益气扶正解毒汤结合足三里穴位注射复方当归注射液治疗晚期胃癌患者疗效及对肿瘤标志物、免疫功能的影响

Effect of Yiqi Fuzheng Jiedu Decoction(益气扶正解毒汤)Combined with Zusanli(ST36)Injection of Compound Danggui Injection on Advanced Gastric Cancer and Its Influence on Tumor Markers and Immune Function

目的分析益气扶正解毒汤结合足三里穴位注射复方当归注射液治疗晚期胃癌患者的疗效及对肿瘤标志物、免疫功能的影响,探讨临床治疗该病的有效方案,为改善患者预后提供参考依据。方法选取该院2020年2月—2021年2月收治的80例晚期胃癌患者,根据不同治疗方案分为A组与B组,每组40例,A组予以奥沙利铂联合培美曲塞治疗,B组在A组的基础上予以益气扶正解毒汤结合足三里穴位注射复方当归注射液治疗,对比两组患者的中医证候积分、临床疗效、肿瘤标志物(CEA、CA125、TPS)、免疫功能指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))以及不良反应(恶心呕吐、白细胞减少、血小板减少、贫血)。结果治疗后B组的中医证候积分为(1.58±0.62)分,A组为(2.76±0.66)分,经统计学分析,两者差异具有统计学意义(P<0.05);经治疗,B组的总有效率为87.5%(35/40),A组的总有效率为67.5%(27/40),B组明显高于A组(P<0.05);在肿瘤标志物方面,B组治疗后的CEA为(2.58±1.02)U/mL、CA125为(20.76±7.61)U/mL、TPS为(28.06±13.83)U/mL;A组治疗后的CEA为(5.76±1.66)U/mL、CA125水平为(31.76±8.34)U/mL、TPS为(65.87±15.76)U/mL,两组差异均具有统计学意义,P<0.05;B组的CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均优于A组,两者差异具有统计学意义(P<0.05);B组的不良反应发生率为25%(10/40),A组不良反应率为30%(12/40),经卡方检验,两组差异无统计学意义(P>0.05)。结论益气扶正解毒汤结合足三里穴位注射复方当归注射液治疗晚期胃癌患者的疗效确切,可有效改善患者的临床症状,降低肿瘤标志物水平,提高免疫功能,且不良反应发生率低,值得推广。

Objective To analyze the effect of Yiqi Fuzheng Jiedu Decoction(益气扶正解毒汤)combined with Zusanli(ST36)injection of Compound Danggui Injection on patients with advanced gastric cancer,tumor markers and immune function and explore the effective scheme for clinical treatment of the disease,so as to provide reference for improving the prognosis of pa⁃tients.Methods Eighty patients with advanced gastric cancer in the hospital from February 2020 to February 2021 were selected and divided into group A and group B according to different treatment schemes,with 40 cases in each group.Group A was treated with oxaliplatin combined with pemetrexed,and group B was treated with Yiqi Fuzheng Jiedu Decoction combined with Zusanli(ST36)injection of Compound Danggui Injection on the basis of group A.The TCM syndrome score,clinical efficacy,clinical cur⁃ative effect of the two groups were compared.Tumor markers(CEA,CA125,TPS),immune function indexes(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))and adverse reactions(nausea and vomiting,leucopenia,thrombocytopenia,anemia)were observed.Results After treatment,the TCM syndrome score of group B was(1.58±0.62)points and that of group A was(2.76±0.66)points(P<0.05).After treatment,the total effective rate of group B was 87.5%(35/40),and that of group A was 67.5%(27/40).The total effec⁃tive rate of group B was significantly higher than that of group A(P<0.05).In terms of tumor markers,the CEA of group B after treatment was(2.58±1.02)U/mL,CA125 was(20.76±7.61)U/mL,TPS was(28.06±13.83)U/mL.The CEA of group A was(5.76±1.66)U/mL,CA125 was(31.76±8.34)U/mL,TPS was(65.87±15.76)U/mL(P<0.05).The levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)in group B were better than those in group A(P<0.05).The incidence of adverse reactions was 25%(10/40)in group B and 30%(12/40)in group A.There was no significant difference between the two groups by chi square test(P>0.05).Conclusion Yiqi Fuzheng Jiedu Decoction combined with Zusanli(ST36)injection of Compound Danggui Injection in the treatment of patients with advanced gastric cancer has definite curative effect,can effectively improve the clinical symptoms of pa⁃tients,reduce the levels of tumor markers,improve the immune function and the incidence of adverse reactions is low.It is worthy of promotion.