参丹活血胶囊联合依托泊苷软胶囊治疗老年晚期卵巢癌

Clinical effects of Shendan-Huoxue capsule combined with etoposide soft capsules in the treatment of advanced ovarian carcinoma in elderly patients

目的评价参丹活血胶囊联合依托泊苷软胶囊治疗老年晚期卵巢癌的疗效。方法将符合入选标准的94例老年晚期卵巢癌患者采用随机数字表法分为2组,每组47例。所有患者均给予常规化疗,对照组在此基础上服用依托泊苷软胶囊,观察组在对照组基础上服用参丹活血胶囊。2组均治疗12周,随访2年。采用卵巢癌特异性量表(Ovarian Cancer Specificity Scale, FACT-OV4)评价患者的生存质量,采用流式细胞检测CD3^+、CD4^+、CD8^+、CD19^+水平,以CT检测卵巢癌病灶,记录治疗期间的毒副作用,评价临床疗效。结果观察组近期疗效总有效率为87.2%(41/47)、对照组为70.2%(33/47),2组比较差异有统计学意义(χ^2=3.782,P=0.041);观察组1、2年生存率分别为87.2%(41/47)、61.7%(29/47),对照组分别为74.4%(35/47)、53.2%(25/47),2组1、2年生存率比较,差异均有统计学意义(χ^2值分别为4.109、4.268,P值分别为0.038、0.036);观察组中位总生存时间[13.9个月,95% IC(12.4~16.2)]较对照组[10.3个月,95% IC(8.2~14.1)]明显延长(P<0.05)。治疗后,观察组社会/家庭状况、功能状况评分高于对照组(t值分别为3.711、4.003,P<0.05),附加关注、生理状况、情感状况评分低于对照组(t值分别为4.335、4.522、4.202,P<0.05)。观察组治疗后CD3^+、CD4^+、CD8^+、CD19^+水平均高于对照组(t值分别为7.217、7.129、7.434、6.521,P<0.01)。治疗期间观察组皮疹、肝功能损伤、白细胞计数下降、恶心呕吐、周围神经病变、腹泻腹痛的发生率均明显低于对照组(χ^2值分别为4.114、4.782、4.521、3.911、3.931、3.821,P<0.05)。结论参丹活血胶囊联合依托泊苷软胶囊可延长老年晚期卵巢癌患者的生存时间,提高机体免疫力,降低毒副作用。

Objective To evaluate the clinical effects of Shendan-Huoxue capsule combined with etoposide soft capsule in the treatment of advanced ovarian cancer in the elderly patients. Methods A total of 94 elderly patients with ovarian cancer who met the inclusion criteria were divided into 2 groups using random number table method, 47 patients in each group. All patients were given conventional chemotherapy, the control group was given etoposide soft capsule on this basis, and the observation group was given Shendan-Huoxue capsule on the basis of the control group. Both groups were treated for 12 weeks and followed up for 2 years. Ovarian cancer specificity scale version 4 (FACT-OV4) was used to evaluate the life quality of the patients, flow cytometry was used to detect the level of CD3^+, CD4^+, CD8^+, CD19^+. Ovarian cancer was detected by CT, toxic and side effects during treatment were recorded, and clinical efficacy was evaluated. Results The total effective rate in the observation group was 87.2%(41/47), and that in the control group was 70.2%(33/47). The difference between the two groups was statistically significant (χ^2=3.782, P=0.041). The 1-year survival rate was 87.2%(41/47) and 2-year survival rate was 61.7%(29/47) in the observation group, and 74.4%(35/47) and 53.2%(25/47) in the control group, respectively. The 1-year and 2-year survival rates of the two groups were statistically significant (χ^2=4.109, 4.268 respectively, P=0.038, 0.036). The median total survival time in the observation group and the control group was 13.9 months (95% IC 12.4-16.2) and 10.3 months (95% IC 8.2-14.1), respectively. The median total survival time in the observation group was significantly longer than that in the control group (P<0.05). After treatment, scores of social/family status and functional status in the observation group were significantly higher than those in the control group (t values were 3.711 and 4.003, respectively, P<0.05), and scores of additional attention, physiological status and emotional status were significantly lower than those in the control group (t values were 4.335, 4.522 and 4.202, respectively, P<0.05). After treatment, the levels of CD3^+, CD4^+, CD8^+, CD19^+ in the observation group were all higher than those in the control group (t values were 7.217, 7.129, 7.434 and 6.521, respectively, P<0.01 or P<0.05). During the period of treatment , the incidence of skin rash, liver function injury, decreased white blood cell count, nausea and vomiting, peripheral neuropathy, diarrhea and abdominal pain in the observation group were significantly lower than those in the control group (χ2 values were 4.114, 4.782, 4.521, 3.911, 3.931, 3.821, P<0.05, respectively). Conclusions The Shendan-Huoxue capsule combined with etoposide soft capsule can improve the survival time of elderly patients with advanced ovarian cancer, improve the body immunity, reduce toxic and side effects, and the clinical effect is better than conventional chemotherapy.