十全大补汤加减联合SOX化疗方案治疗气血两虚证胃癌晚期患者的临床疗效及对其血清CK18、CA-199和CA-724水平的影响  

Effect of Modified Shiquan Dabu Decoction Combined with SOX Chemotherapy Regimen in the Treatment of Advanced Gastric Cancer with Qi and Blood Deficiency Syndrome and Its Effect on Serum CK18,CA-199,and CA-724 Levels

作　　者：张颖 闫向勇 蔺彩娟 ZHANG Ying;YAN Xiang-yong;LIN Cai-juan(Department of Traditional Chinese Medicine,The 940th Hospital of Joint Logistics Support Force,Lanzhou Gansu 730050)

机构地区：[1]联勤保障部队第九四〇医院中医科,甘肃兰州730050

出　　处：《世界中西医结合杂志》2023年第8期1636-1640,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：甘肃省科技计划项目(20JR10RA001)。

摘　　要：目的探讨十全大补汤加减联合SOX[替吉奥(Seggio,S-1)+奥沙利铂(Oxaliplatin,OXA)]化疗方案治疗胃癌晚期气血两虚证的效果及对患者血清细胞角蛋白18(Cytokeratin 18,CK18)、糖链抗原(Carbohydrate antigen,CA)-199和CA-724水平的影响。方法选取2019年12月—2021年12月期间联勤保障部队第九四〇医院收治的150例胃癌晚期气血两虚证患者,采用随机数字表法分为对照组和观察组,每组各75例。对照组给予SOX化疗方案治疗,观察组在对照组基础上加服十全大补汤加减治疗。21 d为1个化疗周期,治疗3个周期后,观察比较两组患者临床疗效、不良反应,治疗前后免疫功能[T淋巴细胞亚群(CD4^(+)、CD8^(+))和自然杀伤细胞(Natural killer cell,NK)],血清CK18、CA-199和CA-724水平。结果治疗后两组患者客观有效率比较,差异无统计学意义(P>0.05);观察组疾病控制率72.00%(54/75)高于对照组48.00%(36/75),差异有统计学意义(P<0.05)。治疗后观察组CD4^(+)、CD4^(+)/CD8^(+)、NK均优于治疗前,差异有统计学意义(P<0.05),且观察组CD4^(+)、CD4^(+)/CD8^(+)、NK均优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CK18、CA-199和CA-724水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组均低于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组骨髓抑制、神经毒性、胃肠反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论十全大补汤加减联合SOX化疗方案治疗胃癌晚期气血两虚证可提高近期疗效,改善免疫功能,减少肿瘤负荷,降低血清CK18、CA-199和CA-724水平。Objective To investigate the therapeutic effect of modified Shiquan Dabu Decoction combined with SOX chemotherapy[S-1 + oxaliplatin(OXA)]on advanced gastric cancer patients with qi and blood deficiency syndrome to assess its impact on serum levels of cytokeratin 18(CK18),carbohydrate antigen(CA)-199,and CA-724.Methods A total of 150 patients diagnosed with advanced gastric cancer with qi and blood deficiency syndrome,admitted to the 940th Hospital of Joint Logistic Support Force between December 2019 and December 2021,were enrolled and randomly divided into a control group and an observation group according to a random number table,with 75 patients in each group.The control group received the SOX chemotherapy regimen,while the observation group received modified Shiquan Dabu Decoction in addition to the SOX regimen.One chemotherapy cycle was completed in 21 days,and after three cycles,the clinical efficacy,adverse reactions,immune function[T lymphocyte subsets CD4^(+),CD8^(+),and natural killer(NK)cells],and serum levels of CK18,CA-199,and CA-724 before and after treatment were compared between the two groups.Results The objective response rate after treatment showed no significant difference between the two groups(P>0.05).However,the disease control rate was significantly higher in the observation group(72.00%,54/75)than in the control group(48.00%,36/75)(P<0.05).After treatment,the CD4^(+),CD4^(+)/CD8^(+),and NK cell levels in the observation group were significantly improved compared with those before treatment(P<0.05).These levels were also significantly better in the observation group than in the control group(P<0.05).Serum levels of CK18,CA-199,and CA-724 in both groups decreased significantly after treatment compared to those before treatment(P<0.05).Furthermore,these levels were significantly lower in the observation group than in the control group(P<0.05).During the treatment period,the observation group had lower incidence rates of bone marrow suppression,neurotoxicity,and gastrointestinal reactions tha

关 键 词：十全大补汤 SOX化疗方案 胃癌晚期 气血两虚证 细胞角蛋白18 

分 类 号：R735.2[医药卫生—肿瘤]