八珍汤加减方在老年进展期胃癌新辅助化疗中的疗效及其意义  

The Effect and Significance of Bazhen Decoction in Neoadjuvant Chemotherapy for the Elderly Advanced Gastric Cancer

作　　者：吴丹[1] 郑晶晶[1] 罗德胜[1] 徐宏涛[1] WU Dan;ZHENG Jing-jing;LUO De-sheng(Department of Gastrointestinal Surgery,Lishui Centre Hospital,Lishui(323000),China)

机构地区：[1]丽水市中心医院,丽水323000

出　　处：《中国中西医结合外科杂志》2020年第4期706-710,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：浙江省丽水市科研自筹项目(2013Zc024)。

摘　　要：目的:评价八珍汤加减方在老年性进展期胃癌新辅助化疗中的疗效及其临床意义。方法:收集丽水市中心医院胃肠外科2016年8月—2018年8月收治的60例局部进展期胃癌,随机分为常规组和治疗组,每组30例,常规组采用SOX方案(替吉奥联合奥沙利铂)新辅助治疗3次后行手术治疗,治疗组在常规组的基础上加用八珍汤加减方治疗后行手术治疗。比较两组患者行新辅助化疗3次后的有效率及手术根治切除率。比较第1次及第3次新辅助化疗期间的不良反应,以及行新辅助化疗前、后的免疫功能(包括CD3+、CD4+、CD8+、CD4+/CD8+),Karnofsky(KPS)评分评价两组的生活质量并进行比较。结果:治疗组的总有效率及手术根治切除率均高于常规组。行新辅助化疗后,治疗组的CD3+、CD4+、CD4+/CD8+水平均高于常规组,生活质量改善情况优于常规组,差异均有统计学意义(P<0.05)。在行第3次新辅助化疗期间,治疗组Ⅲ-Ⅳ级消化道及骨髓不良反应发生率低于常规组,两组比较差异有统计学意义(P<0.05)。结论:老年性进展期胃癌新辅助化疗患者加用八珍汤加减方可增强患者免疫功能,改善患者化疗期间的生活质量,减少化疗的不良反应,提高患者的近期疗效。Objective To evaluate the effect and significance of Bazhen Decoction in neoadjuvant chemotherapy for the elderly advanced gastric cancer.Methods The sixty elderly patients with advanced gastric cancer were treated with neoadjuvant chemotherapy after multidisciplinary discussion of tumor MDT in our hospital.They were divided into routine group and treatment group according to random number method.30 patients in each group were treated with neoadjuvant therapy of SOX regimen(tegio combined with oxaliplatin)three times in routine group after surgical treatment.The treatment group was treated with Bazhen decoction on the basis of routine group after surgery.The image remission and radical resection after neoadjuvant chemotherapy were compared between the two groups.The toxicity and side effects during the first and third neoadjuvant chemotherapy were compared.The immune function(including CD3+,CD4+,CD8+,CD4+/CD8+)and quality of life(using Karnofsky(KPS)score)were compared before and after neoadjuvant chemotherapy.Results The image remission and radical resection in the treatment group were higher than those in the conventional group.After neoadjuvant chemotherapy,CD3+,CD4+and CD4+/CD8+in the treatment group were higher than those in the routine group and the improvement of quality of life was better than those in the routine group,which were both statistically significant(P<0.05).During the third period of neoadjuvant chemotherapy,the side effects of gastrointestinal tract and bone marrow toxicity in the treatment group were lower than those in the routine group(P<0.05).Conclusion Bazhen Decoction can enhance the immune function,improve the quality of life,reduce the toxicity and side effects of chemotherapy and improve the short-term curative effect of elderly patients with advanced gastric cancer undergoing neoadjuvant chemotherapy.

关 键 词：八珍汤加减方 新辅助化疗 老年进展期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]