针刺联合穴位贴敷治疗中晚期食管癌疗效观察及对楔状组织中TGF-β_(1)/Smad信号通路的影响  

Observation on Curative Effect of Acupuncture Combined with Acupoint Application for Middle-Advanced Esophageal Carcinoma and Its Effects on TGF-β_(1)/Smad Signal Pathway of Wedge-Shaped Tissue

作　　者：张慧 张娟[1] ZHANG Hui;ZHANG Juan(Internal Medicine Oncology District I,Henan Province Hospital of Traditional Chinese Medicine,Zhengzhou Henan 450002)

机构地区：[1]河南省中医院肿瘤内科一区,河南郑州450002

出　　处：《新中医》2024年第12期163-170,共8页New Chinese Medicine

基　　金：河南省中医药科学研究专项课题(2021JDZX2027)。

摘　　要：目的:观察针刺联合穴位贴敷治疗中晚期食管癌的临床疗效及对楔状组织中转化生长因子β_(1)(TGF-β_(1))/胰腺癌缺失因子(Smad)信号通路的影响。方法:将90例中晚期食管癌患者随机分为对照组与治疗组各45例。对照组给予常规放化疗治疗,治疗组在对照组基础上给予针刺联合穴位贴敷。观察2组治疗后临床疗效,不良反应及随访3年生存率;以及治疗前后简体中文版生活质量评估表(QLQ-C30)、SF-36健康调查量表[躯体功能(PCS)、社会功能(PSS)和情绪角色(MCS)]评分,血清肿瘤标志物[糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、糖类抗原125(CA125)]、血清胃肠激素[血管活性肠(VIP)、生长抑素(SOM)、胃动素(MTL)、5-羟色胺(5-HT)]、楔状组织上清液中TGF-β_(1)/Smad信号通路(TGF-β_(1)RⅠ型受体、TGF-β_(1)RⅡ型受体、Smad4、Smad7)水平。结果:治疗后,治疗组疾病控制率为95.24%,对照组为73.17%,2组比较,差异有统计学意义(P<0.05)。治疗1、2个疗程,2组PCS、PSS、MCS评分均较治疗前升高(P<0.05),且治疗组相同时间点PCS、PSS、MCS评分均高于对照组(P<0.05)。治疗1、2个疗程,治疗组相同时间点QLQ-C30评分均低于对照组(P<0.05),但对照组QLQ-C30评分治疗前后比较,差异无统计学意义(P>0.05)。治疗1、2个疗程,2组CA19-9、CEA(对照组第1疗程CEA指标除外)、CYFRA21-1、CA125水平均较治疗前降低(P<0.05),且治疗组相同时间点4项指标均低于对照组(P<0.05)。治疗1、2个疗程,2组VIP、SOM、5-HT水平均较治疗前降低(P<0.05),MTL水平均较治疗前升高(P<0.05);且治疗组相同时间点VIP、SOM、5-HT水平均低于对照组(P<0.05),MTL水平均高于对照组(P<0.05)。治疗1、2个疗程,治疗组TGF-β_(1)RⅠ型受体、TGF-β_(1)RⅡ型受体、Smad4和Smad7水平均较治疗前降低(P<0.05),且相同时间点均低于对照组(P<0.05);对照组TGF-β_(1)RⅠ型受体、TGF-β_(1)RⅡ型受Objective:To observe the clinical effect of the therapy of acupuncture combined with acupoint application on middle-advanced esophageal carcinoma and its effects on transforming growth factor-β_(1)(TGF-β_(1))/defect factor of cancer of pancreas(Smad)signal pathway.Methods:A total of 90 patients with middle-advanced esophageal carcinoma were randomly divided into the control group and the treatment group,with 45 cases in each group.The control group was given routine chemoradiotherapy for treatment,and the treatment group was additionally treated with acupuncture combined with acupoint application based on the treatment of the control group.The clinical effects and incidence of adverse reactions in the two groups after treatment,and the survival rates of patients after three years of follow-up were observed;the scores of Quality of Life Core Questionnaire 30(QLQ-C30)and SF-36 Health Survey[physical component summary(PCS),physical social summary(PSS)and mental component summary(MCS)],and the levels of serum tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CYFRA21-1)and carbohydrate antigen 125(CA125)],serum gastrointestinal hormones[vasoactive intestinal peptide(VIP),somatostatin(SOM),motilin(MTL)and 5-hydroxytryptamine(5-HT)]and TGF-β_(1)/Smad signal pathway in supernatant liquid of wedge-shaped tissue(TGF-β_(1) RItype receptor,TGF-β_(1)RII type receptor,Smad4 and Smad7)before and after treatment were also observed.Results:After treatment,the disease control rate was 95.24%in the treatment group,and 73.17%in the control group,the difference being significant(P<0.05).After one and two courses of treatment,the scores of PCS,PSS and MCS in the two groups were increased when compared with those before treatment(P<0.05),and above three scores in the treatment group at the same time point were higher than those in the control group(P<0.05).After one and two courses of treatment,the QLQ-C30 score in the treatment group at the same time point was lower than th

关 键 词：食管癌 放化疗 针刺 穴位贴敷 血清肿瘤标志物 TGF-β_(1)/Smad信号通路 

分 类 号：R735.1[医药卫生—肿瘤]