加味归脾汤联合FOLFOX4化疗方案对气血亏虚型大肠癌患者MMP-9、VEGF、肠黏膜屏障及营养状态的影响  

Effect of Jiawei Guipi decoction combined with FOLFOX4 chemotherapy on MMP-9,VEGF,intestinal mucosal barrier and nutritional status in patients with colorectal cancer with deficiency of qi and blood

作　　者：郑康 余春[1] ZHENG Kang;YU Chun(Department of Traditional Medicine,Quzhou People’s Hospital,Quzhou 324000,China)

机构地区：[1]衢州市人民医院中医科,浙江衢州324000

出　　处：《全科医学临床与教育》2020年第11期985-988,共4页Clinical Education of General Practice

基　　金：衢州市科技计划项目(2016060)。

摘　　要：目的探讨加味归脾汤联合FOLFOX4方案治疗气血亏虚型大肠癌晚期患者的疗效。方法选择中医证型属于气血亏虚型的94例大肠癌晚期患者,按照随机数字表法分为观察组和对照组,各47例。对照组采用FOLFOX4化疗,观察组采用加味归脾汤联合FOLFOX4方案治疗,21 d为一个化疗周期,治疗4个化疗周期后比较疗效。结果观察组治疗后糖类抗原(CA199)、癌胚抗原(CEA)、糖类抗原(CA242)、血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)低于对照组,差异均有统计学意义(t分别=13.08、10.82、9.80、10.36、9.16,P均<0.05);观察组治疗后血红蛋白(Hb)、总蛋白(TP)高于对照组,内毒素含量、尿乳果糖/甘露醇比值低于对照组,差异均有统计学意义(t分别=-10.62、-9.16、8.91、11.63,P均<0.05);观察组获益率均高于对照组,化疗不良反应(Ⅲ~Ⅳ级)发生率低于对照组(χ^2分别=3.90、4.61,P均<0.05)。结论加味归脾汤联合FOLFOX4方案治疗气血亏虚型大肠癌晚期疗效明显,可改善其营养状态及肠黏膜屏障,预防肿瘤转移,预防化疗不良反应。Objective To investigate the efficacy of Jiawei Guipi Decoction combined with FOLFOX4 regimen in the treatment of patients with advanced colorectal cancer(qi-blood deficiency type). Methods Ninety-four patients with advanced colorectal cancer with TCM syndrome type belonging to deficiency of qi and blood were selected.According to the random number table method,the patients were divided into observation group and control group,47 cases in each.The control group was treated with FOLFOX4 chemotherapy,while the observation group was treated with modified Jiawei Guipi decoction combined with FOLFOX4 chemotherapy,21 days as one chemotherapy cycle.The therapeutic effects were compared after 4 chemotherapy cycles. Results The plasma carbohydrate antigen CA199(CA199),carcinoembryonic antigen(CEA),carbohydrate antigen CA242(CA242),vascular endothelial growth factor(VEGF),matrix met alloproteinase-9(MMP-9)in the observation group were significantly lower than those in the control group after treatment(t=13.08,10.82,9.80,10.36,9.16,P<0.05).The plasma hemoglobin(Hb) and total protein(TP) in the observation group were higher than those in the control group after treatment,while the endotoxin content and ratio of urine lactulose/mannitol were lower than those of the control group(t=-10.62,-9.16,8.91,11.63,P<0.05).The improvement rate of the observation group was higher than that of the control group,the incidence of adverse reactions(grade Ⅲ to Ⅳ)was lower than that of the control group(χ^2=3.90,4.61,P<0.05). Conclusion Jiawei Guipi decoction combined with FOLFOX4 regimen is effective in the treatment of advanced colorectal cancer with deficiency of qi and blood.It can improve its nutritional status and intestinal mucosal barrier,prevent tumor metastasis and adverse reactions of chemotherapy.

关 键 词：大肠癌 加味归脾汤 FOLFOX4方案 气血亏虚型 基质金属蛋白酶-9 肠黏膜屏障 营养状态 

分 类 号：R735.34[医药卫生—肿瘤]