培元化淤抗癌汤联合FOLFOX4化疗方案治疗大肠癌术后疗效及对血清VEGF、MMP-9及免疫功能影响

Effects of Peiyuan Huayu Anti-cancer Decoction Combined with FOLFOX4 Chemotherapy Regimen on Serum VEGF,MMP-9 and Immune Function in Patients Undergoing Surgical Resection of Colorectal Cancer

目的探讨培元化淤抗癌汤联合FOLFOX4化疗方案在大肠癌术后患者(脾肾亏虚型)治疗中的应用价值,观察其对血清基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)及免疫功能的影响,旨在为本病提供有效的治疗手段。方法将2017年12月—2019年1月因大肠癌术后于我院就诊且中医证型属于脾肾亏虚型的90例患者纳入研究,纳入研究前均用随机数字表法对患者进行分组。对照组45例采用FOLFOX4化疗,21 d为1个化疗周期,观察组45例则联合培元化淤抗癌汤口服治疗,治疗6个化疗周期后比较临床疗效。结果治疗后观察组癌胚抗原(Carcinogenic antigen,CEA)、糖类抗原CA199等肿瘤标志物指标水平低于对照组,CD4^+/CD8^+、CD4^+细胞、CD3^+细胞等免疫功能指标均高于对照组,差异具统计学意义(P<0.05);治疗后观察组MMP-9、VEGF水平低于对照组,日常生活质量评分(Cartesian score,KPS评分)高于对照组,差异具有统计学意义(P<0.05);观察组总有效率91.11%(41/45),高于对照组的73.33%(33/45),差异具有统计学意义(P<0.05);观察组化疗不良反应总发生率6.67%(3/45),低于对照组的24.44%(11/45),差异有统计学意义(P<0.05)。结论对于大肠癌术后患者(脾肾亏虚型)而言联合培元化淤抗癌汤有重要意义,可抑制新生血管再生,提高免疫力,预防化疗不良反应,值得推广。

Objective To explore the application value of Peiyuan Huayu Anti-cancer Decoction combined with FOLFOX4 chemotherapy regimen in the treatment of patients who have undergone surgical resection of colorectal cancer(with spleen and kidney deficiency),and to observe its effects on serum matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor(VEGF)and the immune function,in an attempt to provide an effective therapeutic approach for this disease. Methods Ninety patients who visited our hospital from December 2017 to January 2019 following surgical resection of colorectal cancer with the TCM syndrome of spleen and kidney deficiency were included in the study and randomly assigned,using random number table,to the control group or observation group each including 45 patients. The control group received chemotherapy with FOLFOX4 regimen in 21-day cycles,in addition to which the observation group received Peiyuan Huayu Anti-cancer Decoction orally. The clinical efficacy was compared after 6 chemotherapy cycles. Results Compared with the control group,the post-treatment levels of the tumor markers including carcinogenic antigen(CEA)and carbohydrate antigen 119(CA199)were lower,and the post-treatment levels of the immune function indicators including CD4^+/CD8^+,CD4^+ and CD3^+ were higher in the observation group,with statistically significant differences(P<0.05);the post-treatment levels of MMP-9 and VEGF were lower,and the Cartesian score(KPS)was higher in the observation group,with statistically significant differences(P<0.05);the overall response rate in the observation group was 91.11%(41/45),which was higher than 73.33%(33/45)in the control group,with statistically significant difference(P<0.05);the overall incidence of adverse reactions to chemotherapy in the observation group was 6.67%(3/45),which was lower than 24.44%(11/45)in the control group,with statistically significant difference(P<0.05). Conclusion For patients who have undergone surgical resection of colorectal cancer(with spleen and kidney deficiency),combined used of Peiyuan Huayu Anticancer Decoction is of important significance,as it inhibits neovascularization,enhances immunity and reduces adverse reactions to chemotherapy,which supports its further application.