竹叶石膏汤对同步放化疗食管癌患者营养和免疫及炎症状态的影响  

Effect of Zhuye Shigao decoction on nutrition,immunity and inflammatory state of patients with esophageal cancer undergoing radiotherapy and chemotherapy

作　　者：任连杰 余志怡 马贤庆 金津津 黎萍 REN Lianjie;YU Zhiyi;MA Xianqing;JIN Jinjin;LI Ping(Traditional Medicine Center,Jinhua Hospital Affiliated to Zhejiang University School of Medicine,Jinhua,Zhejiang,321000,China)

机构地区：[1]浙江大学医学院附属金华医院传统医学中心,浙江金华321000

出　　处：《中国中西医结合消化杂志》2024年第11期966-970,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：2021年度金华市中医药科研基金项目(No:2021JZK03)。

摘　　要：目的探讨竹叶石膏汤对同步放化疗食管癌患者营养、免疫、炎症状态的影响。方法选取2023年1月—2023年12月浙江大学医学院附属金华医院60例行同步放化疗的食管癌患者为研究对象,按随机数字表法分为对照组和治疗组,每组各30例。对照组予同步放化疗加常规营养治疗,治疗组在对照组基础上加用竹叶石膏汤,分别于治疗前后测定两组患者的总蛋白(total protein,TP)、白蛋白(albumin,ALB)、血红蛋白(hemoglobin,Hb)、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+),计算BMI、预后营养指数(prognostic nutritional index,PNI)、系统免疫炎症指数(systemic immune-inflam-matoly index,SII),并在治疗前后进行患者参与的主观全面评定营养状况评估量表(patient-generated subjective global assessment,PG-SGA)评分,用癌症生活质量问卷(quality of life questionnaire-core 30,QLQ-C30)评分、Karnofsky评分(KPS)、健康调查简表(36-item short form health survey,SF-36)、生活质量综合评定问卷(generic quality of life inventory-74,GQOLI-74)评估患者的生活质量。结果两组患者治疗前TP、ALB、Hb、CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、BMI、PNI、SII、QLQ-C30、KPS、SF-36、GQOLI-74比较均差异无统计学意义(均P>0.05);治疗5周后,两组的TP、ALB、Hb、BMI、PNI均低于治疗前,但治疗组高于同期对照组(均P<0.05),PG-SGA低于同期对照组(P<0.05);两组的CD3^(+)、SII、SF-36、GQOLI-74均高于治疗前,其中治疗组的CD3^(+)、SF-36、GQOLI-74高于同期治疗后的对照组(P<0.05),SII则低于同期治疗后的对照组(P<0.05);两组治疗后的QLQ-C30功能评分、健康评分均高于治疗前(均P<0.05),且治疗组高于对照组(P<0.05),症状评分低于治疗前(P<0.05),且治疗组低于对照组(P<0.05);治疗后,对照组的KPS评分低于治疗前(P<0.05),治疗组的KPS评分高于治疗前(P<0.05),且高于同期治疗后的对照组(P<0.05)。结论竹叶石膏汤能够提高同步放化疗食管癌Objective To investigate the effect of Zhuye Shigao decoction on nutrition,immunity and inflammation in patients with esophageal cancer undergoing concurrent chemoradiotherapy.Methods From January 2023 to December 2023,60 patients with esophageal cancer who underwent concurrent chemoradiotherapy in Jinhua Hospital Affiliated to Zhejiang University School of Medicine were selected and divided into control group and observation group according to the random number table method,30 cases in each group.The control group was treated with concurrent chemoradiotherapy and conventional nutrition therapy.The observation group was treated with Zhuye Shigao decoction on the basis of the control group.The total protein(TP),albumin(ALB),hemoglobin(Hb),CD3^(+),CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)values of the two groups were measured before and after treatment,and BMI,prognostic nutritional index(PNI),and systemic immune-inflam-matoly index(SII)values were calculated.Patient-generated subjective global assessment(PG-SGA)scores were performed before and after intervention,and the quality of life of the two groups was evaluated using the quality of life questionnaire-core 30(QLQ-C30),Karnofsky(KPS),36-item short form health survey(SF-36),and generic quality of life inventory-74(GQOLI-74).Results There was no significant difference in TP,ALB,Hb,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),BMI,PNI,SII,QLQ-C30,KPS,SF-36 and GQOLI-74 between the two groups before intervention(P>0.05).After 5 weeks of intervention,TP,ALB,Hb,BMI and PNI in the two groups were lower than those before intervention,but those in the treatment group were higher than those in the control group(P<0.05),and PG-SGA was lower than that in the control group(P<0.05).CD3^(+),SII,SF-36 and GQOLI-74 were higher than those in the two groups before intervention,and CD3^(+),SF-36 and GQOLI-74 in the treatment group were higher than those in the control group after treatment(P<0.05),while SII was lower than that in the control group after treatment(P<0.05).The QLQ-C30 function

关 键 词：竹叶石膏汤 食管癌 放射治疗 化学治疗 营养 免疫 炎症 

分 类 号：R256.3[医药卫生—中医内科学]