苦参碱注射液治疗中晚期口腔癌疗效观察

Clinical observation of matrine injection in treatment of middle or advanced mouth cancer

目的观察苦参碱注射液联合化疗治疗中晚期口腔癌的临床疗效和安全性。方法中晚期口腔癌患者60例随机分为对照组和治疗组,每组30例,对照组给予常规化疗方案,治疗组在常规化疗基础上加用苦参碱注射液。疗程均为12周。观察2组近期疗效、血清肿瘤标志物水平[癌胚抗原(CEA)、神经无特异性烯醇化酶(NSE)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)]、外周血象[血红蛋白(Hb)、白细胞(WBC)、血小板(PLT)]、不良反应发生情况。结果治疗组有效率高于对照组(P<0.05)。治疗组TNM分期降期情况好于对照组(P<0.05)。治疗前2组血清CEA、NSE、CA19-9、CA125水平及外周血Hb、WBC、PLT比较差异无统计学意义(P>0.05)。治疗后2组血清CEA、NSE、CA19-9、CA125水平及外周血Hb、WBC、PLT均明显低于治疗前(P<0.05),且治疗组血清CEA、NSE、CA19-9、CA125水平低于对照组,WBC高于对照组(P<0.05),但Hb、PLT比较差异无统计学意义(P>0.05)。治疗组恶心呕吐、口腔黏膜炎、白细胞减少、外周神经毒性、肝功能损害发生率低于对照组(P<0.05)。结论苦参碱注射液联合化疗治疗中晚期口腔癌疗效确切,能够显著提高近期疗效,降低血清肿瘤标志物水平,同时不良反应发生率明显低于常规化疗方案。

Objective To investigate the therapeutic effects of matrine injection on middle or advanced mouth cancer,and to explore its safety during treatment.Methods Sixty patients with middle or advanced mouth cancer were randomly divided into treatment group and control group,with 30 cases in each group.The patients in control group were treated by conventional chemotherapy,however,the patients in treatment group,on the basis of control group,were treated by matrine injection,with a treatment course of 12 weeks for both groups.After treatment,the short-term curative effects,and the changes of tumor markers levels including CEA,NSE,CA19-9,CA125,and HB,WBC,severe adverse effects were observed and compared between the two groups.Results The total effective rate in treatment group was significantly higher than that in control group(83.33%vs 56.67%,P<0.05).The decrease status of TNM stage in treatment group was superior to that in control group(P<0.05).Before treatment,there were no significant differences in levels of CEA,NSE,CA19-9,CA125,Hb,WBC,PLT between the two groups(P>0.05).After treatment the levels of CEA,NSE,CA19-9,CA125,Hb,WBC,PLT in both groups were significantly decreased(P<0.05),moreover,the levels of CEA,NSE,CA19-9,CA125 in treatment group were significantly lower than those in control group,but WBC levels were significantly higher than those in control group(P<0.05),however,there were no significant differences in the levels of Hb and PLT between the two groups(P>0.05).In addition the incidences rates of vomiting,nausea,leukocytopenia and oral mucosal damage in treatment group were significantly lower than those in control group(P<0.05).Conclusion Matrine injection combined with chemotherapeutics in treatment of middle or advanced mouth cancer can effectively improve the short-term curative effects,reduce the tumor marker levels,moreover,the incidence rate of adverse events is significantly lower than that by conventional chemotherapy.