复方斑蝥胶囊在宫颈癌术后放化疗中的应用价值分析及对肿瘤标志物的影响

Application Value Analysis of Compound Banmao Capsule(复方斑蝥胶囊)in Postoperative Radiotherapy and Chemotherapy of Cervical Cancer and Its Effect on Tumor Markers

观察复方斑蝥胶囊在宫颈癌术后放化疗中的应用价值分析及对肿瘤标志物的影响。方法选择2017年10月—2019年10月医院收治的宫颈癌术后放化疗患者96例为研究对象,依据随机对照法将患者分为研究组和对照组,每组48例。两组均采用广泛性全子宫切除术治疗,对照组术后采取放化疗治疗,研究组在对照组治疗的基础上,口服复方斑蝥胶囊。3粒/次,2次/d。比较两组治疗前后中医证候积分和治疗疗效,治疗前后肿瘤标志物血清糖类抗原(CA125)、癌胚抗原(CEA)水平变化,比较两组治疗前后细胞免疫功能(CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+))水平变化,比较两组治疗期间不良反应发生情况,随访1年,比较两组的转移率和生存率。结果研究组治疗总有效率为87.50%(42/48),对照组治疗总有效率为70.83%(34/48),研究组治疗总有效率高于对照组(P<0.05);两组治疗后盗汗、恶心呕吐、神疲乏力、食欲减退、失眠、头晕目眩和腰膝酸软等中医证候积分较治疗前降低。组间结果比较显示,研究组治疗后盗汗、恶心呕吐、神疲乏力、食欲减退、失眠、头晕目眩和腰膝酸软等中医证候积分低于对照组(P<0.05);两组治疗后血清肿瘤标志物CEA、CA125水平较治疗前降低。组间结果比较显示,研究组治疗后血清肿瘤标志物CEA、CA125水平低于对照组(P<0.05);研究组治疗后CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)较治疗前升高,且高于同期对照组(P<0.05);研究组患者中贫血、胃肠道反应、白细胞降低和肝功能受损的发生率低于对照组(P<0.05);两组治疗后躯体、情绪、角色、社会和认知等评分较治疗前升高,组间结果比较显示,研究组治疗后躯体、情绪、角色、社会和认知等评分高于对照组(P<0.05)。结论宫颈癌术后放化疗患者口服复方斑蝥胶囊辅助治疗,可显著降低患者的中医证候积分,降低肿瘤标志物CA125、CEA含量,改善免疫功能,发挥对机体免疫力的保护作用,提高治疗疗效,有较好的临床应用效果。

Objective To observe the application value of Compound Banmao Capsule(复方斑蝥胶囊)in postoperative radiotherapy and chemotherapy of cervical cancer and its effect on tumor markers.Methods A total of 96 patients with postoperative radiotherapy and chemotherapy of cervical cancer admitted to the hospital from October 2017 to October 2019 were selected as the research subjects.According to the randomized control method,the patients were divided into study group and control group,with 48 cases in each group.The two groups were treated with extensive total hysterectomy.The control group was treated with radiotherapy and chemotherapy after surgery,and the study group was treated with Compound Banmao Capsule orally on the basis of the control group,3 capsules once,twice a day.TCM symptoms score,the treatment curative effect,changes of tumor markers[carbohydrate antigen(CA125)and carcinoembryonic antigen(CEA)]in serum,changes of cellular immune function(CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+))of two groups before and after treatment were compared.The adverse reactions occurred during the treatment of the two groups were observed and compared.The metastatic rate and survival rate after follow-up of 1 year of two groups were compared.Results The total effective rate of the study group was 87.50%(42/48)and that of the control group was 70.83%(34/48).The total effective rate of the study group was higher than that of the control group(P<0.05).After treatment,the scores of night sweats,nausea and vomiting,fatigue,loss of appetite,insomnia,dizziness and weakness of waist and knee were lower in both groups.The results showed that the scores of night sweats,nausea and vomiting,fatigue,loss of appetite,insomnia,dizziness and weakness of waist and knee in the study group were lower than those in the control group(P<0.05).The levels of serum tumor markers(CEA and CA125)in both groups were lower after treatment than those before treatment.The results showed that the levels of serum tumor markers(CEA and CA125)in the study group were lower than those in the control group(P<0.05).The levels of CD_(3)^(+),CD_(4)^(+) and CD_(4)^(+)/CD_(8)^(+) in the study group after treatment were higher than those before treatment,and higher than those in the control group during the same period(P<0.05).The incidence of anemia,gastrointestinal reaction,leukopenia and impaired liver function in the study group was lower than that in the control group(P<0.05).After treatment,the scores of body,mood,role,society and cognition in the two groups were higher than those before treatment.The comparison of the results between the two groups showed that the scores of body,mood,role,society and cognition in the study group were higher than those in the control group(P<0.05).Conclusion Oral administration of Compound Banmao Capsule as the adjuvant therapy for patients with cervical cancer after postoperative radiotherapy and chemotherapy can significantly reduce the scores of TCM symptoms and the contents of tumor markers(CA125 and CEA),improve immune function,play a protective role in the immunity of the body,improve the therapeutic effect,and has good clinical application effect.