化疗结合益气健脾法治疗大肠癌术后患者的临床研究

Clinic Study on Therapeutic Effect of Jianpi Yiqi Herbs Combined with Chemotherapy in Treating Post-operat Lonal Colorectal Cancer Patients

目的:观察益气健脾法联合化疗对大肠癌术后脾虚证患者的疗效。方法:将60例符合入选标准的大肠癌患者,随机分为单纯化疗组(20例);化疗加健脾组(20例);化疗加柘木组(20例);3组疗程为42天。治疗结束后评价疗效,观察3组患者治疗前后中医症状积分和疗效变化、生存质量、免疫功能、毒副反应等方面的变化。结果:①3组中医症状比较,化疗加健脾组治疗后脾虚症状积分明显低于治疗前,有显著差异(P<0.05),与单纯化疗组比较,有显著差异(P<0.01),与化疗加柘木组比较,差异无显著性(P>0.05);化疗加健脾组中医总有效率优于单纯化疗组与化疗加柘木组,差异有显著性(P<0.05);②3组卡氏评分比较,化疗加健脾组、化疗加柘木组较治疗前有明显提高,有显著差异(P<0.05),而单纯化疗组略有降低(P>0.05),治疗后组间卡氏评分比较,化疗加健脾组高于化疗与化疗加柘木组,有非常显著差异(P<0.01);③化疗加健脾组治疗后NK细胞活性及CD4/CD8比值均有提高,与治疗前相比有显著差异(P<0.05),与单组间比较有显著差异(P<0.05);与化疗加柘木组比较,治疗后NK细胞活性,差异无显著性(P>0.05),CD3、CD4/CD8差异有显著性(P<0.05)。结论:化疗结合益气健脾法治疗大肠癌,能够增强化疗的近期疗效,减少部分毒副反应,有效改善大肠癌术后患者脾虚症状,提高生活质量,改善病人免疫状态,起到减毒增效作用。

Objective：To observe and compare the therapeutic effect of Jianpi Yiqi methods combined with chemotherapy in treating post-operational colorectal cancer patients with spleen qi deficiency Syndrome.Methods： Adopting randomized control trial method,60 patients were divided into three groups.The treatment group（chemotherapy plus traditional Chinese medicine,n=20）,control group1（chemotherapy plus tsugeki syrup n=20） and control group 2（chemotherapy only,n=20）.A treatment course of 42 days was applied to all groups,the therapeutic effect,change of spleen qi deficiency Syndrome,life quality and immune effect and adverse reaction were observed.Results： ①in the aspect of TCM symptom control,after treatment,the score of TCM spleen qi deficiency in the treatment group descended,the difference had statistically significance（P〈0.05）,While the score in control group 2 increased.Compared with control group 1 and 2,TCM symptom control in the treatment group is superior,the difference had statistically significance（P〈0.05）.②in the aspect of KPS score,after treatment,the KPS score of treatment group and control group1 was obviously enhanced,the difference was statistically significant（P〈0.05）,the KPS score of control group 2 was reduced,After treatment,the KPS score in treatment group is higher than that in control group 1 and 2,the difference in those three groups was statistically significant（P〈0.01）.③There was a significant enhancement of NK cell activity and ratio of CD4/CD8 in treatment group（P〈0.05）,While the result for control group 2 was contrast,there was a little drop（P〈0.05）,the difference between two groups was statistically significant（P〉0.05）.After treatment,the difference of the change of NK cell between treatment group and group 1 was not obvious（P〉0.05）,while the difference of CD3 and ratio of CD4/CD8 between two groups had statistically significant（P〈0.05）.Conclusions： In the therapy of post-operational colorectal cancer patients with spleen qi deficiency Syndrome,chemotherapy plus Jianpi Yiqi methods could enhance the curative effect,reduce the poisonous side effect,improve symptom control of spleen qi deficiency and life quality,modulate the station of immunity in order to achieve synergy and relive the side effect.