不同中医证型食道癌对化疗药物敏感性的相关性分析

Correlation Analysis of the Sensitivity to Chemotherapy Drugs among Different TCM Syndrome Patients with Esophageal Cancer

目的：分析不同中医证型食道癌和化疗药物敏感性的相关性。方法：随机选取2013年4月至2016年3月,于我院就诊经胃镜取病理组织活检并确诊为食管鳞癌的患者60例,通过中医辨证论治,将其证型分为痰瘀互结型19例、气阴两虚型17例、津亏热结型13例、痰气交阻型11例,其中年龄在40-60岁之间,平均年龄（47.6±6.8）岁,其中男37例,女23例。体外肿瘤组织细胞液制备均由手术切除的食管癌患者提供新鲜组织块,体外加入不同浓度的紫杉醇、伊立替康、泽菲、5-氟尿嘧啶、顺铂等化疗药物,细胞MTT测试计算各个中医证型中化疗药物对肿瘤细胞的抑制率。结果：在用5种不同化疗药物分别对60例食管癌患者的食管癌细胞进行体外抑制试验,结果显示各药物对癌细胞敏感度的基本情况为：紫杉醇〉顺铂〉5-氟尿嘧啶〉伊立替康〉泽菲。各组间经统计学比较,痰瘀互结型、津亏热结型和痰气交阻型各组间经统计学比较,无统计学意义（P〉0.05）。痰瘀互结型、津亏热结型和痰气交阻型的化疗药物敏感性均高于气阴两虚型（P〈0.05）。结论：不同中医证型食道癌与化疗药物敏感性存在相关性,其中气阴两虚型存在耐药性。

Objective：To analyze the correlation between different TCM syndromes of patients with esophageal cancer and chemotherapy drug sensitivity. Methods：A total of 60 cases of patients with esophageal squa,nous cell carcinoma in March 2013 to April 2016 in our hospital were diagnosed by gastroscope pathological biopsy. Through the syndrome differentiation, the patients were divided into 19 cases of combined phlegm and stasis syndrome 17 cases of deficiency of both qi and yin, 13 cases of fluid consumption and heat accumulation and 11 cases of combined phlegm and qi. Their ages were between 40 to 60,with average age（47. 6 ±6. 8 years） ,including 37 male patients,and 23 female patients. In vitro tumor tissue cell fluid was obtained by fresh tissue of surgical resection of esophageal carcinoma patients and mixed with different concentrations of Paclitaxel 〉 CDDP 5-FU irinotecan, gemcitabine chemotherapy drugs. Inhibitory rate of chemotherapy drugs on tumor cells in various TCM Syndrome Types were detected with MTF test. Results：In the inhibition test of the five different chemotherapy drugs,it was found that the cancer cell sensitivity of the drugs was Paelitaxel 〉 CDDP 〉 5-FU 〉 irinotecan 〉 gemeitabine. Among the groups, there were no significant differences among the combined phlegm and stasis group, fluid consumption and heat accumulation and combined phlegm and qi group. But the drug sensitivity of phlegm and blood stasis,deficiency of fluid thermal junction and gas exchange resistance group was significantly higher than that of deficiency of both qi and yin group（ P 〈 0.05 ）. Conclusion ： There is positive correlation between different TCM syndromes of esophageal cancer and chemotherapy drug sensitivity, the drug tolerance in deficiency of both qi and yin syndrome.