健脾益肾解毒方联合化疗对中晚期胃癌患者癌因性疲乏及免疫功能的影响

The Effect of Jianpiyishen Detoxification Prescription Combined with Chemotherapy on Chemotherapy on Cancer-related Fatigue and Immune Function of Patients with Advanced Gastric Cancer

目的:探讨自拟健脾益肾解毒方联合化疗对治疗中晚期胃癌患者癌因性疲乏(CRF)及改善免疫功能的临床疗效。方法:采用随机数字表法将139例中晚期胃癌并CRF患者随机分为对照组69例,观察组70例。对照组采用奥沙利铂、亚叶酸钙联合5-氟尿嘧啶(FOLFOX4)方案化疗,观察组采用健脾益肾解毒方联合FOLFOX4方案化疗,14天一个疗程,治疗4个疗程,分析两组中医疗效、CRF程度、生活质量、免疫功能状态及不良反应。结果:实际完成本研究的患者为122例,对照组和观察组各61例。对照组和观察组治疗后总有效率分别为18.03%、88.52%,观察组中医疗效明显优于对照组(P<0.01)。治疗后观察组CRF程度较治疗前在行为、情感、感觉及整体疲乏度上有改善(P<0.05),在躯体功能、情感功能、社会功能、总体生活质量上亦有改善(P<0.05),且均优于对照组治疗后水平(P<0.05)。对照组治疗后CD3、CD4、CD4/CD8、NK等指标均下降(P<0.05),观察组治疗后CD3、CD4、CD8、CD4/CD8、NK与治疗前比较无明显差异(P>0.05),观察组治疗后CD3、CD4、CD4/CD8、NK等指标优于对照组治疗后水平(P<0.05)。对照组治疗后红细胞、血红蛋白、白细胞、中性粒细胞较治疗前均明显下降(P<0.05),观察组治疗后白细胞、中性粒细胞较治疗前下降(P<0.05);但观察组治疗后红细胞、血红蛋白、白细胞、中性粒细胞优于对照组治疗后水平(P<0.05),且谷丙转氨酶低于对照组治疗后水平(P<0.01)。结论:健脾益肾解毒方联合化疗对改善中晚期胃癌患者CRF及免疫功能有较好效果。

Objective:To discuss the clinical efficacy of self-prepared Jianpiyishen detoxification prescription combined with chemotherapy on treating cancer-related fatigue and immune function of patients with advanced gastric cancer.Method:139 patients with cancer-induced fatigue(CRF)were randomly divided into control group with 69 patients and observation group with 70 patients.Patients in the control group were given four courses of treatment with FOLFOX4 regimen and patients in the observation group were treated with Jianpiyishen detoxification prescription combined with FOLFOX4 regimen to analyze CRF degree, life quality, curative effect of TCM, immune function status and adverse reactions. Results: The study was completed in 122 patients, 61 cases in the control group and 61 cases in the observation group. The total effective rate for patients in the control group and observation group after treatment was 18.03%,88.52%, respectively. The curative effect of TCM in observation group was better than that in control group ( P <0.01).The degree of fatigue in patient behavior, emotion, feeling and overall fatigue was relieved compared to that before treatment ( P <0.05). Patients in the observation group had improvement in physical function, emotional function, social function and overall quality of life after treatment ( P <0.05). Compared with the control group, patients in the observation group had improvement in above four aspects ( P <0.05). After treatment, CD3, CD4, CD4/CD8, NK and other indicators in the control group all decreased, and the difference was statistically significant( P <0.05). There was no significant difference in CD3, CD4, CD4/CD8, NK and relevant immune indexes in the observation group after treatment ( P >0.05). Compared with the control group, the indexes of CD3, CD4, CD4/CD8 and NK in the observation group were better than those in the control group after treatment ( P <0.05);After treatment, the erythrocyte, hemoglobin, white blood cell and neutrophil in the control group decreased significantly compared with before treatment ( P <0.05), while the leucocyte and neutrophil in the observation group decreased after treatment ( P <0.05);compared with the control group, the erythrocyte, hemoglobin, white blood cell and neutrophil in the observation group improved significantly after treatment ( P <0.05).Glutamic-alanine aminotransferase was better than that of control group after treatment ( P <0.01). Conclusion: Jianpiyishen detoxification prescription combined with chemotherapy has a good curative effect on improving CRF and immune function of patients with advanced gastric cancer.