消痰散结中医治疗方案在结直肠癌术后患者中的应用效果

Dispersing phlegm and eliminating stagnation in traditional Chinese medicine for treatment of postoperative colorectal cancer: an observation of outcome

目的观察消痰散结中医治疗方案(金龙蛇口服液+鸦胆子油乳注射液)用于肠癌术后患者的临床疗效和毒性反应,以及其对患者免疫功能和生活质量的影响。方法选择68例结直肠癌术后患者并根据患者意愿分为消痰散结组(36例)和化学治疗组(32例),前者采用消痰散结中医治疗方案(金龙蛇口服液+鸦胆子油乳注射液),后者采用卡培他滨联合奥沙利铂(XELOX)方案,治疗6个周期。观察2组患者肿瘤标志物、中医临床症候积分、毒性反应、免疫功能和生活质量(卡氏评分)的变化。结果治疗6个周期后,消痰散结组癌胚抗原(CEA)、糖类抗原19-9(CA19-9)与化学治疗组相比差异均无统计学意义(P均>0.05),两组中医临床症候积分差异无统计学意义(P>0.05)。消痰散结组出现白细胞减少、手足综合征、过敏等毒性反应的患者比例均低于化学治疗组(P均<0.05)。两组患者治疗后CD4^+、CD8^+T淋巴细胞亚群比例与治疗前相比均下降,差异均有统计学意义(P均<0.05);两组间CD3^+、CD4^+、CD8^+T淋巴细胞亚群比例及CD4^+/CD8^+T淋巴细胞比值差异无统计学意义(P>0.05)。消痰散结组卡氏评分高于化学治疗组,差异有统计学意义(P<0.05)。结论与XELOX化学治疗方案相比,消痰散结中医治疗方案用于结直肠癌术后患者可减轻毒性反应,提高患者生活质量。

Objective To evaluate the efficacy and toxicity of dispersing phlegm and eliminating stagnation traditional Chinese medicine (TCM) treatment protocol (Jinlongshe oral liquid combined with Javanica oil emulsion injection) in treating postoperative colorectal cancer, and to observe the immunologic function and quality of life of the patients. Methods Sixtyeight patients with postoperative colorectal cancer were divided into two groups according to the patients’ wishes: phlegm elimination group (n=36) received Jinlongshe oral liquid combined with Javanica oil emulsion injection, and chemotherapy group (n=32) received capecitabine combined with oxaliplatin (XELOX) protocol for 6 cycles. The changes of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), clinical symptoms of TCM, toxicity, immunologic function, and the quality of life (assessed by Karnofsky performance scale [KPS]) were observed. Results After 6 cycles of treatment, there were no significant differences in CEA or CA19-9 between the two groups (P>0.05), and the scores of clinical symptoms of TCM also showed no significant difference between the two groups (P>0.05). The incidences of leucopenia, hand-foot syndrome and allergy in the phlegm elimination group were significantly lower than those in the chemotherapy group (all P<0.05). Immune function examination showed that the proportions of CD4+ and CD8^+ T lymphocytes after treatment were significantly lower than those before treatment in the two groups (both P<0.05), but the proportions of CD3^+, CD4^+, and CD8^+ T lymphocytes, and the ratio of CD4^+/CD8^+ lymphocytes showed no significant differences between the two groups (P>0.05). The quality of life in the phlegm elimination group was higher than that in the chemotherapy group, and the difference of KPS scores was significant (P<0.05). Conclusion Compared with XELOX chemotherapy, TCM treatment of dispersing phlegm and eliminating stagnation can alleviate the toxic reaction and improve the quality of life in patients with intestinal cancer after operation.