益气通腑汤预防结直肠癌根治术后复发转移疗效研究

Yiqi Tongfu decoction on the prevention of recurrence and metastasis after radical resection of colorectal cancer

目的:研究益气通腑汤在预防结直肠癌根治术后复发转移的临床疗效。方法:将124例结直肠癌根治术患者随机分为治疗组和对照组各62例,两组均于根治术后予以常规西医治疗,治疗组加用益气通腑汤治疗。观察两组患者术后第1年、第2年、第3年复发转移率,比较两组患者术前、术后1年血清肿瘤标志物癌胚抗原(CEA)、糖类抗原199(CA199)含量和复发转移相关蛋白血管内皮生长因子(VEGF)、基质金属蛋白酶-9(MMP-9)、骨桥蛋白(OPN)含量变化,并记录两组患者化疗不良反应发生率。结果:术后第2年,治疗组和对照组各失访1例,术后3年,治疗组失访5例、对照组失访3例。术后第2年、第3年及总复发转移率治疗组均低于对照组(P<0.05);术后1年,两组CEA、CA199均低于术后即刻(P<0.05),治疗组降低幅度明显优于对照组(P<0.05);术后1年,两组患者VEGF、MMP-9、OPN水平均低于术后即刻(P<0.05),治疗组降幅大于对照组(P<0.05);两组血小板减少、红细胞减少、肝功能损害发生率比较,差异无统计学意义(P>0.05);治疗组白细胞减少、恶心呕吐、胃肠道反应发生率均低于对照组(P<0.05)。结论:益气通腑汤有利于预防结直肠癌根治术后复发转移,降低CEA、CA199血清肿瘤标志物含量和VEGF、MMP-9、OPN复发转移相关蛋白含量,减轻化疗毒副反应,提高临床疗效。

Objective:To study the clinical effect of Yiqi Tongfu decoction in preventing recurrence and metastasis of colorectal cancer after radical operation.Methods:124 patients with radical resection of colorectal cancer were randomly divided into treatment group and control group,62 cases in each group.Both groups were treated with routine western medicine after radical resection.The treatment group was treated with Yiqi Tongfu decoction.The recurrence and metastasis rates in the first,second and third year after operation were observed.The serum levels of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),vascular endothelial growth factor(VEGF),matrix metalloproteinase-9(MMP-9)and osteopontin content were compared between the two groups before and after operation.The incidence of adverse reactions to chemotherapy in the two groups were recorded.Results:In the second year after operation,1 case in the treatment group and 1 case in the control group was lost.5 cases in the treatment group and 3 cases in the control group was lost in the third year after operation.The recurrence and metastasis rates in the treatment group were lower than those in the control group(P<0.05).After operation 1 year,in CEA and CA199 both groups were lower than that immediately after operation(P<0.05),and the treatment group was significantly better than that in the control group(P<0.05).After operation 1 year,the levels of vascular endothelial growth factor,MMP-9 and OPN in both groups were lower than that immediately after operation(P<0.05).The decrease of the treatment group was greater than that of the control group(P<0.05);there was no significant difference in the incidence of thrombocytopenia,erythrocytopenia and liver function damage between the two groups(P>0.05);the incidence of leucopenia,nausea and vomiting,gastrointestinal reaction in the treatment group waslower than that in the control group(P<0.05).Conclusions:Yiqi Tongfu decoction can prevent recurrence and metastasis of colorectal cancer after radical operation,reduce the contents of serum tumor markers CEA,CA199 and related proteins of VEGF,MMP-9 and OPN,reduce the toxicity and side effects of chemotherapy,and improve the clinical efficacy.