扶正培本祛邪汤辅助调强放疗治疗中晚期胃癌患者的临床观察  

Clinical Efficacy of Fuzheng Peiben Quxie Decoction Combined with Intensity-modulated Radiotherapy in the Treatment of Intermediate and Advanced Gastric Cancer

作　　者：凤元芳 梁惠 FENG Yuan-fang;LIANG Hui(Radiotherapy Department,Traditional Chinese Hospital of LuAn,Lu′an Anhui 237000)

机构地区：[1]安徽省六安市中医院肿瘤放疗科,安徽六安237000

出　　处：《世界中西医结合杂志》2023年第9期1847-1852,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：国家中医药管理局建设科研项目(JDZX2015074)。

摘　　要：目的探讨扶正培本祛邪汤辅助调强放疗治疗中晚期胃癌的临床疗效。方法选取2019年1月—2021年6月期间六安市中医院肿瘤放疗科收治的98例中晚期胃癌患者,按随机数字表法分为对照组和治疗组,每组各49例。对照组给予常规调强放疗,治疗组在常规调强放疗基础上配合扶正培本祛邪汤治疗。治疗4周后,观察比较两组患者临床疗效,生存期限[中位无进展生存期(Progression-Free Survival,PFS)、中位生存期(Overall Survival,OS)、12个月生存率],治疗前后血清肿瘤标志物[癌胚抗原(Carcinoembryonic antigen,CEA)、糖链抗原19-9(Carbohydrate antigen 19-9,CA19-9)、巨噬细胞炎性蛋白3α(Macrophage Inflammatory Protein 3α,CCL20)]、免疫功能[外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))]、促血管生成因子[血管内皮生长因子(Vascular endothelial growth factor,VEGF)、转移生长因子β1(Transfer growth factorβ1,TGF-β1)、缺氧诱导因子1α(Hypoxia-inducing factor 1α,HIF-1α)]、炎症因子[肿瘤坏死因子-α(Tumor necrosis factor-alpha,TNF-α)、白细胞介素-4(Interleukin-4,IL-4)、白细胞介素-6(Interleukin-6,IL-6)]。结果治疗后治疗组总有效率57.14%(28/49)高于对照组39.58%(19/48),疾病控制率87.76%(43/49)高于对照组68.75%(33/48),差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、CA19-9、CCL20水平较治疗前下降,差异有统计学意义(P<0.05);且治疗组血清CEA、CA19-9、CCL20水平低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前升高,对照组外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较治疗前下降,差异均有统计学意义(P<0.05);且治疗组外周血CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清VEGF、TGF-β1、HIF-1α水平均较治疗前下降,差异有统计学意义(P<0.05);且治疗组血清VEGF、TGF-β1、HObjective To investigate the clinical efficacy of Fuzheng Peiben Quxie Decoction(FZPBQX)as an adjuvant therapy in combination with intensity-modulated radiotherapy in the treatment of intermediate and advanced gas⁃tric cancer.Methods A total of 98 patients with intermediate and advanced gastric cancer admitted to the Radiotherapy Department of Traditional Chinese Hospital of LuAn from January 2019 to June 2021 were enrolled and randomly divided into a control group and a treatment group according to a random number table,with 49 patients in each group.The control group received conventional intensity-modulated radiotherapy,while the treatment group received FZPBQX in addition to conventional intensity-modulated radiotherapy.After 4 weeks of treatment,the clinical efficacy,survival outcomes[median progression-free survival(PFS),median overall survival(OS),and 12-month survival rate],serum tumor markers[car⁃cinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9),and macrophage inflammatory protein 3α(CCL20)],immune function[peripheral blood T lymphocyte subsets(CD3+,CD4^(+),and CD4^(+)/CD8^(+))],pro-angiogen⁃ic factors[vascular endothelial growth factor(VEGF),transforming growth factorβ1(TGF-β1),and hypoxia-inducing factor 1α(HIF-1α)],and inflammatory cytokines[tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),and in⁃terleukin-6(IL-6)]were compared between the two groups.Results After treatment,the total effective rate in the treatment group was 57.14%(28/49),which was significantly higher than 39.58%(19/48)in the control group(P<0.05).The disease control rate in the treatment group was 87.76%(43/49),significantly higher than 68.75%(33/48)in the control group(P<0.05).After treatment,the serum levels of CEA,CA19-9,and CCL20 in both groups decreased(P<0.05),and the treatment group was lower than the control group(P<0.05).After treatment,the levels of peripheral blood CD3+,CD4^(+),and CD4^(+)/CD8^(+)in the treatment group were higher than those before treatment,while the levels of peripheral blood

关 键 词：中晚期胃癌 调强放疗 扶正培本祛邪汤 肿瘤标志物 免疫功能 促血管生成因子 炎症因子 

分 类 号：R735.2[医药卫生—肿瘤]