自拟益气养阴方对胃癌晚期化疗患者免疫功能、肿瘤标志物及化疗毒副作用的影响  

Effect of self-made Yiqi Yangyin Decoction on immune function,tumor markers and toxic and side effects of chemotherapy in patients with advanced gastric cancer chemotherapy

作　　者：时广伟 景文冬 金星宇 郑晓霆 吴生保 Shi Guangwei;Jing Wendong;Jin Xingyu;Zheng Xiaoting;Wu Shengbao(Department of Oncology,Tianchang Hospital of Traditional Chinese Medicine,Tianchang 239300,China)

机构地区：[1]安徽省天长市中医院肿瘤科,天长239300

出　　处：《国际中医中药杂志》2022年第2期154-158,共5页International Journal of Traditional Chinese Medicine

摘　　要：目的探讨自拟益气养阴方对胃癌晚期化疗患者免疫功能、血清肿瘤标志物及化疗毒副作用的影响。方法将符合入选标准的2018年12月-2020年12月本院胃癌晚期患者88例,采用随机数字表法分为2组,每组44例。对照组采用替吉奥+奥沙利铂化疗,治疗2周,间隔1周为1个化疗周期,连续4个化疗周期;观察组在对照组基础上服用自拟益气养阴方,3周为1个疗程,连续4个疗程。分别于治疗前后进行中医症状评分,采用免疫比浊法测定IgG、IgA和IgM水平,ELISA法检测癌胚抗原(carcinoembryonic antigen,CEA)和癌抗原125(cancer antigen 125,CA125)水平,记录并评估治疗期间的胃肠道反应、血小板减少、贫血、白细胞降低、神经毒性反应,评价临床疗效。结果观察组总有效率为81.8%(36/44)、对照组为61.4%(27/44),2组比较差异有统计学意义(χ^(2)=4.53,P<0.05)。治疗后,观察组胃痛胃胀、食少纳呆、气短乏力、精神萎靡评分均低于对照组(t值分别为17.28、11.91、5.02、5.65,P值均<0.001),血清IgG[(9.39±0.46)g/L比(8.54±0.23)g/L,t=10.96]、IgA[(1.35±0.42)g/L比(1.07±0.15)g/L,t=6.90]和IgM[(0.92±0.09)g/L比(0.78±0.10)g/L,t=4.17]水平均高于对照组(P<0.01);血清CEA[(9.07±1.01)μg/L比(14.89±2.13)μg/L,t=16.38]、CA125[(24.87±4.68)kU/L比(30.75±5.33)kU/L,t=5.50]水平均低于对照组(P<0.01)。治疗期间,观察组胃肠道反应、血小板减少、贫血、白细胞下降、神经毒性的毒副作用程度低于对照组(Z值分别为18.52、2.54、3.12、3.84、2.34,P<0.05)。结论自拟益气养阴方可明显改善晚期胃癌化疗患者中医症状,提高机体免疫力,降低血清肿瘤标志物水平,减轻化疗毒副作用。Objective To explore the effect of self-made Yiqi Yangyin Decoction on immune function,serum tumor markers and toxic and side effects of chemotherapy in patients with advanced gastric cancer chemotherapy.Methods A total of 88 patients with advanced gastric cancer who met the inclusion criteria in the hospital between December 2018 and December 2020 were divided into two groups according to the random number table method,with 44 in each group.The control group was treated with chemotherapy,and the observation group was given self-made Yiqi Yangyin Decoction on the basis of the control group.The two groups were treated for 4 consecutive cycles with 3 weeks as 1 cycle.The Traditional Chinese Medicine(TCM)symptoms were scored before and after treatment,and the levels of IgG,IgA and IgM were detected by immunoturbidimetry.The levels of carcinoembryonic antigen(CEA)and cancer antigen 125(CA125)were detected by ELISA.The gastrointestinal reactions,thrombocytopenia,anemia,leukopenia and neurotoxicity were recorded and evaluated during treatment,and the clinical efficacy was assessed.Results The total effective rate was 81.8%(36/44)in observation group and 61.4%(27/44)in control group(χ^(2)=4.53,P<0.05).After treatment,the scores of stomachache and gastric distension,poor appetite,shortness of breath,and drooping spirit in observation group were significantly lower than those in the control group(t=17.28,11.91,5.02,5.65,all Ps<0.001)while the levels of serum IgG[(9.39±0.46)g/L vs.(8.54±0.23)g/L,t=10.96],IgA[(1.35±0.42)g/L vs.(1.07±0.15)g/L,t=6.90]and IgM[(0.92±0.09)g/L vs.(0.78±0.10)g/L,t=4.17]were significantly higher than those in the control group(P<0.01).The levels of serum CEA[(9.07±1.01)μg/L vs.(14.89±2.13)μg/L,t=16.38]and CA125[(24.87±4.68)kU/L vs.(30.75±5.33)kU/L,t=5.50]were significantly lower than those in the control group(P<0.01).During treatment,the toxic and side effects of gastrointestinal reactions,thrombocytopenia,anemia,leukopenia and neurotoxicity were significantly lower in the observation

关 键 词：胃肿瘤 化学疗法 辅助 益气养阴方 药物相关副作用及不良反应 免疫功能 肿瘤标志物 

分 类 号：R273[医药卫生—中西医结合]