下气汤对Ⅲ-Ⅳ期结直肠癌化疗患者癌因性疲乏的疗效分析  

Analysis of Clinical Efficacy of Xiaqi Decoction on Cancer-Related Fatigue in Patients with StageⅢ-ⅣColorectal Cancer After Chemotherapy

作　　者：李寿杰[1] 高海利[1] 张念华[1] LI Shoujie;GAO Haili;ZHANG Nianhua(Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095 Guangdong,China)

机构地区：[1]广东省第二中医院,广东广州510095

出　　处：《广州中医药大学学报》2025年第2期358-366,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20231032)。

摘　　要：【目的】探讨下气汤(由茯苓、法半夏、炙甘草、杏仁、橘红、白芍、何首乌、牡丹皮等中药组成)对伴有癌因性疲乏的Ⅲ-Ⅳ期结直肠癌化疗患者的临床疗效。【方法】将2023年1月至2024年3月就诊于广东省第二中医院的60例伴有癌因性疲乏的Ⅲ-Ⅳ期结直肠癌化疗的患者按随机数字表法随机分为化疗组和下气汤组,每组各30例。化疗组给予Avastin+mFOLFOX6/FOLFIRI方案化疗,下气汤组在化疗组的基础上给予服用下气汤治疗,每2周为1个疗程,连续治疗2个疗程。观察2组患者治疗前后Piper疲乏修订量表(PFS-R)评分、EORTC核心生活质量问卷(QLQ-C30)评分、患者主观整体营养评估(PG-SGA)评分、Karnofsky功能状态量表(KPS)评分、食欲减退评分及血清白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)水平的变化情况,评价2组患者的临床疗效及用药安全性。【结果】(1)疗效方面,治疗2个疗程后,下气汤组的总有效率为86.21%(25/29),化疗组为62.07%(18/29),组间比较(χ^(2)检验),下气汤组的疗效明显优于化疗组(P<0.05)。(2)疲乏程度方面,化疗第2周和第4周,2组患者的PFS-R评分均较化疗前1 d升高(P<0.05),但下气汤组化疗后的PFS-R评分均明显低于化疗组(P<0.01)。(3)生活质量方面,化疗第2周和第4周,化疗组的QLQ-C30评分均较化疗前1 d降低(P<0.05),而下气汤组的QLQ-C30评分均较化疗前1 d无明显变化(P>0.05);组间比较,下气汤组化疗后的QLQ-C30评分均明显高于化疗组(P<0.01)。(4)营养状况方面,化疗第4周,2组患者的PG-SGA评分、食欲减退评分及下气汤组的KPS评分均较化疗前1 d升高(P<0.05),而化疗组的KPS评分较化疗前1 d降低(P<0.05);组间比较,下气汤组化疗后的PG-SGA评分、食欲减退评分低于化疗组,KPS评分高于化疗组,差异均有统计学意义(P<0.05或P<0.01)。(5)炎症因子方面,化疗组化疗第2周的血清TNF-α、IL-6水平及化疗第4�Objective To investigate the clinical efficacy of Xiaqi Decoction(mainly composed of Poria,Pinelliae Rhizoma Praeparatum,Glycyrrhizae Radix et Rhizoma Praeparata cum Melle,Armeniacae Semen Amarum,Citri Grandis Exocarpium,Paeoniae Radix Alba,Polygoni Multiflori Radix,and Moutan Cortex)on patients with stageⅢ-Ⅳcolorectal cancer accompanied by cancer-related fatigue(CRF)after chemotherapy.Methods Sixty patients with stageⅢ-Ⅳcolorectal cancer accompanied by CRF after chemotherapy who admitted to Guangdong Second Traditional Chinese Medicine Hospital from January 2023 to March 2024 were randomly divided into chemotherapy group and Xiaqi Decoction group according to the random number table method,with 30 patients in each group.The chemotherapy group was given chemotherapy regimen of Avastin+mFOLFOX6/FOLFIRI,and Xiaqi Decoction group was given Xiaqi Decoction orally on the basis of treatment for the chemotherapy group.Two weeks constituted a course of treatment,and two consecutive courses of treatment were performed.Before and after treatment,the two groups were observed in the changes of Revised Piper Fatigue Scale(PFS-R)scores,EORTC Quality of Life Questionnaire-Core 30(QLQ-C30)scores,Patient-Generated Subjective Global Assessment(PG-SGA)scores,Karnofsky Performance Status(KPS)scores,poor appetite scores,and serum levels of interleukin 6(IL-6),tumor necrosis factorα(TNF-α),and interleukin 1β(IL-1β)were observed.After treatment,the clinical efficacy and safety between the two groups of patients were evaluated.Results(1)After two courses of treatment,the total effective rate of the Xiaqi Decoction group was 86.21%(25/29)and that of the chemotherapy group was 62.07%(18/29),and the intergroup comparison(tested by chi-square test)showed that the efficacy of Xiaqi Decoction group was significantly superior to that of chemotherapy group(P<0.05).(2)In the second and fourth weeks of chemotherapy,the PFS-R scores for evaluating the degree of fatigue of patients in the two groups were increased when compared with tho

关 键 词：下气汤 结直肠癌 化疗 癌因性疲乏 炎症因子 营养状况 生活质量 

分 类 号：R273.353[医药卫生—中西医结合]