志苓胶囊联合丝裂霉素腹腔灌注对直肠癌合并恶性胸腹腔积液患者治疗效果分析

The Efficacy of Zhiling Capsule Combined with Mitomycin Intraperitoneal Perfusion in the Treatment of Rectal Cancer Patients with Malignant Peritoneal or Pleura Ascites

[目的]探讨志苓胶囊联合丝裂霉素腹腔灌注对直肠癌合并恶性胸腹腔积液患者治疗效果。[方法 ]选取收治的82例晚期直肠癌合并恶性胸腹腔积液患者,随机分为观察组和对照组。对照组患者给予丝裂霉素腹腔灌注治疗,观察组在对照组治疗基础上另口服给予志苓胶囊治疗。治疗结束后对腹水控制疗效进行评价;分析治疗前、治疗后第1周、第2周、第3周及第4周卡氏评分评;治疗前后分别对患者恶心呕吐、腹痛、尿量减少、呼吸困难、腹胀等症状进行评价;治疗前后分别检测患者CD3^+、CD4^+、CD8^+及CD19^+等T淋巴细胞亚群水平;治疗前后分别检测患者胸腹腔积液中CYFRA21,NSE,CEA及LDH的含量。观察所有患者治疗期间不良反应发生情况。[结果 ]观察组总有效率为86.8%,明显高于对照组的71.8%(P=0.043);治疗后观察组KPS评分均明显高于对照组(P<0.05);治疗后,观察组患者恶心呕吐、腹痛、尿量减少、呼吸困难及腹胀等评分分别为(1.11±0.19)分、(0.97±0.16)分、(0.87±0.15)分、(0.92±0.21)分及(1.13±0.27)分,均明显低于对照组(P均<0.05);观察组CD3^+、CD4^+、CD8^+及CD19^+水平均明显高于对照组(均P<0.05);观察组胸腹腔积液中CYFRA21,NSE,CEA及LDH的含量均明显低于对照组(P均<0.05);所有患者治疗期间均未发生严重不良反应,两组不良反应发生率无显著性差异(P>0.05)。[结论]志苓胶囊联合丝裂霉素腹腔灌注治疗晚期直肠癌合并恶性胸腹腔积液疗效确切,值得深入研究。

[Objective] To investigate the efficacy of Zhiling capsule combined with Mitomycin intraperitoneal perfusion in the treatment of rectal cancer patients with malignant peritoneal or pleura ascites.[Methods] eighty-two cases with rectal cancer with malignant peritoneal or pleura ascites were selected as the participants and divided into observation group and control group. Patients in control group were treated by oxaliplatinmitomycin intraperitoneal perfusion,while the observation group was given Zhiling capsule on the base of control group. After treatment,the effects were evaluated. KPS were performed before treatment and treatment after 1,2,3 and 4 week. The symptoms scores of nausea and vomiting,abdominal pain,urine reduced,difficulty breathing,abdominal distension were evaluated before and after the treatment. The levels of CD3^＋,CD4^＋,CD8^＋,CD19^＋in the two groups were detected,while the levels of CYFRA21-1,NSE,CEA and LDH were detected either. The toxicity of the two groups was compared.[Results] The total effective rate was 86.8% in the observation group,it was higher than that in the control group（71.8%）（P=0.043）. The KPS score were significantly higher in the observation group than that in the control group from the first week（P〈0.05）. The symptoms scores of nausea and vomiting,abdominal pain,urine reduced,difficulty breathing,abdominal distension were（1.11±0.19）,（0.97±0.16）,（0.87±0.15）,（0.92±0.21） and（1.13±0.27） in the observation group,significantly higher than those in the control group（P〈0.05）. The levels of CD3^＋,CD4^＋,CD8^＋and CD19^＋in the observation group were significantly higher than those in the control group（P〈0.05）. After treatment,the levels of CYFRA21-1,NSE,CEA and LDH were significantly lower in the observation group than those in the control group（P 〈0.05）. There were no serious toxicity was found,and the toxicity rate was similar between the two groups（P〉 0.05）.[Conclusion] Zhiling capsule combined with mitomycin intraperitoneal perfusion for rectal cancer patients with malignant peritoneal or pleura ascites has a good effect and worth to the next study.