健脾祛瘀方择时用药联合化疗治疗脾虚瘀毒型中晚期结直肠癌的临床疗效及对T淋巴细胞亚群的影响  

Clinical efficacy of timing medication of Jianpi Quyu Formula combined with chemotherapy for advanced colorectal cancer of spleen deficiency and stasis toxin type and how to impact on cellular immune function

作　　者：邹永红 徐娇 李静[2] 陈大光 ZOU Yonghong;XU Jiao;LI Jing;CHEN Daguang(Department of Gastrointestinal Surgery,Shandong Provincial Third Hospital,Jinan,Shandong 250000;Department of Emergency,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250000)

机构地区：[1]山东省立第三医院胃肠外科,山东济南250000 [2]山东中医药大学附属医院急诊科,山东济南250000

出　　处：《河北中医》2022年第6期968-972,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察健脾祛瘀方择时用药联合化疗治疗脾虚瘀毒型中晚期结直肠癌(CRC)的临床疗效及对T淋巴细胞亚群的影响。方法将90例脾虚瘀毒型中晚期CRC患者随机分为2组,对照组45例予化疗治疗,治疗组45例在对照组治疗基础上加用健脾祛瘀方择时用药治疗。2组均治疗6个月。比较2组临床疗效;比较2组治疗前后中医证候评分变化;比较2组治疗前后T淋巴细胞亚群变化;比较2组毒副反应发生情况。结果治疗后治疗组缓解率27.27%(12/44)、控制率79.55%(35/44),对照组缓解率19.51%(8/41)、控制率58.54%(24/41),2组缓解率、控制率比较差异均有统计学意义(P<0.05),治疗组疗效优于对照组。2组治疗后腹痛腹胀、神疲乏力、便中带血、食少纳呆、恶心呕吐、腹有肿块、大便稀溏或干结评分及总评分均较本组治疗前降低(P<0.05),且治疗组治疗后腹痛腹胀、神疲乏力、便中带血、食少纳呆、恶心呕吐评分及总评分均低于对照组(P<0.05)。治疗组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较本组治疗前升(P<0.05),CD8^(+)较本组治疗前降低(P<0.05),对照组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均较本组治疗前降低,CD8^(+)较本组治疗前升高(P<0.05);治疗组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05),CD8^(+)低于对照组(P<0.05)。2组白细胞计数(WBC)减少、血小板计数(PLT)减少、血红蛋白(Hb)减少、转氨酶升高、恶心呕吐、腹泻、神经毒性发生率比较差异均有统计学意义(P<0.05),治疗组均低于对照组。结论健脾祛瘀方择时用药联合化疗治疗脾虚瘀毒型中晚期CRC,能提高疾病控制率,改善患者临床症状,减少化疗所致毒副反应发生,可能与改善细胞免疫功能有关。Objective To observe the clinical efficacy of timing medication of Jianpi Quyu Formula combined with chemotherapy for advanced colorectal cancer(CRC)of spleen deficiency and stasis toxin type and how to impact on cellular immune function.Methods Totally 90 patients with advanced CRC(spleen deficiency and stasis toxin type)were randomly assigned into the treatment group(n=45)and the control group(n=45).All patients were managed by chemotherapy,and those in the treatment group were additionally treated with timing medication of Jianpi Quyu Formula.A 6-month treatment was performed to compare traditional Chinese medicine(TCM)syndrome scores,cellular immune function indexes,toxicity;the curative effect was assessed.Results The remission rate and control rate in the treatment group were better than those in the control group(27.27%[12/44]vs 19.51%[8/41],79.55%[35/44]vs 58.54%[24/41],respectively),and with statistically significant difference(P<0.05).After treatment,TCM symptom(abdominal pain,abdominal distension,fatigue,bloody stool,anorexia,nausea and vomiting,abdominal mass,loose stool or dry knot)scores in groups were decreased(P<0.05),TCM symptom(abdominal pain,abdominal distension,fatigue,bloody stool,anorexia,nausea and vomiting)were decreased in the treatment group in comparison with the control group(P<0.05);CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in the treatment group were increased,which in the control group were decreased(all P<0.05);CD8^(+)in the treatment group was decreased,which in the control group was increased(all P<0.05);higher CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),and lower CD8^(+)were detected in the treatment group than those in the control group(all P<0.05);reduction rate of white blood cell count(WBC),platelet count(PLT)and hemoglobin(Hb),elevated rate of transaminase,rate of nausea and vomiting,diarrhea rate,neurotoxicity rate in the treatment group were lower than those in the control group,and with statistically significant difference(P<0.05).Conclusion For patients with advanced CRC(spleen deficiency

关 键 词：结肠肿瘤 直肠肿瘤 辨证分型 中西医结合疗法 

分 类 号：R735.370.58[医药卫生—肿瘤] R735.370.58[医药卫生—临床医学]