扶元复衡汤辅助化疗对结直肠癌细胞免疫功能、不良反应及预后的影响  

Effects of Adjuvant Intervention of Fuyuan Fuheng Decoction on Cellular Immune Function,Adverse Reactions and Prognosis of Colorectal Cancer Treated with Chemotherapy

作　　者：穆美玲 文小强 秋彤 崔寅箫 MU Meiling;WEN Xiaoqiang;QIU Tong;CUI Yinxiao(Dept.of Oncology and Breast Surgery,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000 Shaanxi,China;Second Dept.of Oncology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712000 Shaanxi,China;Dept.of Oncology and Breast Surgery,the Affiliated Hospital of Shaanxi University of Chinese Medicine,Xianyang 712046 Shaanxi,China)

机构地区：[1]陕西中医药大学第二附属医院肿瘤乳腺外科,陕西咸阳712000 [2]陕西中医药大学第二附属医院肿瘤二科,陕西咸阳712000 [3]陕西中医药大学附属医院肿瘤乳腺外科,陕西咸阳712046

出　　处：《广州中医药大学学报》2025年第4期863-871,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：陕西省自然科学基础研究计划项目(编号:2023-JC-YB-667)。

摘　　要：【目的】探究扶元复衡汤辅助化疗治疗结直肠癌(CRC)脾肾亏虚证患者的临床疗效及其对细胞免疫功能、不良反应及预后的影响。【方法】对2021年1月~2023年1月陕西中医药大学第二附属医院收治的120例CRC脾肾亏虚证患者的临床资料开展回顾性研究,根据治疗方案的不同将120例患者分为研究组和对照组,每组各60例。2组患者均予以CRC根治切除术治疗,对照组术后给予mFOLFOX6化疗方案(5-氟尿嘧啶^(+)奥沙利铂^(+)亚叶酸钙)治疗,研究组在对照组的基础上联合扶元复衡汤治疗。以14 d为1个周期,连续治疗12个周期。观察2组患者治疗前后中医证候积分、细胞免疫功能[T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)和自然杀伤(NK)细胞]、欧洲癌症研究与治疗组织生活质量测定量表(EORTC QLQ-C30)评分、癌因性疲乏程度Piper疲乏量表(PFS)评分、Karnofsky功能状态(KPS)评分、预后相关标志物[糖类抗原199(CA199)、癌胚抗原(CEA)、血管内皮生长因子(VEGF)、乳酸脱氢酶(LDH)]的变化情况,并比较2组患者的治疗效果、不良反应发生率与1年生存率。【结果】(1)治疗效果方面:治疗12个周期后,研究组的总缓解率为75.00%(45/60),明显高于对照组的53.33%(32/60),差异有统计学意义(χ^(2)=6.125,P<0.05)。(2)中医证候积分方面:治疗后,2组患者的神疲乏力、腰膝酸软、食欲不振、头晕目眩、大便溏稀等证候积分均较治疗前明显降低(P<0.05),且研究组的降低幅度均明显优于对照组(P<0.01)。(3)细胞免疫功能方面:治疗后,2组患者的外周血T淋巴细胞亚群CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)和NK细胞水平均较治疗前降低(P<0.05),但研究组的降低幅度均明显小于对照组(P<0.01)。(4)生活质量、癌因性疲乏程度和功能状态方面:治疗后,2组患者的EORTC QLQ-C30评分、KPS评分均较治疗前升高(P<0.05),PFS评分均较治疗前降低(P<0.05),且研究组对EORTC QLQ-C30评�Objective To investigate the clinical efficacy of adjuvant intervention of Fuyuan Fuheng Decoction for chemotherapy in the treatment of patients with colorectal cancer(CRC)of spleen-kidney deficiency syndrome,and to observe its effects on cellular immune function,adverse reactions and the prognosis of CRC treated by chemotherapy.Methods From January 2021 to January 2023,a retrospective study was conducted on 120 patients with CRC of spleen-kidney deficiency syndrome admitted to the Second Affiliated Hospital of Shaanxi University of Chinese Medicine.The patients were divided into a study group and a control group according to the treatment protocols,with 60 patients in each group.The patients of the two groups were treated by radical resection of CRC,and then the control group was given mFOLFOX6 chemotherapy(5-Fluorouracil^(+)Oxaliplatin^(+)Calcium Folinate)while the study group was given Fuyuan Fuheng Decoction together with mFOLFOX6 chemotherapy after operation.Fourteen days constituted a cycle of treatment,and the two groups were given 12 consecutive cycles of treatment.Before and after treatment,the two groups were observed in the changes of traditional Chinese medicine(TCM)syndrome scores,cellular immune function indicators[T-lymphocyte subsets CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and natural killer(NK)cells],European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30)scores,PipersFatigueScale(PFS)scoresofcancer-related fatigue,Karnofsky Performance Status(KPS)scores,and prognosis-related markers[carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),vascular endothelial growth factor(VEGF),and lactate dehydrogenase(LDH)].After treatment,the therapeutic efficacy,the incidence of adverse reactions,and the one-year survival rate of the two groups were compared.Results(1)After 12 cycles of treatment,the overall response rate of the study group was 75.00%(45/60),which was significantly higher than that of the control group[53.33%(32/60)],the difference being st

关 键 词：结直肠癌 脾肾亏虚证 扶元复衡汤 化疗 mFOLFOX6方案 免疫功能 生活质量 癌因性疲乏 预后 不良反应 

分 类 号：R273.353[医药卫生—中西医结合]