自拟抑癌汤在锁肛痔(直肠癌)术后患者中的应用  

Application of self-designed anti-cancer decoction in patients with anorectal cancer after surgery

作　　者：王三学 张斌[2] 陈晓博 李彩霞 WANG San-xue;ZHANG Bin;CHEN Xiao-bo;LI Cai-xia(Outpatient Department,the Second People's Hospital of Jiyuan,Jiyuan 459000,Henan,CHINA;Department of Surgery,Jiyuan People's Hospital,Jiyuan 459000,Henan,CHINA)

机构地区：[1]济源市第二人民医院门诊部,河南济源459000 [2]济源市人民医院外科,河南济源459000

出　　处：《海南医学》2024年第2期179-184,共6页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20205076)。

摘　　要：目的 观察自拟抑癌汤在锁肛痔(直肠癌)术后患者中的应用效果,并分析其对患者凋亡相关因子、细胞外信号调节激酶(ERK)通路蛋白表达水平的影响。方法 选取2020年3月至2023年1月济源市第二人民医院收治的80例直肠癌术后患者为研究对象,按奇偶数分组法分为观察组和对照组,每组40例。对照组患者术后实施常规辅助化疗,观察组患者于此基础上予以自拟抑癌汤治疗,疗程3个月。疗程结束后比较两组患者的临床疗效、毒副反应,以及治疗前、治疗1、3个月后的中医证候积分、肿瘤标志物[糖类抗原199 (CA199)、癌胚抗原(CEA)、糖类抗原242 (CA242)]、凋亡相关因子[肿瘤抑制基因(p53)、细胞凋亡信号受体(Fas)、肿瘤坏死因子-α (TNF-α)、细胞周期素E (cyclin E)]及ERK信号通路关键分子[丝裂原活化蛋白激酶(MEK)、细胞外信号调节激酶1/2 (ERK1/2)、Ras、Raf]变化。结果 治疗3个月后,观察组患者的总有效率为75.00%,略高于对照组的62.50%,但差异无统计学意义(P>0.05);治疗1、3个月后,观察组患者的各项中医证候积分明显低于对照组,差异均具有统计学意义(P<0.05);治疗1个月和3个月后,观察组患者的血清CA199、CA242、CEA、cyclin E、MEK、ERK1/2、Ras、Raf水平均明显低于对照组,而血清p53、Fas、TNF-α水平均明显高于对照组,差异均有统计学意义(P<0.05);两组患者治疗期间的各项毒副反应发生率比较差异均无统计学意义(P>0.05)。结论 直肠癌术后患者联合应用自拟抑癌汤和辅助化疗具有一定临床疗效及安全性,其可改善患者的临床症状,抑制肿瘤生长,促进肿瘤凋亡,其作用机制可能与调节凋亡相关因子、ERK通路蛋白表达有关。Objective To observe the efficacy of a self-designed anti-cancer decoction in patients with anal hem-orrhoids(anorectal cancer)after surgery,and to analyze its impact on the expression levels of apoptosis-related factors and extracellular signal-regulated kinase(ERK)pathway proteins in patients.Methods Eighty patients with anorectal cancer admitted to the Second People's Hospital of Jiyuan from March 2020 to January 2023 were selected and divided into an ob-servation group and a control group according to the even-odd number grouping method,with 40 cases in each group.The patients in the control group received routine adjuvant chemotherapy after surgery,while the patients in the observation group received self-designed anti-cancer decoction on this basis,for a period of 3 months.After treatment,the clinical effi-cacy,toxic side effects,and changes in TCM syndrome scores,tumor markers[carbohydrate antigen 199(CA199),carcino-embryonic antigen(CEA),carbohydrate antigen 242(CA242)],apoptosis-related factors[tumor suppressor gene(p53),apoptosis signal receptor(Fas),tumor necrosis factor-α(TNF-α),cell cycle protein E(cyclin E)],and key molecules of ERK signaling pathway[mitogen-activated protein kinase(MEK),extracellular signal-regulated kinase 1/2(ERK1/2),Ras,Raf]were observed in the two groups.Results After 3 months of treatment,the total effective rate was 75.00%of the ob-servation group and 62.50%of the control group,with no significant difference between the two groups(P>0.05).After 1 month and 3 months of treatment,the TCM syndrome scores of the observation group were significantly lower than those of the control group(P<0.05).After 1 month and 3 months of treatment,the serum levels of CA199,CA242,CEA,cyclin E,MEK,ERK1/2,Ras,and Raf in the observation group were significantly lower than those in the control group;the serum levels of p53,Fas,and TNF-αin the observation group were significantly higher than those in the control group;the differences were statistically significant(P<0.05).There was no statisticall

关 键 词：锁肛痔 自拟抑癌汤 化疗 疗效 凋亡 细胞外信号调节激酶 中医证候积分 肿瘤标志物 

分 类 号：R735.37[医药卫生—肿瘤]