八珍汤加味调节大肠癌术后癌因性疲乏免疫功能

Effect of Modified Treatment of Bazhen Decoction to Cancer-related Fatigue Immune Function After Colorectal Surgery

目的:观察八珍汤加味对大肠癌术后患者癌因性疲乏(CRF)气血两虚证患者疲乏状态、生活质量和免疫功能的影响。方法:160例患者按完全计算机软件平衡分组法,分为对照组和观察组各80例。两组患者均给予止痛、止吐、营养支持、适当的有氧运动、免疫调节、改善睡眠、心理护理等综合对症处理。对照组口服补中益气合剂,10 m L/次,3次/d。观察组内服八珍汤加味,2次/d,1剂/d。两组疗程均为3个月。进行治疗前后Piper疲乏修订量表(PFS-R),气血两虚证辨证评分和癌症患者生命质量测定量表(EORTC QLQ-C30)评分,检测治疗前后T淋巴细胞亚群(CD3^+,CD4^+,CD8^+,CD4^+/CD8^+),自然杀伤细胞(NK),肿瘤坏死因子-α(TNF-α),白细胞介素-1β(IL^(-1)β)和干扰素-γ(IFN-γ)的水平。结果:治疗后观察组PFS-R评分和气血两虚证辨证评分均低于对照组(P<0.01);经Ridit分析,治疗后观察组疲乏程度轻于对照组(P<0.01);观察组治疗后QLQ-BR30量表躯体功能、角色功能、情绪功能、认知功能和社会功能和整体生活质量评分均高于对照组(P<0.01),疲劳、恶心呕吐、睡眠困难、食欲下降、便秘、腹泻等症状评分均低于对照组(P<0.01);观察组CD3^+,CD4^+,CD4^+/CD8^+和NK水平均高于对照组,CD8^+低于对照组(P<0.01);观察组炎症因子TNF-α和IL^(-1)β水平均低于对照组,IFN-γ水平高于对照组(P<0.01)。结论:八珍汤加味治疗大肠癌术后CRF患者,可调节免疫炎症因子,提高机体的免疫功能,有效的改善CRF症状,提高患者生活质量。

Objective： To observe the effects of Bazhen decoction modified fatigue state, quality of life and immune function in patients with cancer-related fatigue （CRF） and Qi and blood deficiency after colorectal cancer surgery. Method： One hundred and sixty patients were divided into control group （80 cases） and observation group （80 cases） by complete computer software balanced grouping method. The patients in both groups received comprehensive symptomatic treatment such as relieving pain, antiemetic, nutritional support, appropriate aerobic exercise, immunomodulatory, improving sleeping, psychological adjustment and nursing. Patients in control group received Buzhong Yiqi mixture, 10 mL/time, 3 times/day. Patients in observation group received Bazhen decoction modified, 2 times/day, 1 dose/day. The course of treatment was 3 months in both groups. Before and after treatment, Piper fatigue revision scale （PFS-R） , Qi and blood deficiency and quality of life measurement for cancer patients （EORTC QLQ-C30） scale were graded, and levels of T lymphocyte subsets （CD3＋ , CD4＋ , CD8＋ , CD4＋/CD8＋ ） , natural killer cells （NK） , tumor necrosis factor- （TNF-a） , interleukin-1β （IL-1β） and interferon-γ （IFN-γ） were detected. Result： After treatment, scores of PFS-R and Qi and blood deficiency in observation group were lower than those in control group （P 〈 0.01 ）. Ridit analysis showed that, degree of fatigue in observation group was lighter than that in control after treatment （P 〈 0.01 ）. Scores of somatic function, role function, emotional function, cognitive function, social function and overall quality of life were higher than those in control （P 〈0.01 ）. And scores of fatigue, nausea and vomiting, sleep difficulties, loss of appetite, constipation and diarrhea were lower than those in control group （P 〈 0.01 ）. Levels of CD3＋ , CD4＋ , CD4 ＋/CD8 ＋ , NK and IFN-γ in observation group were higher than those in control group （P 〈0.01 ）. While the levels of TNF-α and IL-1β were lower than those in control group （P 〈 0.01 ）. Conclusion： Bazhen decoction modified can regulate inflammatory factors, improve immune function, and ameliorate symptoms caused by CRF and improve their quality of life.