中药胃宁颗粒联合化疗防治胃癌复发转移的临床分析

Weining granules combined with chemotherapy for recurrent and metastatic gastric cancer

目的:研究胃宁颗粒联合化疗对胃癌复发转移的防治作用.方法:160例术后胃癌患者随机分为治疗组80例予胃宁颗粒配合化疗,对照组80例予单纯化疗.观察治疗前后局部复发及远处转移情况,血液流变学指标血浆黏度、全血黏度、血沉方程(K值)、红细胞聚集指数、纤维蛋白原,金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)含量、复发转移病灶大小,复发转移者生活质量的变化.结果:治疗组1年后复发转移率22.22%,对照组为32.22%,两组比较差异有显著性意义(p<0.05);治疗组治疗后血浆黏度、全血黏度、纤维蛋白原、MMP-9、VEGF含量与对照组相比显著降低(1.26±0.13mPa·s vs 1.75±0.11 mPa·s,8.73±1.98mPa·s vs 20.56±2.31mPa·s,2.15±0.16 vs 3.85±0.41,135.46±22.16μg/L vs 186.23±31.56μg/L,102.46±18.43 vs 176.43±21.56,P<0.05或P<0.01);治疗组对复发转移灶大小抑制率为30.00%,对照组为17.85%,两组比较差异有显著性意义(P<0.05);治疗组对复发转移患者生活质量改善显著优于对照组(P<0.01).结论:胃宁颗粒和化疗药物联用,具有一定的协同作用,可以提高疗效,改善患者生存质量,其机制可能与改善微循环、降低MMP-9、VEGF含量有关.

AIM： To study the inhibitory effect of Weining granules combined with chemotherapy on recurrent and metastatic gastric cancer and its possible mechanism. METHODS： One hundred and sixty cases of postoperative gastric cancer were randomly divided into treatment group （n = 80） receiving Weining granules combined with chemotherapy and control group （n = 80） receiving chemotherapy. The following parameters were observed, including recurrence and metastasis rate of gastric cancer within 1 year, and changes in plasma viscosity, blood viscosity, value K of blood sedimentation equation, erythrocyte aggregation index, fibrinogen, level of metalloproteinase -9 （MMP-9） and vascular endothelial growth factor （VEGF）, size of recurrent tumors, life quality of recurrent and metastastic cases. RESULTS： The recurrent and metastatic rate was 22.22% in the treatment group and 32.22% in the control group with a significant difference between the two groups （P 〈 0.05）. Plasma viscosity, blood viscosity, fibrinogen, MMP-9, VEGF were significantly higher in the treatment group than in the control group （1.26±0.13 mPa·s vs 1.75±0.11 mPa·s, 8.73±1.98 mPa·s vs 20.56±2.31 mPa·s, 2.15±0.16 vs 3.85±0.41, 135.46± 22.16 μg/L vs 186.23±31.56 μg/L, 102.46±18.43 vs 176.43 ±21.56, P 〈 0.05 or P 〈 0.01）. The inhibitory rate for the recurrent and metastatic foci was 33.33% in the treatment group and 17.85% in the control group with a significant difference between the two groups （P 〈 0.05）. Improvement in the quality of life was much better in the treatment group than in the control group （P 〈 0.01）. CONCLUSION： Weining granules combined with chemotherapy inhibit recurrence and metastasis of gastric cancer and improve curative effect by decreasing MMP-9 and VEGF level and promoting microcirculation.