十全大补汤合五味消毒饮加减对食管癌术后气血亏虚证患者免疫功能的影响

Effect of Shiquan Dabu Tang Combined with Wuwei Xiaodu Yin on Immune Functions in Postoperative Qi and Blood Deficiency Patients with Esophagus Cancer

目的:探讨十全大补汤合五味消毒饮加减对食管癌术后气血亏虚证患者免疫功能、生活质量的影响。方法:本组研究共选择符合条件的病例90例,随机分为治疗组(46例)和对照组(44例);对照组于术后第2~9天采用肠内营养支持疗法;治疗组在对照组基础上给予十全大补汤合五味消毒饮加减辅助治疗;比较两组中医临床症状积分;检测两组血清CD4+和CD8+及免疫球蛋白(Ig)A,IgG,IgM水平;比较两组生活质量核心量表(EORTC QLQ-C30)V3.0评分和食管癌补充模式表(QLQ-OES18)评分。结果:治疗组患者术后10 d的中医症状各指标评分均显著低于对照组(P<0.01);治疗组术后10 d患者CD4^+,CD4^+/CD8^+,IgA,IgG,IgM均显著高于对照组,CD8+显著低于对照组(P<0.01);治疗组术后10 d患者功能领域指标评分均显著高于对照组,而症状领域指标评分均显著低于对照组(P<0.01);术后10 d,治疗组患者EORTC QLQ-OES18各项评分均显著低于对照组(P<0.01)。结论:在常规肠内营养治疗基础上,十全大补汤合五味消毒饮加减治疗食管癌术后患者,可显著改善患者中医症状和生活质量,提高免疫功能。

Objective： To observe the effects of Shiquan Dabu Tang combined with Wuwei Xiaodu Yin on immune function and living quality in postoperative Qi and blood deficiency patients with esophagus cancer.Method： Ninety eligible patients were selected in this study and randomly divided into control group（ 44 cases）and treatment group（ 46 cases）. Patients in control group received enteral nutrition supporting therapy on postoperative day 2 to day 9. Patients in treatment group were treated with Shiquan Dabu Tang combined with Wuwei Xiaodu Yin based on the treatment in control group. Symptom scores of traditional Chinese medicine（ TCM） were compared between two groups. Levels of serum CD4^＋,CD8^＋,IgA,IgG and IgM were detected in serum of two groups. Quality of Life Questionary-Core 30（ EORTC QLQ-C30） V3. 0 scores and Esophageal Cancer Supplementary Schema Table（ QLQ-OES18） scores were compared between two groups. Result： The TCM symptom scores in treatment group were significantly lower than those in control group on postoperative day 10（ P〈0. 01）,CD4^＋,CD4^＋/ CD8^＋,IgA,IgG and IgM levels in treatment group were significantly higher than those in control group on postoperative day 10,while CD8^＋level was significantly lower than that in control group（ P〈0. 01）,scores of functional area indexes in treatment group were significantly higher than those of control group,while scores of symptom area indexes in treatment group were significantly lower than those of control group（ P〈0. 01）,on postoperative day 10,scores of EORTC QLQ-OES18 in treatment group were significantly lower than those of control group with statistical differences（ P〈0. 01）. Conclusion： Based on enteral nutrition supporting therapy,Shiquan Dabu Tang combined with Wuwei Xiaodu Yin in treatment of postoperative esophagus cancer with deficiency of Qi and blood could improve TCM symptoms and quality of life,and increase immune function.