消痰化瘀通噎颗粒配合通道开结丸联合化疗治疗食管癌的临床疗效研究  

Clinical Study on the Combination of Xiaotan Huayu Tongyi Granules,Channel Kaijie Pills and Chemotherapy in the Treatment of Esophageal Cancer

作　　者：李吉磊 李洪霖 许彦超 刘亚南 陈梦利 邵帅 马纯政[2] LI Jilei;LI Honglin;XU Yanchao;LIU Yanan;CHEN Mengli;SHAO Shuai;MA Chunzheng(Capital Medical University,Beijing 100010,China;Henan Hospital of Traditional Chinese Medicine,Zhengzhou 450002,China;Henan University of Chinese Medicine,Zhengzhou 450046,China)

机构地区：[1]首都医科大学,北京市100010 [2]河南省中医院,河南省郑州市450002 [3]河南中医药大学,河南省郑州市450046

出　　处：《中国全科医学》2023年第30期3759-3764,共6页Chinese General Practice

基　　金：第二批国家中医临床研究基地专项课题(2019JDZX008)。

摘　　要：背景食管癌病因复杂,愈后较差,严重威胁患者的生命健康,中西医结合的个体化治疗具有一定的优势。目的观察消痰化瘀通噎颗粒配合通道开结丸联合CF方案(氟尿嘧啶+顺铂)治疗Ⅲ~Ⅳ期痰瘀互结型食管鳞癌的临床疗效。方法选取2020年2月—2021年2月在河南省中医院、安阳市肿瘤医院及河南省肿瘤医院诊治的Ⅲ~Ⅳ期辨证为痰瘀互结型食管鳞癌患者99例为研究对象。将患者随机分为对照组、治疗Ⅰ组、治疗Ⅱ组,每组均为33例。对照组给予CF方案治疗,治疗Ⅰ组给予消痰化瘀通噎颗粒联合CF方案,治疗Ⅱ组给予消痰化瘀通噎颗粒配合通道开结丸联合CF方案,21 d为1个疗程,共4个疗程。观察三组患者在中医症候积分、生活质量评分、功能状态(KPS)评分、病灶缓解率、癌胚抗原(CEA)、鳞状细胞癌抗原(SCC)及毒副作用方面的差异性。结果三组患者性别、年龄、体质量、肿瘤分期比较,差异无统计学意义(P>0.05)。与治疗前相比,三组患者治疗后胸骨后疼痛、恶心呕吐、咯吐黏液、呕吐物评分及总积分均降低,对照组和治疗Ⅱ组吞咽困难、食少、大便干燥评分均降低(P<0.05);与治疗前相比,三组患者治疗后生活质量评分均升高,KPS评分均升高,CEA、SCC水平均降低(P<0.05)。治疗后,治疗Ⅱ组吞咽困难、胸骨后疼痛、恶心呕吐、呕吐物、食少、大便干燥评分及总积分低于对照组和治疗Ⅰ组,咯吐黏液评分低于对照组(P<0.05);治疗后,两治疗组生活质量评分、KPS评分均高于对照组,治疗Ⅱ组患者KPS评分高于治疗Ⅰ组,治疗Ⅱ组CEA、SCC水平低于治疗Ⅰ组与对照组(P<0.05)。三组患者治疗后病灶缓解率、各项毒副作用发生率比较,差异无统计学意义(P>0.05)。结论消痰化瘀通噎颗粒配合通道开结丸联合CF方案治疗Ⅲ~Ⅳ期痰瘀互结型食管鳞癌能改善患者临床症状,降低肿瘤标志物水平,提升患者生存�Background Esophageal cancer threatens the life and health of patients due to its complex etiology and poor prognosis,and individualized combination treatment of traditional Chinese medicine and western medicine has certain advantages.Objective To observe the clinical efficacy of the combination of Xiaotan Huayu Tongyi Granules,Channel Kaijie Pills and CF regimen(fluorouracil+cisplatin)on the treatment of stageⅢ-Ⅳphlegm-stasis interjunction esophageal squamous cell carcinoma.Methods A total of 99 patients with phlegm-stasis interjunction type esophageal squamous cell carcinoma diagnosed and treated in Henan Hospital of Traditional Chinese Medicine,Anyang Cancer Hospital and Henan Cancer Hospital from February 2020 to February 2021 were selected as the study objects and randomly divided into the control group,treatment groupⅠand treatment groupⅡ,with 33 cases in each group.The control group was treated with CF regimen,the treatment groupⅠwas treated with Xiaotan Huayu Tongyi Granules combined with CF regimen,and the treatment groupⅡwas treated with the combination of Xiaotan Huayu Tongyi Granules,Channel Kaijie Pills and CF regimen.A total of 4 courses of chemotherapy were administered with 21 days as a course.The differences in TCM syndrome score,quality of life score,Karnofsky Performance Status(KPS)score,lesion remission rate,carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC)and toxic side effects among the three groups were observed.Results There was no significant difference in gender,age,body mass and tumor staging among the three groups(P>0.05).Compared with pre-treatment,retrosternal chest pain,nausea and vomiting,mucus and vomit,vomitus scores and total score were reduced in the three groups,dysphagia,oligophagia and dry stool scores were reduced in the control group and treatment groupⅡafter treatment(P<0.05);quality of life score and KPS score were increased,CEA and SCC levels were reduced in the three groups after treatment(P<0.05).After treatment,dysphagia,retrosternal ch

关 键 词：食管肿瘤 食管癌 痰瘀互结 消痰化瘀通噎颗粒 通道开结丸 CF方案 癌胚抗原 

分 类 号：R735.1[医药卫生—肿瘤]