扶正养阴散结方加减联合同步放化疗治疗晚期宫颈癌的临床研究  

Efficacy of modified Fuzheng Yangyin Powder plus concurrent chemoradiotherapy on advanced cervical cancer

作　　者：朱伯琴 徐海波[1] 邱小丽[1] ZHU Boqin;XU Haibo;QIU Xiaoli(Department of Gynecology,Nantong Tumor Hospital,Nantong,Jiangsu 226361)

机构地区：[1]江苏省南通市肿瘤医院妇瘤科,江苏南通226361

出　　处：《河北中医》2024年第1期73-78,共6页Hebei Journal of Traditional Chinese Medicine

基　　金：江苏省南通市科技计划项目(编号:MSZ21085)。

摘　　要：目的观察扶正养阴散结方加减联合同步放化疗治疗晚期宫颈癌的临床疗效。方法将86例晚期宫颈癌患者按照随机信封法分为2组,对照组43例给予同步放化疗治疗,治疗组43例在对照组的基础上联合扶正养阴散结方加减治疗。2组均治疗3个疗程后统计疗效,比较2组治疗前及治疗1、3个疗程后促癌因子[包括组织蛋白酶D(CatD)、Ki-67、组织蛋白酶L(CatL)及细胞周期素D1(CyclinD1)]mRNA、抑癌因子[包括P53、P16及脆性组氨酸三联体(FHIT)]mRNA、免疫功能(包括T淋巴细胞亚群CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+))及Kamofsky功能状态(KPS)评分变化情况,观察比较2组治疗期间不良反应发生情况,2组治疗结束后均随访6个月比较2组获访生存率情况。结果治疗组客观缓解率18.60%(8/43),疾病控制率88.37%(38/43),对照组客观缓解率13.95%(6/43),疾病控制率69.77%(30/43),2组客观缓解率比较差异无统计学意义(P>0.05),但治疗组疾病控制率高于对照组(P<0.05)。与本组治疗前比较,治疗组治疗1、3个疗程后促癌因子血清CatD mRNA、Ki-67 mRNA、CatL mRNA及CyclinD1 mRNA水平均降低(P<0.05),且治疗组治疗后各指标水平均低于对照组同期(P<0.05);对照组治疗1、3个疗程后促癌因子各指标与本组治疗前比较差异均无统计学意义(P>0.05)。与本组治疗前比较,治疗组治疗1、3个疗程后抑癌因子血清P53 mRNA、P16 mRNA及FHIT mRNA水平均升高(P<0.05),且治疗组治疗后各指标水平均高于对照组同期(P<0.05);对照组治疗1、3个疗程后抑癌因子各指标与本组治疗前比较差异均无统计学意义(P>0.05)。与本组治疗前比较,治疗组治疗1、3个疗程后免疫功能指标T淋巴细胞亚群CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均升高(P<0.05),且治疗组治疗后各指标水平均高于对照组同期(P<0.05);对照组治疗1、3个疗程后免疫功能指标T淋巴细胞亚群CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平均降低(P<0.05)。与�Objective To investigate the efficacy of modified Fuzheng Yangyin Powder plus concurrent chemoradiotherapy on advanced cervical cancer.Methods Eighty-six patients with advanced disease were assigned into a control group(n=43)and a treatment group(n=43)by a random envelope method.All patients were managed concurrent chemoradiotherapy,and patients in the treatment group were additionally given modified Fuzheng Yangyin Powder.The treatment continued 3 courses for statistical efficacy.Before treatment and after 1 and 3 courses of treatment,the tumor-promoting factors including cathepsin D(CatD)mRNA,Ki-67 mRNA,cathepsin L(CatL)mRNA and CyclinD1 mRNA,tumor-suppressing factors including P53 mRNA,P16 mRNA and fragile histidine triad(FHIT)mRNA,and immune function including T lymphocyte subsets:CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),as well as Karnofsky performance status(KPS)were included as comparisons.The incidences of treatment-emergent adverse events and the survival rates of 6-month follow-up were assessed.Results The objective remission rate in the treatment group was comparable to that of the control group(18.60%[8/43]vs 13.95%[6/43],P>0.05).The disease control rate in the treatment group was significantly higher than that of the control group(88.37%[38/43]vs 69.77%[30/43],P<0.05).After 1 and 3 courses of treatment,the levels of tumor-promoting factors(serum CatD mRNA,Ki-67 mRNA,CatL mRNA and CyclinD1 mRNA)in the treatment group were significantly decreased(P<0.05),and which in the treatment group were significantly lower than the control group(P<0.05).There was no significant difference in cancer-promoting factors between 1 and 3 courses of treatment and before treatment in the control group(P>0.05).The levels of tumor-suppressing factors(serum P53 mRNA,P16 mRNA and FHIT mRNA)in the treatment group were significantly increased(P<0.05),and which in the treatment group were significantly higher than the control group(P<0.05).There was no significant difference in tumor-suppressing factors between 1 and 3 courses of trea

关 键 词：宫颈癌 放射疗法 化学疗法 中西医结合疗法 

分 类 号：R737.31[医药卫生—肿瘤]