健脾抗癌汤加减对晚期胃癌化疗患者免疫功能、血清基质金属蛋白酶-2及血管内皮生长因子的影响  

Influence of Modified Jianpi Kangai Decoction on Immune Function and Serum MMP-2,and VEGF in Patients with Advanced Gastric Cancer

作　　者：贾媛媛 雍红梅[1] JIA Yuan-yuan;YONG Hong-mei(Department of Integrative Medicine Oncology,The Second People's Hospital of Huai'an,Huai'an Jiangsu 223001)

机构地区：[1]淮安市第二人民医院肿瘤内科,江苏淮安223001

出　　处：《世界中西医结合杂志》2021年第11期2134-2139,2143,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：江苏省青年医学人才计划(2019M651813)。

摘　　要：目的探讨健脾抗癌汤加减联合化疗对晚期胃癌患者免疫功能、血清基质金属蛋白酶-2(Matrix metalloproteinase 2,MMP-2)及血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平的影响。方法选取2018年6月—2019年10月期间淮安市第二人民医院中西医结合肿瘤科收治的晚期胃癌患者120例,采用随机数字表法按照1∶1比例分为对照组与观察组,每组各60例。对照组给予单纯化疗,观察组在对照组基础上加用健脾抗癌汤加减治疗。3个疗程后,观察两组患者肿瘤近期疗效,治疗前后行中医证候、简明疲劳量表(Brief Fatigue Inventory,BFI)、Karnofsky(KPS)评分和欧洲癌症治疗与研究组织(EORTC)的生活质量问卷(QOL-C30)评分,检测外周血T淋巴细胞亚群(CD4^(+)、CD8^(+))、肿瘤标志物[癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原125(Carbohydrate antigen 125,CA125)、糖类抗原199(Carbohydrate antigen199,CA199)、糖类抗原72-4(Cancen Antigen 72-4,CA72-4)]、MMP-2及VEGF水平。结果治疗后,两组的疾病控制率(CBR)比较,差异无统计学意义(P>0.05),但观察组的临床总有效率(ORR)及中医证候疗效总有效率明显高于对照组(P<0.05)。治疗后,观察组的中医证候积分、BFI评分均低于对照组,KPS、QLQ-C30评分均高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组的CD4^(+)、CD4^(+)/CD8^(+)、NK均高于对照组,血清CEA、CA125、CA199、CA72-4、MMP-2及VEGF水平均低于对照组(P<0.05)。观察组骨髓抑制、神经毒性及胃肠反应率均低于对照组(P<0.05)。结论健脾抗癌汤加减治疗晚期胃癌能够提高免疫功能,下调肿瘤标志物及MMP-2、VEGF表达,改善近期疗效及生活质量。Objective To explore the influence of modified Jianpi Kangai Decoction on immune function and serum matrix metalloproteinase-2(MMP-2)and vascular endothelial growth factor(VEGF)in patients with advanced gastric cancer.Methods From June 2018 to October 2019,120 patients with advanced gastric cancer admitted to the Department of Integrated Traditional Chinese and Western Medicine oncology of Huai'an Second People's Hospital were selected.The random number table method was used to divide the patients into the control group and the observation group at a ratio of 1∶1,60 cases in each group.The control group received chemotherapy alone,the observation group received modified Jianpi Kangai Decoction treatment on the basis of control group.The short-term curative effects of the two groups of tumors were compared.The TCM syndrome score,Brief Fatigue Inventory(BFI)score,Karn of sky(KPS)score and EORTC Quality of Life Questionnaire(QOL-C30)score were performed before and after treatment.The peripheral blood T lymphocyte subsets,tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),carbohydrate antigen 72-4(CA72-4)],MMP-2 and VEGF were detected.Results After treatment,there was no statistically significant difference in disease control rate(CBR)between the two groups(P>0.05),but the total clinical effective rate(ORR)and the total effective rate of TCM syndrome curative effect of the observation group were significantly higher than those of the control group(P<0.05).After treatment,the scores of TCM syndromes and BFI of the observation group were lower than those of the control group,and the scores of KPS and QLQ-C30 were higher than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the observation group's CD4^(+),CD4^(+)/CD8^(+),NK were higher than those of the control group,and the serum levels of CEA,CA125,CA199,CA72-4,MMP-2 and VEGF were lower than those of the control group(P<0.05).The rates of bone marrow suppres

关 键 词：胃癌 晚期 健脾抗癌汤 免疫功能 肿瘤标志物 基质金属蛋白酶-2 血管内皮生长因子 

分 类 号：R735.2[医药卫生—肿瘤]