参芪苡术汤辅助化疗对中晚期胃癌患者生存期及生活质量的影响  

Effect of Shenqi Yizhu Decoction combined with chemotherapy on survival time and quality of life of patients with advanced gastric cancer

作　　者：焦克 冯天明[1] 胡小莲 JIAO Ke;FENG Tianming;HU Xiaolian(Department of Oncology,Tianchang Hospital of Traditional Chinese Medicine,Tianchang,Anhui 239300)

机构地区：[1]安徽省天长市中医院肿瘤科,安徽天长239300

出　　处：《河北中医》2024年第12期2005-2009,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察参芪苡术汤辅助化疗对中晚期胃癌患者生存期及生活质量的影响。方法选择2019年1月至2021年12月天长市中医院肿瘤科中晚期胃癌患者92例为研究对象,按照随机数字表法分为2组。对照组46例予奥沙利铂^(+)卡培他滨(XELOX)化疗,治疗组46例在对照组基础上联合参芪苡术汤治疗,均3周为1个疗程,连续治疗4个疗程后比较2组临床疗效。比较2组治疗前后中医证候评分、肿瘤标志物[糖类抗原125(CA125)、癌胚抗原(CEA)及糖类抗原199(CA199)]水平、免疫功能、欧洲癌症研究与治疗组织(EORTC)生命质量核心量表-30(QLQ-C30)评分,比较2组治疗过程中不良反应发生率;随访2年,统计2组患者中位生存期(MST)、肿瘤进展时间(TTP)。结果治疗组疾病控制率为86.96%(40/46),对照组为67.39%(31/46),治疗组疾病控制率高于对照组(P<0.05)。治疗后,2组胃脘痛、食少纳差、恶心呕吐、神疲乏力评分及CA125、CA199、CEA水平均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。治疗后,治疗组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较本组治疗前升高(P<0.05),CD8^(+)水平较本组治疗前降低(P<0.05),且治疗后治疗组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平较对照组更高(P<0.05),CD8^(+)水平较对照组更低(P<0.05)。治疗后,2组EORTC QLQ-C30各项评分均较本组治疗前升高(P<0.05),且治疗组均高于对照组(P<0.05)。治疗组不良反应发生率为28.26%(13/46),对照组为65.22%(30/46),治疗组不良反应发生率低于对照组(P<0.05)。治疗组TTP、MST均长于对照组(P<0.05)。结论参芪苡术汤辅助化疗治疗中晚期胃癌,相较于单一化疗,可减少患者不良反应,改善免疫功能,延长患者生存时间,并促进生活质量提高。Objective To analyze the effect of Shenqi Yizhu Decoction with chemotherapy on survival time and quality of life of patients with advanced gastric cancer(AGC).Methods A total of 92 AGC patients treated in Department of Oncology,Tianchang Hospital of Traditional Chinese Medicine from January 2019 to December 2021 were randomly assigned into treatment group(n=46)and control group(n=46).All patients were managed by XELOX regimen(capecitabine plus oxaliplatin),and those in treatment group were additionally treated with Shenqi Yizhu Decoction.The treatment continued for 4 courses(1 course for 3 weeks),the aim was to compare traditional Chinese medicine(TCM)syndrome score,tumor markers including carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),CA199,immune function,the European Organisation for research and treatment of cancer quality of life questionnaire core 30(EORTC QLQ-C30)scores,as well as treatment-emergent adverse events(TEAEs).The median survival time(MST)and time to tumor progression(TTP)were assessed during 2-year follow-up study.Results The disease control rate in the treatment group was significantly higher than that in the control group(86.96%[40/46]vs 67.39%[31/46],P<0.05).After treatment,TCM syndrome(epigastric pain,reduced food intake and poor appetite,nausea and vomiting,tiredness)scores,CA125,CA199 and CEA levels in the both groups were decreased(P<0.05),which were significantly decreased in the treatment group relevant to the control group(P<0.05).After treatment,significantly increased CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)levels,and decreased CD8^(+)level were found in the both groups(all P<0.05),and the treatment group was superior to the control group for the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),CD8^(+)(all P<0.05).The EORTC QLQ-C30 scores in the both groups were significantly increased(P<0.05),the increase in the treatment group was more common than the control group(P<0.05).The TEAEs in the treatment group was significantly lower than that in the control group(28.26%[13/46]vs 65.

关 键 词：胃肿瘤 化疗 植物药疗法 无进展生存期 生活质量 

分 类 号：R735.205.31[医药卫生—肿瘤]