八珍汤辅助放化疗治疗中晚期食管癌45例临床观察

Clinical Observation on 45 Cases with Esophageal Cancer in the Middle and Advanced Stage Treated with Bazhen Tang( 八珍汤) Combined with Chemoradiotherapy

目的观察八珍汤辅助放化疗治疗中晚期食管癌的近期疗效。方法将90例中晚期食管癌患者随机分为治疗组和对照组各45例。对照组行精确放疗,每日1次,每周5天;同时给予紫杉醇化疗(30 mg/m^2、第1天),每周重复,共6周。治疗组在放化疗的同时,加服中药八珍汤口服,每日1剂,共6周。于放疗结束后4周观察两组近期疗效,治疗前后采用KPS评分和简体中文版生活质量评估表(QLQC30)评价生活质量,检测细胞免疫功能(包括CD4^+、CD8^+、CD4^+/CD8^+),观察毒副反应(包括放射性食管炎、肝肾功能损害、放射性肺炎及骨髓抑制)。结果治疗组近期疗效有效率为82.2%,对照组为62.2%,治疗组近期疗效优于对照组(P<0.05)。治疗组治疗后KPS评分较治疗前升高,而QLQ-C30评分降低,并且优于对照组治疗后(P<0.05)。对照组治疗后与治疗前比较,CD4^+、CD4^+/CD8^+水平明显降低,CD8^+水平增高(P<0.05),而治疗组治疗后CD4^+、CD4^+/CD8^+、CD8^+水平差异无统计学意义(P>0.05)。治疗组放射性食管炎、肝肾功能损害、放射性肺炎及骨髓抑制发生率低于对照组(P<0.05)。结论八珍汤辅助放化疗治疗中晚期食管癌能减轻放化疗毒副反应,增强机体免疫功能,提高近期疗效和生活质量。

Objective To observe the short-term effects of Bazhen Tang combined with chemoradiotherapy in the treatment of esophageal cancer on the middle and advanced stage. Methods Ninety patients with esophageal cancer in the middle and advanced stage were randomly divided into the treatment group and the control group, 45 cases in each group. Both groups were treated with precise radiotherapy, once a day, five days a week ; at the same time, they were all given paclitaxel as chemotherapy, 30 mg/m^2, the first day, and it was repeated every week for six cycles in all. Meanwhile in addition, the treatment group was given Bazhen Tang, one dose daily for six weeks. In the fourth week after completing radiotherapy, the short-term effects in the two groups were observed. Before and after treat- ment, KPS score and simplified Chinese version quality of life assessment form （QLQ-C30） were used to evaluate quality of life, cellular immune function （ including CD4^＋ , CD8^＋ , CD4^＋/CD8^＋ ） was detected, and toxic and side effects （including radioactive esophagitis, hepatorenal functional lesion, radioactive pneumonia and myelosuppression） were Observed. Results The effective rate about the short-term effects was 82. 2% in the treatment group and 62.2% in the control group. The short-term effect in the treatment group was better than those in the control group （ P 〈 0. 05 ）. After treatment in the treatment group, KPS score was higher than that before treatment, but QLQ-C30 score reduced and was better than that in the control group after treatment （P 〈 0.05）. After treatment, the levels of CD4^＋ and CD4^＋/CD8^＋ in the control group were much lower, but level of CD8^＋ increased than those before treatment （P 〈 0. 05 ）. While in the treatment group there were no statistical differences in, levels of CD4^＋, CD4^＋ / CD8^＋ and CD8^＋ between before and after treatment （P 〉 0. 05 ）. In the treatment group, the incidence rates of radioactive esophagitis, hepatorenal functional lesion, radioactive pneumonia and myelosuppression were lower than those in the control group （P 〈 0. 05 ）. Conclusion In the treatment of esophageal cancer on the middle and advanced stage, Bazhen Tang combined with chemoradiotherapy may relieve toxic and side effects of chemoradiotherapy, enhance body＇s immune function and improve short-term effects and quality of life.