参苓胃消胶囊联合奥沙利铂+卡培他滨化学治疗方案治疗脾气亏虚型大肠癌疗效观察  

Effect of Shenling Weixiao capsules combined with oxaliplatin and capecitabine chemotherapy regimen in the treatment of spleen-qi deficient colorectal cancer

作　　者：王飞 徐湘江[1] 王振强[2] 许迪[1] WANG Fei;XU Xiangjiang;WANG Zhenqiang;XU Di(Department of Gastroenterology,Cangzhou Hospital of Integrated TCM-WM•Hebei,Cangzhou 061000,Hebei Province,China;Department of Traditional Chinese Medicine,Cangzhou Hospital of Integrated TCM-WM•Hebei,Cangzhou 061000,Hebei Province,China)

机构地区：[1]河北省沧州中西医结合医院消化内科,河北沧州061000 [2]河北省沧州中西医结合医院中医内科,河北沧州061000

出　　处：《新乡医学院学报》2024年第6期554-559,共6页Journal of Xinxiang Medical University

基　　金：河北省中医药管理局项目(编号:2020463)。

摘　　要：目的探讨参苓胃消胶囊联合XELOX(奥沙利铂+卡培他滨)化学治疗方案治疗脾气亏虚型大肠癌患者的临床疗效。方法选择2020年1月至2022年5月河北省沧州中西医结合医院收治的80例脾气亏虚型大肠癌患者为研究对象。按随机数字表法将患者分为对照组和观察组,每组40例。对照组患者给予XELOX方案治疗,观察组患者给予XELOX方案和参苓胃消胶囊治疗。21 d为1个治疗周期,共治疗4个周期。治疗结束后,根据实体瘤疗效评价标准评估2组患者的临床疗效;记录2组患者的中医证候评分。采用大肠癌患者生命质量测定量表(V4.0)评估2组患者的生活质量,电化学发光免疫法测定2组患者血清中肿瘤标志物[鳞状细胞癌相关抗原(SCC-Ag)、癌胚抗原(CEA)、糖类抗原199(CA199)]水平,酶联免疫吸附试验测定2组患者血清中炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C-反应蛋白(CRP)]及血管内皮生长因子(VEGF)水平,流式细胞仪检测血液中CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞亚群水平并计算CD4^(+)/CD8^(+)比值;记录2组患者治疗期间不良反应发生情况。结果对照组和观察组患者治疗总有效率分别为52.5%(21/40)、75.0%(30/40),观察组患者的总有效率显著高于对照组(χ^(2)=4.381,P<0.05)。治疗前,2组患者的中医证候评分、生活质量评分比较差异无统计学意义(P>0.05)。与治疗前相比,2组患者治疗后的中医证候评分显著减少、生活质量评分显著增加(P<0.05)。治疗后,观察组患者的中医证候评分显著低于对照组,生活质量评分显著高于对照组(P<0.05)。治疗前,2组患者血清中SCC-Ag、CEA、CA199水平比较差异无统计学意义(P>0.05)。2组患者治疗后血清中SCC-Ag、CEA、CA199水平均显著低于治疗前(P<0.05)。治疗后,观察组患者血清中SCC-Ag、CEA、CA199水平均显著低于对照组(P<0.05)。治疗前,2组患者血清中TNF-α、IL-6、CRP、VEGF水平比较差Objective To investigate the clinical efficacy of Shenling Weixiao capsules combined with XELOX(oxaliplatin+capecitabine)chemotherapy regimen in the treatment of patients with spleen-qi deficient colorectal cancer.Methods Eighty patients with spleen-qi deficient colorectal cancer treated at the Cangzhou Hospital of Integrated TCM-WM·Hebei from January 2020 to May 2022 were selected as the research subjects.The patients were divided into the control group and the observation group by using the random number table,with 40 patients in each group.The patients in the control group were treated with XELOX regimen,and the patients in the observation group were treated XELOX regimen and Shenling Weixiao capsules.The patients in both groups were treated for 4 treatment cycles,with 21 days as one treatment cycle.After treatment,the clinical efficacy of patients in the two groups was evaluated according to the evaluation criteria in solid tumors,and the traditional Chinese medicine(TCM)syndrome score was recorded.The quality of life of patients in the two groups was assessed by using the functional assessment of cancer theraphy-colorectal(V4.0).Serum levels of tumor markers like squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),and carbohydrate antigen 199(CA199)were measured by using the electrochemiluminescence immunoassay.Serum levels of inflammatory factors like tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),and vascular endothelial growth factor(VEGF)were measured by using the enzyme-linked immunosorbent assay.The levels of CD3^(+),CD4^(+)and CD8^(+)T lymphocyte subpopulations in blood were detected by using the flow cytometry,and the CD4^(+)/CD8^(+)ratio was calculated.The incidence of adverse reactions was recorded.Results The overall effective rate of patients in the observation group[75.0%(30/40)]was significantly higher than that of patients in the control group[52.5%(21/40)](χ^(2)=4.381,P<0.05).There was no statistically significant difference in the TCM syndrom

关 键 词：大肠癌 脾气亏虚 参苓胃消胶囊 奥沙利铂 卡培他滨 炎症反应 免疫功能 

分 类 号：R735.35[医药卫生—肿瘤]