探讨脾气虚证胃癌术后应用胃肠安方加减治疗的疗效及其对免疫功能的影响  

Curative effect of modified Weichang'an Decoction and in gastric cancer of spleen-qi deficiency syndrome its influences on immune function

作　　者：何萍[1] 蔡芸芸 沈克平[1] HE Ping;CAI Yun-yun;SHEN Ke-ping(Department of Oncology,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200030,China;Department of Integrated Chinese and Western Medicine for Hepatic-Biliary-Pancreatic Medicine,Minhang Branch,Cancer Hospital Affiliated to Fudan University,Shanghai 200240,China)

机构地区：[1]上海中医药大学附属龙华医院肿瘤科,上海200030 [2]复旦大学附属肿瘤医院闵行分院肝胆胰中西医结合科,上海200240

出　　处：《临床和实验医学杂志》2023年第10期1045-1049,共5页Journal of Clinical and Experimental Medicine

基　　金：上海市卫生和计划生育委员会科研课题计划项目(编号:20154Y0100)。

摘　　要：目的观察胃癌术后患者应用胃肠安方加减治疗的疗效及其对免疫功能的影响。方法前瞻性选取2020年8月至2022年7月在上海中医药大学附属龙华医院肿瘤科门诊确诊脾气虚证胃癌的82例患者为研究对象进行前瞻性研究,记录所有患者的临床资料。将82例患者1∶1分为对照组和联合组,对照组行术后常规治疗,联合组术后应用胃肠安方加减治疗,持续服药2周。治疗2周后,评估临床疗效和中医证候积分变化;流式细胞仪检测T淋巴细胞亚群水平;采用免疫比浊法检测患者血清IgG、lgA、IgM、补体C3、补体C4、C-反应蛋白(CRP)水平。结果治疗后,联合组患者胃脘痛、嗳气、纳呆、乏力等中医证候积分分别为(2.02±0.33)、(2.34±0.36)、(2.09±0.71)、(2.11±1.08)分,均明显低于对照组[(2.38±0.60)、(2.99±0.81)、(2.82±1.15)、(2.75±1.32)分],差异均有统计学意义(P<0.05)。治疗后,联合组脾气虚证患者血清CD4^(+)、CD4^(+)/CD8^(+)、IgA、IgG、补体C3和C4水平分别为(30.36±2.91)%、1.04±0.26、(1.78±0.16)g/L、(10.37±1.18)g/L、(1.17±0.11)g/L、(0.40±0.04)g/L,明显高于对照组[(24.82±2.55)%、0.73±0.18、(1.26±0.11)g/L、(8.84±1.02)g/L、(0.83±0.09)g/L、(0.33±0.05)g/L],CD8^(+)、IgM和CRP水平分别为(29.47±2.64)%、(0.97±0.10)g/L、(16.36±3.69)mg/L,均明显低于对照组[(34.13±2.97)%、(1.18±0.13)g/L、(21.82±5.33)mg/L],差异均有统计学意义(P<0.05)。两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论脾气虚证胃癌患者术后应用胃肠安方加减治疗具有一定临床疗效,能够改善炎症水平,调节免疫,安全性较高。Objective To observe the curative effect of modified Weichang'an Decoction and its influences on immune function after gastric cancer surgery.Methods A total of 82 patients with gastric cancer of spleen-qi deficiency syndrome confirmed in Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were prospectively enrolled as the research objects between August 2020 and July 2022.The clinical data of all patients were recorded.All patients were divided into control group and combination group,41 cases in each group.The control group was given routine treatment,while combination group was additionally treated with modified Weichang'an Decoction.After 2 weeks of treatment,clinical curative effect and changes in scores of TCM syndromes were evaluated.The levels of T lymphocyte subsets were detected by flow cytometry.The levels of serum IgG,lgA,IgM,C-reactive protein(CRP),complements C3 and C4 were detected by immunoturbidimetry.Results After treatment,the scores of traditional Chinese medicine syndromes such as epigastric pain,belching,dizziness,and fatigue in the combined group were(2.02±0.33),(2.34±0.36),(2.09±0.71),and(2.11±1.08)points,respectively,which were significantly lower than those in the control group(2.38±0.60),(2.99±0.81),(2.82±1.15),and(2.75±1.32)points,the differences were statistically significant(P<0.05).After treatment,levels of CD4^(+),CD4^(+)/CD8^(+),IgA,IgG,complements C3 and C4 in combination group were(30.36±2.91)%,1.04±0.26,(1.78±0.16)g/L,(10.37±1.18)g/L,(1.17±0.11)g/L and(0.40±0.04)g/L,which were significantly higher than those in control group[(24.82±2.55)%,0.73±0.18,(1.26±0.11)g/L,(8.84±1.02)g/L,(0.83±0.09)g/L,(0.33±0.05)g/L],while the levels of CD8^(+),IgM and CRP were(29.47±2.64)%,(0.97±0.10)g/L and(16.36±3.69)mg/L,which were significantly lower than those in control group[(34.13±2.97)%,(1.18±0.13)g/L,(21.82±5.33)mg/L],the differences were statistically significant(P<0.05).There was no statistically significant difference in incidence o

关 键 词：脾虚型胃癌 胃肠安方加减治疗 细胞免疫 体液免疫 

分 类 号：R273[医药卫生—中西医结合]