健脾消癌方联合mFOLFOX6化疗对胃癌患者增效减毒及肿瘤标志物的影响

Effect of Jianpi Xiaoai Decoction Combined with mFOLFOX6 Chemotherapy on Tumor Attenuation and Tumor Markers with Gastric Cancer Patients

目的：观察健脾消癌方联合mFOLFOX6化疗对胃癌患者增效减毒的作用。方法：将55例胃癌患者随机分为对照组25例和治疗组30例,其中治疗组和对照组分别有2例和3例脱落病例,对照组采用mFOLFOX6化疗方案：静脉滴注奥沙利铂（85 mg/m^2）和1-LV（100 mg/m^2）连续2 h,随后快速静注5-FU（400 mg/m^2）,接着静脉维持5-FU（2400 mg/m^2）46 h。于化疗1周后口服健脾消癌方,1贴/d,连续服药8周。所有患者均按化疗方案治疗10个周期。观察两组胃癌患者的临床疗效,生活质量,不良反应和相关肿瘤标志物并进行比较。结果：两组患者近期疗效评估显示,治疗组RR为71.4%,DCR为89.3%;对照组RR为40.9%,DCR为81.3%。χ2检验结果显示,两组患者RR：χ2=4.711,P=0.030（P〈0.05）;DCR：χ2=0.571,P=0.450;KPS评分表明治疗组患者生存质量提高率为71.4%,对照组为45.4%;两组患者在治疗过程中均有一定比例患者产生不良反应,与对照组相比,治疗组患者白细胞、血小板异常,肝肾功能异常,胃肠道反应和外周神经毒性发生率均显著性降低,且差异具有统计学意义（P〈0.05）;与治疗前相比,两组患者治疗后CEA、CA125、CA199和CA724均明显下降,且统计结果均有显著性差异（P〈0.05）,且治疗组各肿瘤标志物降低程度更大,其中CEA下降较对照组差异具有统计学意义（P〈0.05）。结论：健脾消癌方联合mFOLFOX6化疗能有效提高患者的临床疗效,改善患者的生存质量,减轻不良反应和相关肿瘤标志物。

Objective： To observe the effect of Jianpi Xiaoai Decoction combined with mFOLFOX6 chemotherapy on the efficacy and toxicity of gastric cancer patients. Methods： Fifty-five cases of gastric cancer patients were randomly divided into the control group 25 cases and the treatment group 30 cases. Andthe treatment group and the control group respectively had 2 and 3 exfoliated cases. The control group was treated with mFOLFOX6 chemotherapy： continuous 2 h infusion of oxaliplatin（85 mg/m^2） and 1-LV（100 mg/m^2）,rapid intravenous injection of 5-FU（400 mg/m^2）. Then 5-FU（2400 mg/m^2） vein maintained 46 h. The experimental group received oral Jianpi Xiaoai Decoction one week later after chemotherapy. one paste/day,continuous oral administration for 8 weeks. All patients were treated with chemotherapy for 10 cycles. Then the clinical efficacy,quality of life,side effects and related tumor markers of two groups of gastric cancer patients were observed and compared. Results：Two groups＇ short-term efficacy evaluation showed thatthe RR in treatment group was 71. 4%. DCR was 89. 3%. RR in control group was 40. 9% and DCR was 81. 3%. χ2 test showedRR：χ2= 4. 711,P = 0. 030（ P〈0. 05）. DCR：χ2= 0. 571. P = 0. 450. The KPS score showed 71. 4% improvement in the quality of life in the treatment group and 45. 4% in the control group. There was a certain proportion of patients in the two groups had toxic side effects. Compared with the control group,the incidence of WBC,platelet abnormalities,liver and kidney dysfunction,gastrointestinal tract reaction and peripheral nerve toxicity in the treatment group decreased significantly,and the difference was statistically significant（ P〈0. 05）. Compared with those before treatment,the CEA,CA125,CA199 and CA724 of the two groups were significantly decreasedand the statistical results were significantly different（ P〈0. 05） while the tumor markers decreased much more in the treatment groupand the decrease of CEA was statistically significant compared with those of the control group（ P〈0. 05）. Conclusion： Jianpi Xiaoai Decoction combined with mFOLFOX6 chemotherapy can effectively improve the clinical efficacy,improve the quality of life and reduce toxicity and related tumor markers of patients.