益气健脾汤联合腹腔热灌注化疗治疗结直肠癌腹膜转移的临床研究  

Clinical study of Yiqi Jianpi Decoction combined with hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal metastasis of colorectal cancer

作　　者：钟育波[1] 罗兵 彭树灵[1] 邓淑平 邱磊[1] 余思 林梓阳 胡旭东[1] 魏君[1] 张少锐[1] Zhong Yubo;Luo Bing;Peng Shuling;Deng Shuping;Qiu Lei;Yu Si;Lin Ziyang;Hu Xudong;Wei Jun;Zhang Shaorui(不详;Department of Gastroenterology,the Second People′s Hospital of Foshan,Guangdong 528000,China)

机构地区：[1]广东省佛山市第二人民医院胃肠外科,528000 [2]广东省佛山市禅城区人民医院大内科

出　　处：《山西医药杂志》2022年第1期3-8,共6页Shanxi Medical Journal

基　　金：广东省佛山市医学类科技攻关项目(2018AB002811);广东省中医药局科研课题资助项目(20180312230354)。

摘　　要：目的探讨益气健脾汤联合腹腔热灌注化疗治疗结直肠癌腹膜转移的安全性和有效性。方法采用前瞻性的队列研究方法,选取2018年1月至2020年11月广东省佛山市第二人民医院胃肠外科收治80例结直肠癌腹膜转移患者,随机分为治疗组和对照组,每组40例。对照组常规采用腹腔热灌注化疗+术后辅助化疗,治疗组在对照组的基础上联合益气健脾汤治疗。使用t检验,χ^(2)检验比较2组术后早期临床结局、术后并发症、化疗相关不良反应、抑郁评分以及术后中性粒细胞/淋巴细胞比值(NLR)和肿瘤标志等情况。结果与对照组比较,治疗组患者术中出血量、手术时间、腹膜种植指数(PCI)、肿瘤细胞减灭满意度(CC)评级、术中是否输血等差异无统计学意义;而术后首次肛门排气时间[(3.0±1.5)d与(4.0±1.6)d]、首次进食流质时间提前[(3.0±1.5)d与(4.0±1.6)d],术后发生吻合口漏[2.5%(1/40)与5%(2/40)]等并发症的风险较低,术后3 d患者的NLR显著降低,化疗期间不良反应程度更轻,术后抑郁程度明显减轻[(52±8)分与(57±10分)](均P<0.05)。结论益气健脾汤联合腹腔热灌注化疗治疗结直肠癌腹膜转移,可明显改善患者术后早期临床结局,减少化疗相关不良反应,提高机体的抗肿瘤免疫,减轻肿瘤伴发抑郁,值得进一步研究。Objective To investigate the safety and efficacy of Yiqi Jianpi Decoction combined with intraperitoneal hyperthermic infusion chemotherapy in the treatment of peritoneal metastasis of colorectal cancer.Methods The prospective cohort study method was conducted.Eighty patients with peritoneal metastasis of colorectal cancer admitted to the Gastrointestinal Surgery Department of Foshan Second People′s Hospital from January 2018 to November 2020 were randomly divided into treatment group and control group,with 40 patients in each group.The patients in control group were routinely treated with intraperitoneal hyperthermic perfusion chemotherapy plus postoperative adjuvant chemotherapy,while the ones in treatment group were treated with Yiqi Jianpi Decoction on the basis of the control group.The early postoperative clinical outcome,postoperative complications,chemotherapy-related adverse reactions,depression score,postoperative neutrophil/lymphocyte ratio(NLR)and tumor markers were compared in the two groups by t test and chi-square test.Results Compared with the control group,there were no significant differences in intraoperative blood loss,operative time,peritoneal carcinomatosis index(PCI),tumor cell extinction satisfaction(CC)ratings,intraoperative blood transfusion or not in the treatment group(P>0.05).However,the time of the first postoperative anal exhaust[(3.0±1.5)d vs(4.0±1.6)d]and the time of the first fluid intake[(3.0±1.5)d vs(4.0±1.6)d]was earlier,and the risk of postoperative complications such as anastomotic leakage[2.5%(1/40)vs 5%(2/40)],the NLR of patients three days after surgery was significantly reduced,the degree of adverse reactions during chemotherapy was lighter,and the degree of postoperative depression was significantly decreased in the treatment group[(52±8)vs(57±10)](P<0.05).Conclusion Yiqi Jianpi Decoction combined with peritoneal heat perfusion chemotherapy in the treatment of peritoneal metastasis of colorectal cancer can significantly improve the early postoperative clinical out

关 键 词：化学疗法 肿瘤 局部灌注 结直肠肿瘤 抑郁 益气健脾汤 

分 类 号：R735.34[医药卫生—肿瘤]