五味宣痹汤联合手脚食醋浸泡防治HER2阴性晚期胃癌患者XP方案一线治疗所致手足综合征疗效及对免疫功能及生存质量的影响

Effect of Wuwei Xuanbi Decoction combined with hand and foot vinegar soaking on hand-foot syndrome caused by first-line treatment of XP program for HER2-negative advanced gastric cancer and its effect on immune function and quality of life

目的观察五味宣痹汤联合手脚食醋浸泡防治HER2阴性晚期胃癌患者XP方案一线治疗所致手足综合征(HFS)的疗效及对免疫功能及生存质量的影响。方法将74例拟行XP方案治疗的HER2阴性晚期胃癌患者随机分为观察组和对照组,每组37例。对照组给予XP方案化疗及维生素B6片口服,观察组在对照组基础上给予五味宣痹汤口服联合手足食醋浸泡。2组化疗3周为1个疗程,治疗2个疗程。治疗结束后比较2组患者手足综合征的发生情况,手足痛的程度,神疲乏力、纳差、舌质淡暗、大便稀溏和呕吐症状积分,治疗前后外周血CD3^+、CD4^+、CD8^+、NK细胞百分比及CD4^+/CD8^+,治疗前后生活质量。结果治疗结束后,观察组手足综合征的发生率明显低于对照组(P<0.05),神疲乏力、纳差、舌质淡暗、大便稀溏和呕吐积分及手足痛VAS评分均明显低于对照组(P均<0.05),CD3^+、CD4^+、CD4^+/CD8^+、NK和EORTCQLQ-C30量表各项功能评分均明显高于治疗前及对照组(P均<0.05),CD8^+明显低于治疗前及对照组(P均<0.05)。结论五味宣痹汤联合手脚食醋浸泡可以有效防治HER2阴性晚期胃癌患者XP方案一线治疗所致的手足综合征,改善生活质量,可能与改善患者的免疫功能有关。

Objective It is to observe the curative effect of Wuwei Xuanbi Decoction combined with hand-foot vinegar soaking on hand-foot syndrome (HFS) caused by first-line treatment of XP program for HER2-negative advanced gastric cancer and its effect on immune function and quality of life.Methods Seventy-four patients with HER2-negative advanced gastric cancer who were treated with XP program were randomly divided into observation group and control group, with 37 cases in each group.The control group was given XP chemotherapy and vitamin B6 tablets.The observation group was given Wuwei Xuanbi Decoction combined with hand-foot vinegar soaking on the basis of the control group.3 weeks as one course of chemotherapy, both groups were treated for 2 courses.The incidence of HFS and its degree, the scores of fatigue, anorexia, pale tongue, loose stool and vomiting was compared between the two groups at the end of treatment.The percentages of CD3^+, CD4 ^+, CD8 ^+, CD4^+/CD8 ^+ and NK cells in peripheral blood and quality of life before and after treatment were compared.Results After treatment, the incidence of HFS, the scores of fatigue, anorexia, pale tongue, loose stool and vomiting, and hand and foot pain VAS scores in the observation group were significantly lower than that in the control group ( P <0.05), while CD3 ^+, CD4 ^+, CD4 ^+/CD8 ^+, NK and EORTC QLQ-C30 scales were significantly higher and CD8 ^+ was significantly lowerthan those before treatment and in the control group( P <0.05).Conclusion Wuwei Xuanbi Decoction combined with hand and foot vinegar soaking can effectively prevent HFS caused by first line treatment of XP in patients with HER2 negative advanced gastric cancer, and improve quality of life, which may be related to improving immune function of patients.