和解剂联合西妥昔单抗注射液治疗肝胆湿热型晚期胆囊癌的疗效及对患者生存质量、化疗毒副反应的影响  

Therapeutic effect of reconciliation agent combined with cetuximab injection on advanced gallbladder cancer of liver and gallbladder damp heat type and its effect on quality of life and toxic and side effects of chemotherapy

作　　者：吴若晨[1] 徐文江[1] WU Ruo-chen;XU Wen-jiang(Baoji Hospital of Traditional Chinese Medicine,Shaanxi Province(Baoji,Shannxi,721001),China)

机构地区：[1]陕西省宝鸡市中医医院,陕西宝鸡721001

出　　处：《中西医结合肝病杂志》2022年第11期998-1002,1011,共6页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨和解剂联合西妥昔单抗注射液治疗肝胆湿热型晚期胆囊癌的疗效及对患者生存质量、化疗毒副反应的影响。方法:选取2018年1月至2020年1月我院收治的153例晚期胆囊癌患者,随机数字表法分为3组,每组51例,3组患者均给予吉西他滨^(+)奥沙利铂化疗联合靶向治疗。在此基础上,西妥昔单抗组患者给予西妥昔单抗注射液,和解剂组患者给予和解剂治疗,联合组患者给予和解剂联合西妥昔单抗注射液。比较3组患者临床疗效及治疗前、治疗1个和2个周期后中医证候积分、肿瘤标志物[糖类抗原19-9(CA19-9)、糖类抗原242(CA242)、癌胚抗原(CEA)、糖类抗原125(CA125)]、T细胞亚群(CD3^(+)、CD4^(+)/CD8^(+))、免疫球蛋白(Ig)A、IgM、IgG、Karnofsky功能状态(KPS)评分、微小RNA-187(miR-187)、微小RNA-143(miR-143)、毒副反应。结果:联合组、西妥昔单抗组患者疾病控制率(78.43%、76.47%)高于和解剂组(52.94%)(P<0.05);联合组患者治疗1个、2个周期后胁肋胀痛、腹胀厌食、灼热、口苦中医证候积分低于西妥昔单抗组、和解剂组(P<0.05);联合组患者治疗1个、2个周期后CA19-9、CA242、CEA、CA125低于西妥昔单抗组、和解剂组,且西妥昔单抗组低于和解剂组(P<0.05);联合组、和解剂组患者治疗2个周期后CD3^(+)、CD4^(+)/CD8^(+)、IgA、IgM、IgG、KPS评分高于西妥昔单抗组(P<0.05);联合组患者治疗1个、2个周期后miR-143高于西妥昔单抗组、和解剂组,且西妥昔单抗组高于和解剂组(P<0.05);联合组患者治疗1个、2个周期后miR-187低于西妥昔单抗组、和解剂组,且西妥昔单抗组低于和解剂组(P<0.05);联合组患者白细胞下降(7.84%)、血小板下降发生率(7.84%)与和解剂组白细胞下降(5.88%)、血小板下降发生率(5.88%)低于西妥昔单抗组(27.45%、25.49%)(P<0.05)。结论:和解剂联合西妥昔单抗注射液治疗肝胆湿热型晚期胆囊癌,能有效缓解患者临床症状,增Objective:To investigate the efficacy of reconciliation agent combined with cetuximab injection in the treatment of advanced gallbladder cancer of liver and gallbladder damp heat type and its effect on the the quality of life and toxic and side effects of chemotherapy.Methods:A total of 102 patients with advanced gallbladder cancer treated in our hospital from January 2018 to January 2020 was randomly divided into three groups with 51 cases in each group.All three groups were given gemcitabine and oxaliplatin chemotherapy combined with targeted therapy.On this basis,the cetuximab group was given cetuximab injection,the reconciliation group was given a reconciliation treatment,and the combined group was given reconciliation agent combined with cetuximab injection.The curative effects,TCM syndrome scores,tumor markers[carbohydrate antigen 19-9(CA19-9),carbohydrate antigen 242(CA242),carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)],T cell subsets(CD3^(+),CD4^(+)/CD8^(+)),immunoglobulin(Ig)a,IgM,IgG,Karnofsky functional status(KPS)scores before and after treatment were compared Microrna-187(miR-187),microrna-143(miR-143),toxic and side effects.Results:The disease control rate of the combined group and cetuximab group(78.43%,76.47%)was higher than that of the reconciliation group(52.94%)(P<0.05).After one or two cycles of treatment,the TCM syndrome scores of hypochondriac pain,abdominal distension,anorexia,burning,and bitter mouth in the combined group were lower than those in the cetuximab group and reconciliation group(P<0.05).After one and two cycles of treatment,CA19-9,CA242,CEA,and CA125 in the combined group were lower than those in the cetuximab group and the reconciliation group,and those in the cetuximab group were lower than those in reconciliation group(P<0.05).After two cycles of treatment,the scores of CD3^(+),CD4^(+)/CD8^(+),IgA,IgM,IgG,and KPS in the combination group and the reconciliation group were higher than those in the cetuximab group(P<0.05).After one and two cycles of treatment,mi

关 键 词：胆囊癌 和解剂 西妥昔单抗注射液 生存质量 化疗毒副反应 

分 类 号：R735.8[医药卫生—肿瘤]