补气清肠汤联合XELOX化疗加贝伐珠单抗方案治疗气虚湿热证转移性结直肠癌患者的临床观察  

Clinical Observation on Buqi Qingchang Decoction Combined with XELOX Chemotherapy and Bevacizumab Regimen in the Treatment of Patients with Metastatic Colorectal Cancer of Qi Deficiency and Damp-Heat Syndrome and Damp-Heat Syndrome

作　　者：唐睿 肖国航 彭永焕 周德奇 TANG Rui;XIAO Guo-Hang;PENG Yong-Huan;ZHOU De-Qi(Graduate School of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China;Chongqing Medical University,Chongqing 400016,China;Chongqing Hospital,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Chongqing Beibei District Hospital of Traditional Chinese Medicine,Chongqing 400700,China)

机构地区：[1]广州中医药大学研究生院,广东广州510006 [2]重庆医科大学,重庆400016 [3]广州中医药大学第一附属医院重庆医院,重庆市北碚区中医院,重庆400700

出　　处：《广州中医药大学学报》2024年第10期2720-2726,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：重庆市卫生健康委员会中医药科研基金项目(编号:2024ZYYB004);重庆市北碚区科技局2023年第三批科研项目(编号:2023-24)。

摘　　要：【目的】探讨补气清肠汤(由补中益气汤合白头翁汤加郁金、姜黄等组方而成)联合XELOX化疗加贝伐珠单抗靶向治疗对气虚湿热证转移性结直肠癌患者的临床疗效、生活质量及生存周期的改善作用。【方法】采用回顾性研究方法,选取2020年12月至2023年12月就诊于广州中医药大学第一附属医院重庆医院(重庆市北碚区中医院)肿瘤科的气虚湿热证转移性结直肠癌患者70例,根据治疗方式的不同将其分为观察组和对照组,每组各35例。对照组接受XELOX化疗联合贝伐珠单抗方案治疗,观察组在接受化疗联合靶向治疗方案的同时加用补气清肠汤口服治疗。观察2组患者治疗前后血清癌胚抗原(CEA)、糖类抗原199(CA199)等肿瘤标志物水平及生活质量Karnofsky功能状态(KPS)评分的变化情况,比较2组患者的临床疗效、无进展生存期(PFS)和总生存时间(OS)。【结果】(1)疗效方面,经治疗后,观察组的客观缓解率(ORR)和疾病控制率(DCR)分别为51.42%(18/35)、85.71%(30/35),显著高于对照组的25.71%(9/35)、54.29%(19/35),组间比较,差异均有统计学意义(P<0.05或P<0.01)。(2)生存周期方面,观察组和对照组的PFS分别为16.7个月和12.9个月,OS分别为23.3个月和17.7个月;观察组的PFS和OS均较对照组显著延长,组间比较,差异均有统计学意义(P<0.05或P<0.01)。(3)生活质量和肿瘤标志物水平方面,治疗后,2组患者的血清CEA、CA199水平均较治疗前显著下降(P<0.05),KPS评分均较治疗前显著升高(P<0.05),且观察组对血清CEA、CA199水平的下降幅度及对KPS评分的升高幅度均显著优于对照组,差异均有统计学意义(P<0.05)。【结论】XELOX化疗联合贝伐珠单抗方案配合补气清肠汤是气虚湿热证转移性结直肠癌的有效治疗方案,可在一定程度上提高患者疗效,延长患者生存周期,降低疾病进展风险,降低血清肿瘤标志物水平,提高患者生活质量。Objective To explore the influence of Buqi Qingchang Decoction(composed of Buzhong Yiqi Decoction plus Baitouweng Decoction with Curcumae Radix and Curcumae Longae Rhizoma added)combined with XELOX chemotherapy and Bevacizumab targeted therapy on the clinical efficacy,quality of life and survival period of patients with metastatic colorectal cancer of qi deficiency and damp-heat syndrome.Methods A retrospective study was conducted in 70 patients with metastatic colorectal cancer of qi deficiency and damp-heat syndrome who were admitted to the Department of Oncology,Chongqing Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine(Chongqing Beibei District Hospital of Traditional Chinese Medicine)from December 2020 to December 2023.The patients were divided into an observation group and a control group according to the therapy,with 35 cases in each group.The control group was treated with XELOX chemotherapy combined with Bevacizumab targeted therapy,while the observation group was given oral administration of Buqi Qingchang Decoction together with chemotherapy and targeted therapy.The changes in the serum levels of tumor markers such as carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199),and Karnofsky Performance Status(KPS)scores for quality of life in the two groups were observed before and after treatment.Moreover,the clinical efficacy,progression-free survival(PFS)and overall survival(OS)were compared between the two groups.Results(1)After treatment,the objective response rate(ORR)and disease control rate(DCR)in the observation group were 51.42%(18/35)and 85.71%(30/35),respectively,which were significantly higher than those in the control group[25.71%(9/35)and 54.29%(19/35),respectively],and the differences between the two groups were statistically significant(P<0.05 or P<0.01).(2)The PFS of the observation group was 16.7 months and that of the control group was 12.9 months,and the OS of the observation group was 23.3 months and that of the control group was 17.7 mont

关 键 词：转移性结直肠癌 补气清肠汤 补中益气汤 白头翁汤 XELOX方案 贝伐珠单抗 生活质量 生存周期 肿瘤标志物 

分 类 号：R273.353[医药卫生—中西医结合]