复方中药同步放化疗治疗局部晚期直肠癌的临床研究

Clinical research of rectal cancer patients treated by compound Chinese medicine combined with concurrent radiochemotherapy

目的:探讨复方中药同步放化疗治疗局部晚期直肠癌的疗效。方法:将50例局部晚期直肠癌患者,随机分为治疗组和对照组各25例,所有患者均接受同步放化疗,治疗组在放化疗的同时同步服用复方中药,从放化疗开始连续用至治疗结束,对照组只行放化疗,治疗完成后评价疗效和毒副反应。结果:治疗组总有效率(CR+PR)为88.0%,完全缓解率(CR)为36.0%;对照组总有效率(CR+PR)为68.0%,完全缓解率(CR)为28.0%,两组间总有效率差异无统计学意义(P>0.05)。放疗相关毒副反应主要为肛门不适及消化道症状。对照组肛门不适、大便带血、恶心及呕吐、腹痛、腹泻发生率明显高于治疗组(P<0.05)。治疗组大于Ⅱ级的放射性直肠炎、放射性膀胱炎及骨髓抑制等毒副反应总发生率为12.0%,远低于对照组的40.0%,两组间差异有统计学意义(P<0.05)。与对照组比较,治疗组明显提高晚期结直肠癌患者的NK细胞及CD4/CD8(P<0.05)。结论:复方中药联合放化疗可提高局部晚期直肠癌近期疗效,明显减轻放化疗所致的毒副反应,改善免疫功能。

Objective：To analyze the efficacy and toxicity of concurrent radiochemotherapy combined with com- pound Chinese medicine in treatment of rectal cancer patients. Methods： A total of 50 cases of rectal cancer treated by concurrent radiochemotherapy, were randomly divided into treatment group 25 cases and control group 25 cases. Two groups were given the same radioactive dosages and methods. But the treatment group was treated by concurrent radio- chemotherapy with compound Chinese medicine. Results： The total effective rate （ CR ＋ PR） of patients in the treatment group was higher than that patients in the concurrent radiochemotherapy alone（88.0% vs 68.0% ,P 〉 0.05 ）. The complete remission rate was also much higher in the treatment group than the control group（ 36.0% vs 28.0% ）. Anal discomfort, blood in stool, nausea and vomiting, stomachache and diarrhea were much higher in the control than the treatment group（P 〈 0.05 ）. Also the total incidence rate of more than 1i levels of radiation proctitis, radiation cystitis and bone marrow suppression toxicity were much higher in the control group than the treatment group（40.0% vs 12.0%, P 〈 0.05 ）, Compare with the control group, the treatment group could apparently improve NK ceils and CD4/CD8 （P 〈 0. 05）. Conclusion：Compound Chinese medicine can improve the short -term curative effect of con- current radiochemotherapy of rectum cancer, can significantly decreased side effect of concurrent radiochemotherapy and improve immune function.