扶脾益胃方治疗大肠癌术后化疗患者的近期疗效及其对免疫功能的影响

Short term therapeutic effect on treatment of postoperational large intestine carcinoma by Fupiyiwei decoction combined with chemotherapy and it′s effect on immune fuction

目的:观察中药扶脾益胃方治疗大肠癌术后化疗患者的近期临床疗效,并探讨其对患者免疫功能的影响。方法:58例大肠癌术后化疗患者随机分为中药组(33例)和对照组(25例),观察化疗期间不良反应、卡氏(Karnofsky)评分以及近期临床疗效,在治疗前后检测T细胞亚群(CD3+,CD4+,CD8+细胞)和NK细胞的百分比,同时将28例健康成年人做为正常对照组(正常组)。结果:化疗12个周期后中药组近期疗效优于对照组,但无明显差异,而中药组病人生活质量明显优于对照组(P<0.05),化疗不良反应的发生低于对照组(P<0.05),化疗前所有患者外周血CD3+,CD4+T细胞下降、CD8+T细胞升高、NK细胞活性下降。治疗后患者外周血CD3+T细胞和NK细胞增高,但仍低于正常组,CD8+T细胞降低但高于正常组,均无显著性差异,中药组CD4+T细胞升高,与对照组和正常组相比有显著性差异(P<0.05)。结论:扶脾益胃中药能有效防治大肠癌术后化疗不良反应,同时能改善患者的生活质量和免疫功能,提高化疗效果。

Objective： To investigate short term clinical therapeutic effect of fupiyiwei decoction （FPYWD） combined with chemotherapy in treating postoperational large intestine carcinoma and the effect on immune function. Method： The 58 cases of postoperational large intestine carcinoma were randomly divided into the traditional Chinese medicine （TCM） group （33 cases） and the control group （25 cases）. The toxic and adverse reaction, Karnofsky score and clinical therapeutic effect during chemotherapy were observed, and the level of subgroup of T cells CD3, CD4, CD8 and NK cells were detected, before and after treatment 28 healthy adult were regarded as normal group. Result： There was no significant difference in clinic therapeutic effect between the TCM group and the control group after 12 chemotherapy treatment courses. But the quality of life the TCM group remarkably better than in the control group （P 〈 0. 05 ）. while the incidence rate of toxic and adverse reaction of chemotherapy in the former group was lower than in the latter （ P 〈 0. 05 ）. The level of CD3 ＋, CD4 ＋ T cell and the viability of NK cells in all patients decreased during the chemotherapy treatment course while the level of CD8 ＋ T cell increased, the level of CD3 ＋ T cell and NK cells in peripheral blood in patients increased after treatment, but was lower than in normal group. The level of CD8 ＋ T cell was decreased and was lower than in normal group. There wa s no significant difference（P 〈 0. 05）. The level of CD4 ＋T cell after TCM group, there was significant different in CD4＋T cell be- tween TCM group and control group, nowal group（ P 〈 0. 05 ）. The viability of NK cell increased but there was no significant difference between the two group. Conclusion ： Fupiyiwei decoction （FPYWD） is effective in prevention and treatment of the toxic and adverse effects of chemotherapy of postoperational large intestine carcinoma, and can improve quality of life and immune function of patients. increase the effctive of chemotherapy.