黄芪建中汤加减联合甲磺酸阿帕替尼对晚期胃癌患者临床疗效及VEGF、Survivin、FGF表达的影响  

Effect of modified Huangqi Jianzhong decoction combined with apatinib mesylate on the treatment and expression of VEGF,Survivin,FGF in patients with advanced gastric cancer

作　　者：陶肖馨[1] 朱利群[1] 朱云涛[1] 滕钰浩[2] TAO Xiao-xin;ZHU Li-qun;ZHU Yun-tao;TENG Yu-hao(Department of Oncology,Liyang People's Hospital,213300Liyang,Jiangsu China;Department of Oncology,Jiangsu Province Hospital of Chinese Medicine,210029Nanjing,Jiangsu China)

机构地区：[1]溧阳市人民医院肿瘤科,江苏溧阳213300 [2]江苏省中医院肿瘤科,江苏南京210029

出　　处：《临床消化病杂志》2021年第3期196-202,共7页Chinese Journal of Clinical Gastroenterology

基　　金：江苏省基础研究计划(自然科学基金,No:BK20181097)。

摘　　要：[目的]探讨黄芪建中汤加减联合甲磺酸阿帕替尼对晚期胃癌患者临床疗效及血管内皮生长因子(vascular endothelial growth factor,VEGF),成纤维细胞生长因子(fibroblast growth factor,FGF)及细胞凋亡抑制蛋白存活素(Survivin)表达的影响。[方法]选择符合诊断标准的晚期胃癌患者60例为研究对象,采用SPSS软件随机生成法将患者分为观察组和对照组,每组30例。对照组给予甲磺酸阿帕替尼,观察组在对照组治疗基础上加用黄芪建中汤加减治疗。比较2组患者疗效评价、KPS评分,检测治疗前后患者血清炎症因子C反应蛋白(hs-CRP)、粒细胞集落刺激因子(G-G-CSF)、肿瘤坏死因子-α(TNF-α)水平变化,检测血清肿瘤标志物癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原72-4(CA 72-4)水平变化及外周血中VEGF,FGF和Survivin水平变化,并观察不良反应出现情况及生存质量改善率。[结果]治疗后,观察组、对照组总有效率分别为83.33%、60.00%,2组比较差异有统计学意义(χ~2=11.9730,P=0.020)。观察组、对照组治疗后营养状况与生活质量评分均较治疗前显著升高;观察组评分高于对照组,2组比较差异有统计学意义(P<0.05)。治疗后观察组及对照组患者血清炎症因子hs-CRP、G-G-CSF及TNF-α水平均显著改变,且观察组血清炎症指标低于对照组,2组比较差异有统计学意义(P<0.05);观察组与对照组治疗后血清肿瘤标志物CEA、CA19-9、CA72-4水平均显著降低,治疗前后比较差异有统计学意义(P<0.05);且观察组血清肿瘤标志物下降尤为明显(P<0.05);观察组与对照组治疗后血清VEGF、Survivin、FGF水平均降低,且观察组血清VEGF、Survivin、FGF水平降低更显著,2组比较差异有统计学意义(P<0.05);观察组较对照组不良反应显著减少,生存质量显著改善(P<0.05)。[结论]黄芪建中汤加减联合甲磺酸阿帕替尼对胃癌患者具有良好的临床疗效,其可提高KPS评分,改善患者体内[Objective]To investigate the clinical effect of modified Huangqi Jianzhong decoction combined with apatinib mesylate on the treatment and expression of vascular endothelial growth factor,(VEGF),Survivin,fibroblast growth factor(FGF)in patients with advanced gastric cancer.[Methods]From December 2016to December 2018,patients with advanced gastric cancer who were admitted to our hospital were selected as the subjects of the study.The patients were divided into the control group and the observation group by using the SPSS software random generation method with 30cases for each group.The control group was given apatinib mesylate,and the observation group was treated with apatinib mesylate and Huangqi Jianzhong decoction at the same time.Efficacy,kps score,serum inflammatory factor hs-CRP,G-CSF,TNF-αwere evaluated before and after treatment.The changes of serum tumor marker carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199,CA72-4and the levels of VEGF,FGF and Survivin in peripheral blood were detected,and the occurrence of toxic and secondary reactions and the improvement rate of survival quality were observed.[Results]After treatment,the total effective rate was 83.33%in the observation group and 60.00%in the control group(χ2=11.9730,P<0.020).After treatment,the scores of nutritional status and quality of life in the control group and the observation group were significantly increased,and the scores in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the levels of serum inflammatory factors hs-CRP,G-CSF and TNF-αin the observation group and the control group were significantly changed,and the serum inflammatory indexes in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of serum tumor markers CEA,CA19-9,CA72-4in the control group and the observation group were significantly lower than those in the observation group(P<0.05),and the serum tumor markers in the observation group were significantly lower t

关 键 词：胃癌 黄芪建中汤 甲磺酸阿帕替尼 

分 类 号：R735.2[医药卫生—肿瘤]