肠益煎联合奥沙利铂方案对大肠癌术后患者免疫功能、癌因性疲乏和生活质量的影响

Effects of Changyi decoction combined with oxaliplatin scheme on the immune function,cancer-related fatigue and the life quality of patients with carcinoma of large intestine after operation

目的观察肠益煎联合奥沙利铂方案对大肠癌术后患者免疫功能、癌因性疲乏和生活质量的影响。方法大肠癌患者110例,随机分为对照组和观察组,每组55例,对照组给予奥沙利铂化疗方案,观察组在对照组基础上加用肠益煎。观察2组治疗前后外周血T淋巴细胞亚群(CD_3^+、CD_4^+、CD_8^+、CD_4^+/CD_8^+)、自然杀伤细胞(NK)、IgG、IgA、IgM水平及Piper疲乏修订量表(PFS-R)评分、疲乏程度、癌症患者生命质量测定量表(QLQ-C30)评分。结果治疗前2组外周血CD_3^+、CD_4^+、CD_8^+、NK、CD_4^+/CD_8^+、IgG、IgA、IgM水平及PFS-R评分、QLQ-C30评分比较差异无统计学意义(P>0.05)。治疗后2组外周血CD_3^+、CD_4^+、NK、CD_4^+/CD_8^+、IgG、IgA、IgM水平及QLQ-C30量表中躯体、角色、情绪、认知、社会、总体健康评分均较治疗前显著升高,血清CD_8^+水平及PFS-R评分、QLQ-C30量表中疲乏、疼痛、恶心呕吐、呼吸困难、失眠、食欲下降、腹泻、便秘、经济困难评分均较治疗前显著降低,差异均有统计学意义(P<0.05),且观察组改善程度优于对照组(P<0.05)。观察组术后疲乏程度较对照组显著减轻,差异有统计学意义(P<0.05)。结论黄肠益煎联合奥沙利铂方案治疗大肠癌术后能够明显增强机体免疫功能,减轻癌因性疲乏程度,从而改善患者生活质量,这可能是其发挥治疗作用的机制之一。

Objective To observe the effects of Changyi decoction combined with oxaliplatin scheme on the immune function,cancer-related fatigue and the life quality of patients with carcinoma of large intestine after operation. Methods A total of 110 patients with carcinoma of large intestine who were admitted and treated in our hospital from March 2015 to March2018 were enrolled in the study,who were randomly divided into the control group（n = 55） and observation group（n = 55）.The patients in control group were treated by oxaliplatin scheme,and the patients in observation group,on the basis of control group,were treated by Changyi decoction. After treatment,the serum levels of CD3~＋,CD4~＋,CD8~＋,CD4~＋/CD8~＋,NK,IgG,IgA,IgM,and PFS-R scores,degree of fatigue and QLQ-C30 scores were observed and compared between the two groups. Results Before treatment,there were no significant differences in the serum levels of CD3~＋,CD4~＋,CD8~＋,CD4~＋/CD8~＋,NK,IgG,IgA,IgM and PFS-R scores,degree of fatigue and QLQ-C30 scores between two groups（P〈0. 05）. After treatment,the serum levels of CD3~＋,CD4~＋,NK,CD4~＋/CD8~＋,IgG,IgA,IgM,and the scores of somatic function,role function,emotional function,cognitive function,social function and life quality were significantly increased in both groups,however,the serum levels of CD8~＋,PFS-R scores and the scores of fatigue,nausea and vomiting,sleep difficulties,loss of appetite,constipation and diarrhea were significantly decreased in both groups（P〈0. 05）. Moreover the improvement degree in observation group was superior to that in control group（P〈0. 05）. In addition the degree of fatigue in observation group was significantly lighter than that in control（P〈0. 05）. Conclusion Changyi decoction combined with oxaliplatin scheme in treatment of carcinoma of large intestine can significantly enhance immune function,alleviate the degree of cancer-related fatigue so as to improve life quality of patients,which may be one of action mechanisms.