放射疗法联合应用活血与扶正活血中药治疗鼻咽癌的对比研究

A comparative study on the long -term effects of radiotherapy combined with herbs of blood circulation-promoting and healthy qistrengthening on nasopharyngeal carcinoma

目的 观察活血与扶正活血中药联合放射治疗鼻咽癌的远期疗效。方法９８例首程放疗的鼻咽癌患者随机分成三组，Ｉ组３１例采用单纯放射治疗，Ⅱ组３３例联合活血汤治疗，Ⅲ组３４例联合扶正活血汤治疗。观察治疗前后患者症状、瘤体变化及细胞免疫功能，随访５年以上。结果 三组近期有效率差异无显著性意义（Ｐ＞０．０５）。毒副反应Ⅰ组明显高于Ⅱ、Ⅲ组（Ｐ＜０．０５）。５年生存率三组依次为３５．４８％、５１．５２％、６１．７０％，Ｉ组明显低于后两组（Ｐ＜０．０１）。远处转移率三组依次为１９．３５％、２７．２７％和１１．７６％，Ⅱ组与 Ⅰ、Ⅲ组比较差异有显著性意义（Ｐ＜０．０５）。治疗结束２个月后Ⅱ组ＣＤ３、ＣＤ４及ＮＫ细胞活性明显低于Ⅰ、Ⅲ组（Ｐ＜０．０５）。结论 扶正活血中药联合放射治疗能明显提高鼻咽癌患者远期生存率，而单纯活血药物有可能增加远处转移。

Objective To investigate the long - term effects of Huoxue Decoction (HD) or Fuzheng Huoxue Decoction (FHD) combined with radiotherapy on nasopha-ryngeal carcinoma (NPC). Methods 98 cases of newly hospitalized patients with NPC were randomly divided into three groups, all received a routine course of radiotherapy during the therapeutic period. However, 33 cases of group II were supplemented with a herbal therapy of HD, 34 cases of group III supplented with FHD, and 31 cases of group I supplemented with nothing. Meanwhile, the therapeutic effects of the combined thera-py were carefully evaluated among all the patients during a following up period of 5 years. Results Despite of there were no significant differences in the short - term re-mission rates among all the groups, the side-effects with the therapy were significantly severer in group I than in group II and I (P<0. 01). The 5 -year survival rates were 35. 48% ,51. 52% and 61. 76% for groups I , II and III respectively, with a significantly lower rate in group I . Furthermore, the stant metastatic rates were 19. 35%, 27. 27% and 11. 76% for the three groups respectively, with a significantly higher rate in group I . Still more, the numbers of CDS and CD4, which are the sub - populations of T cells, and NK cells were significantly decreased in group II (P<0. 05). Conclusion Herbal medicine, like FHD, can improve the long - term survival rate of cases with NPC, when combined with radiotherapy. In contrast, it should be kept in mind that simply using of herbs with the effect of blood circulation -promoting, like HD, may in-crease the distant metastic risk for NPC patients, even if combined with radiotherapy.