养阴健脾散毒法辅助化疗治疗晚期胃癌临床研究

Advanced gastric cancer treated by the method of nourishing Yin and invigorating spleen and dispersing toxin

目的:观察养阴健脾散毒法辅助化疗干预晚期胃癌的效果,探讨其对患者免疫状态、血清肿瘤标记物、生活质量的影响。方法:选择80例晚期胃癌患者,按照随机数字表分为对照组和观察组,每组各40例。对照组患者单纯给予替吉奥/奥沙利铂(SOX)化疗,观察组患者给予养阴健脾散毒法辅助化疗干预,中药连续服用3个月,化疗进行3个周期。比较两组患者的中位无进展生存期、中医证候积分、T淋巴细胞亚群、血清肿瘤标志物、生活质量SF-36评分变化,观察用药过程中的不良反应。结果:观察组在晚期胃癌的治疗中存在更高生存优势(P<0.05);治疗后与对照组相比,观察组患者中医证候积分显著降低(P<0.05);观察组患者与机体免疫相关的CD3^+、CD4^+、CD4^+/CD8^+水平明显升高,CD8^+水平则明显降低(P<0.05);对照组患者治疗后与治疗前相比,CD3^+、CD4^+、CD4^+/CD8^+水平有所降低,但差异无统计学意义(P>0.05);治疗后,观察组患者的血清肿瘤标志物CEA、CA19-9、CA125水平均显著低于对照组(P<0.05);治疗后观察组患者的生活质量相关各评分与对照组相比显著升高(P<0.05);观察组用药在减轻恶心呕吐、白细胞下降程度、改善贫血等方面效果明显优于对照组(P<0.05)。结论:养阴健脾散毒法辅助化疗干预晚期胃癌更利于提高患者的生存率,缓解临床症状,提高免疫功能,降低肿瘤标志物水平,显著改善患者的生活质量,且利于减轻化疗过程中的不良反应。

Objective:To observe the effect of the method of nourishing yin and invigorating spleen and dispersing toxin used to assist the chemotherapy in the treatment of advanced gastric cancer,and to explore its influence on patients'immune status,serum tumor markers and quality of life.Methods:Eighty patients with advanced gastric cancer were divided into control group and observation group,with 40 cases in each group.Patients in the control group were simply given tiggio/oxsliplatin(SOX)chemotherapy,while patients in the observation group were given the adjuvant chemotherapy intervention of nourishing Yin and invigorating spleen powder poisoning.The traditional Chinese medicine was taken for 3 months continuously,and the chemotherapy was carried out for 3 cycles.The median progression-free survival,TCM syndrome score,T lymphocyte subsets,serum tumor markers,and SF-36 score of quality of life were compared between the two groups,and the toxic and side effects of the drug were observed.Results:The observation group had a higher survival advantage in the treatment of advanced gastric cancer(P<0.05).The score of TCM syndrome in the observation group after treatment was significantly lower than that in the control group(P<0.05).The immune-related levels of CD3^+,CD4^+and CD4^+/CD8^+in the observation group were significantly higher than those in the control group,and the levels of CD8^+were significantly lower than those in the control group(P<0.05).After treatment,the levels of CD3^+,CD4^+and CD4^+/CD8^+in the control group were lower than those before treatment,but the difference was not statistically significant(P>0.05).After treatment,the levels of serum tumor markers CEA,CA19-9 and CA125 in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the quality-of-life scores of the observation group were significantly higher than those of the control group(P<0.05).The observation group was significantly better than the control group in reducing nausea and vomiting,decreasing degree of white blood cells and improving anemia(P<0.05).Conclusion:The method of nourishing Yin,strengthening spleen and dispersing toxin to assist chemotherapy in the intervention of advanced gastric cancer is more conducive to improving the survival rate of patients,alleviating clinical symptoms,improving immune function,reducing the level of tumor markers,significantly improving the quality of life of patients,and reducing the toxic and side effects of chemotherapy,which has certain clinical promotion value.