、人附睾蛋白(human epididymis protein 4,HE4)及上皮型钙黏蛋白(epithelial-type calcium mucin,E-cadherin),观察2组治疗期间的毒副作用,评价临床疗效.记录随访期间患者的生存率、总生存时间及无病生存时间.结果观察组控制率为90.8%(99/109)、有效率为41.3%(45/109),对照组分别为64.2%(70/109)、28.4%(31/109),2组控制率及有效率比较,差异均有统计学意义(Z值分别为4.002、3.401,P值均<0.05).治疗后,观察组ILK[(12.31±1.15)ng/L比(23.57±2.32)ng/L,t=3.245]、HIF-α[(2.41±0.22)mg/L比(6.67±0.67)mg/L,t=3.596]、HE4[(0.34±0.03)pg/L比(1.24±0.12)pg/L,t=3.621]水平均低于对照组(P<0.05),E-cadherin[(5.25±0.56)ng/L比(2.52±0.26)ng/L,t=3.434]水平高于对照组(P<0.05).观察组治疗后功能状况、社会/家庭状况评分均高于对照组(t值分别为3.282、3.214,P值均<0.05),附加关注、情感状况、生理状况评分均低于对照组(t值分别为3.121、3.512、3.526,P值均<0.05).治疗期间,观察组心脏、肝脏及肾脏毒性,骨髓抑制,恶心呕吐,腹痛腹泻发生率均明显低于对照组(χ^2值分别为4.947、4.893、4.525、4.692、4.637、4.905,P<0.05).随访1、2年,观察组生存率高于对照组(χ^2值分别为3.782、3.893,P<0.05),总生存时间、无病生存时间高于对照组(t值分别为3.251、3.561,P<0.05).结论自拟抗癌固本消癥汤辅助TP方案可降低老年Ⅳ期�Objective To investigate the clinical effects of Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme in the treatment of advanced ovarian carcinoma in elderly patients.Methods A total of 218 elderly patients with advanced ovarian carcinoma in our hospital were randomly divided into the observation and control group,109 in each group.The control group was treated by TP scheme,while the observation group was treated by Kangai-Guben-Xiaozheng decoction based on pathogenesis theory of cancerous toxin combined with TP scheme.Both groups received 1 chemotherapy cycle at 3 weeks,and a total of 4 cycles of chemotherapy were followed up for 2 years.Quality of life was assessed by Functional Assessment of Cancer Therapy-ovarian Cancer v4.0(FACT-OV4).Enzyme-linked immunosorbent assay(ELISA)was used to detect tumor markers,including Integrin-Linked Kinase(ILK),Hypoxic Inducible Factor-α(HIF-α),Human Epididymal Protein(HE4)and Epithelial-type calcium mucin(E-cadherin).The toxic and side effects of two groups were observed and the clinical efficacy was evaluated.The survival rate,total survival time and disease-free survival time were observed and recorded during follow-up.Results The control rate and effective rate of the observation group were 90.8%(99/109)and 41.3%(45/109),respectively,and those of the control group were 64.2%(70/109)and 28.4%(31/109),respectively.The comparison of control rate and effective rate between the two groups were statistically significant(Z value were 4.002,3.401,respectively,all Ps<0.05).After treatment,the ILK(12.31±1.15 ng/L vs.23.57±2.32 ng/L,t=3.245),HIF-α(2.41±0.22 mg/L vs.6.67±0.67 mg/L,t=3.596),HE4(0.34±0.03 pg/L vs.1.24±0.12 pg/L,t=3.621)levels in the observation group are significantly lower than those in the control group(P<0.05),while the E-cadherin(5.25±0.56 ng/L vs.2.52±0.26 ng/L,t=3.434)was significantly higher than that in the control group(P<0.05).After treatment,the scores of functional status and social/family stat
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