和胃解毒汤联合同步放化疗对食管癌骨髓抑制的影响  

Effect of Hewei Jiedu Decoction Combined with Concurrent Chemoradiotherapy on Bone Marrow Suppression in Esophageal Cancer

作　　者：温嘉敏 黄清苑[1] 林呼[1] 曾志威[1] WEN Jiamin;HUANG Qingyuan;LIN Hu;ZENG Zhiwei(Department of Traditional Chinese Medicine,Meizhou Peoples Hospital,Meizhou 514000,China)

机构地区：[1]梅州市人民医院中医科,广东梅州514000

出　　处：《中医药学报》2025年第3期87-91,共5页Acta Chinese Medicine and Pharmacology

基　　金：广东省中医药局科研项目(20191336)。

摘　　要：目的:观察和胃解毒汤联合同步放化疗对食管癌骨髓抑制的影响。方法:选取2020年1月—2022年12月梅州市人民医院治疗的100例食管癌患者,采用随机数字表法分为对照组和联合组。对照组50例(脱落2例,最终纳入48例),采用适型调强放射治疗及TP方案化疗,联合组50例(脱落3例,最终纳入47例),在对照组基础上同时加用和胃解毒汤治疗,治疗后比较两组临床疗效,治疗前后给予患者中医证候评分比较,通过营养风险筛查量表(NRS2002)评价患者营养状态,检测患者血清白蛋白、前白蛋白、鳞状细胞癌抗原(SCC)、细胞角蛋白19片段(CY-FRA21-1)、NK细胞亚群CD16^(+)CD56^(+)细胞、T淋巴细胞亚群(CD4^(+)细胞、CD8^(+)细胞)、B淋巴细胞亚群CD19^(+)细胞水平,记录两组不良反应发生情况。结果:联合组疾病控制率、有效率分别为97.87%(46/47),82.98%(39/47),对照组疾病控制率、有效率分别为83.33%(40/48)、56.25%(27/48),联合组疾病控制率、有效率高于对照组(P<0.05);联合组中医证候评分较对照组低(P<0.05);联合组NRS2002评分较对照组低(P<0.05),联合组患者血清白蛋白、前白蛋白表达量均高于对照组(P<0.05);两组CD4^(+)细胞水平较治疗前降低(P<0.05),CD16^(+)CD56^(+)细胞、CD19^(+)细胞、CD8^(+)细胞水平较治疗前升高(P<0.05),联合组患者CD4^(+)细胞、CD16^(+)CD56^(+)细胞、CD19^(+)细胞水平均高于对照组(P<0.05),CD8^(+)细胞水平低于对照组(P<0.05);联合组SCC、CY-FRA21-1表达量低于对照组(P<0.05);联合组骨髓抑制、恶心呕吐、脱发发生率低于对照组(P<0.05)。结论:和胃解毒汤联合同步放化疗治疗食管癌患者,可调节TBNK淋巴亚群水平及营养指标,降低肿瘤标志物水平,提升疗效,减少不良反应发生率。Objective:To observe the effect of Hewei Jiedu Decoction combined with concurrent chemoradiotherapy on bone marrow suppression in esophageal cancer.Methods:A total of 100 esophageal cancer patients treated at Meizhou Peoples Hospital from January 2020 to December 2022 were selected.They were randomly divided into two groups:the control group(50 cases,48 included in the final analysis after 2 dropped out)and the combination group(50 cases,47 included in the final analysis after 3 dropped out).The control group received intensity-modulated radiotherapy and TP chemotherapy regimen,while the combination group received Hewei Jiedu Decoction in addition to the treatment of the control group.After treatment,the clinical efficacy of both groups was compared.Chinese medicine syndrome scores before and after treatment were assessed,and the nutritional status of patients was evaluated using the Nutrition Risk Screening(NRS2002)scale.Serum levels of albumin,prealbumin,squamous cell carcinoma antigen(SCC),cytokeratin 19 fragment(CY-FRA21-1),NK cell subgroups(CD16^(+)CD56^(+)cells),T lymphocyte subgroups(CD4^(+)cells,CD8^(+)cells),and B lymphocyte subgroups(CD19^(+)cells)were measured.The occurrence of adverse reactions in both groups was recorded.Results:The disease control rate and effective rate in the combination group were 97.87%(46/47)and 82.98%(39/47),respectively,while in the control group they were 83.33%(40/48)and 56.25%(27/48),respectively.The disease control rate and effective rate in the combination group were higher than those in the control group(P<0.05).The Chinese medicine syndrome score in the combination group was lower than that in the control group(P<0.05).The NRS2002 score in the combination group was lower than that in the control group(P<0.05).Serum albumin and prealbumin levels were higher in the combination group compared to the control group(P<0.05).The levels of CD4^(+)cells in both groups decreased compared to before treatment(P<0.05),while the levels of CD16^(+)CD56^(+)cells,CD19^(+)cells,and CD8^

关 键 词：和胃解毒汤 同步放化疗 食管癌 TBNK淋巴亚群 营养 肿瘤标志物 

分 类 号：R256.32[医药卫生—中医内科学]