自拟健脾补肾和胃组方联合化疗对晚期脾肾虚弱型大肠癌患者的临床疗效及作用机制研究  

Study on clinical efficacy and mechanism of self-designed spleen-bushen and stomach formula with chemotherapy in advanced colorectal cancer patients with weak spleen and kidney deficiency

作　　者：何新颖[1] 高志远[2] 梁伟 孙云川[1] HE Xinying;GAO Zhiyuan;LIANG Wei;SUN Yunchuan(Department of Radiation Oncology,Cangzhou Hospital of Integrated Traditional and Western Medicine,Cangzhou,Hebei,061001,China;Department of Gastroenterology,Cangzhou Hospital of Integrated Traditional and Western Medicine)

机构地区：[1]河北省沧州中西医结合医院放化疗一科,河北沧州061001 [2]河北省沧州中西医结合医院脾胃肝病科

出　　处：《中国中西医结合消化杂志》2024年第11期1012-1016,1020,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：河北省自然科学基金项目(No:H2023110021)。

摘　　要：目的观察自拟健脾补肾和胃组方联合化疗对晚期脾肾虚弱型大肠癌患者的临床疗效、中医证候及生活质量的影响。方法将50例脾肾虚弱型大肠癌患者随机分为治疗组和对照组。对照组给予CAPEOX联合贝伐珠单抗方案化疗,治疗组在此基础上加服自拟健脾补肾和胃组方汤剂(每日1剂,连服8周),化疗每3周重复1次,连用3个周期后观察两组的临床疗效、中医证候评分、生活质量及Bcl-2、Bax的表达情况。结果3周期治疗后,治疗组与对照组的临床总体疗效相当;中医证候积分和中医证候疗效比较,治疗组优于对照组(P<0.05);治疗后,两组患者Bcl-2的表达均较治疗前下降(P<0.01),Bax的表达均较治疗前升高(P<0.01),且治疗组的变化比对照组更明显(P<0.05)。结论自拟健脾补肾和胃组方能提高晚期大肠癌化疗患者的临床疗效,改善中医症状,增强机体免疫力。其可能是通过提高促凋亡蛋白Bax和降低抑凋亡蛋白Bcl-2的表达起到增加化疗疗效、改善患者生活质量的作用。Objective To observe the clinical efficacy,traditional Chinese medicine(TCM)syndrome and quality of life of patients with spleen and kidney deficiency with chemotherapy of self-designed spleen-bushen and stomach formula in patients with advanced colorectal cancer.Methods Fifty patients with colorectal cancer were randomly divided into treatment group and control group.Patients in both groups were treated with CAPEOX combined with bevacizumab regimen for chemotherapy.The treatment group was also treated with self-designed spleen-bushen and stomach formula(one dose a day for eight weeks),and chemotherapy was repeated once every three weeks.After three consecutive cycles,the clinical efficacy,TCM syndrome score and Bcl-2 and bax expression of the two groups were observed.Results After three cycles of treatment,the overall clinical efficacy of the treatment group was comparable to the control group,the improvement of the symptoms in the treatment group was better than the control group(P<0.05);the expression of the apoptosis regulating protein Bcl-2 decreased after treatment in both groups(P<0.01),and the expression of the apoptosis regulating protein Bax increased(P<0.01),and the change in the treatment group was more obvious(P<0.05).Conclusion Self-designed spleen-bushen and stomach formula can improve the clinical effect,improve the symptoms of TCM and enhance the immunity of patients with colorectal cancer.It may enhance the efficacy of chemotherapy and improve the quality of life of patients by increasing the expression of pro-apoptotic protein Bax and decreasing the expression of anti-apoptotic protein Bcl-2.

关 键 词：大肠癌 自拟健脾补肾和胃组方 化学治疗 临床疗效 Bax Bcl-2 

分 类 号：R256.3[医药卫生—中医内科学]