参苓白术汤加减联合化疗治疗结肠癌的效果分析

Effect of Shenling Baizhu decoction combined with chemotherapy in colon cancer

目的探讨参荼白术汤加减联合亚叶酸钙+奥沙利铂+5-氟尿嘧啶(FOLFOX4)化疗治疗结肠癌的临床效果。方法将70例结肠癌术后化疗患者按随机数字表法分为对照组和观察组,每组35例。对照组给予FOLFOX4方案化疗,观察组在对照组基础上联合参苓白术汤加减治疗。比较两组患者治疗有效率、中医证候积分、血清肿瘤标志物水平、炎症免疫细胞水平、不良发应发生情况。结果治疗前,两组患者食少纳呆、神疲乏力、脘腹胀满证候积分及癌胚抗原(CEA)、糖类抗原72-4 (CA72-4)、CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者各证候积分及CEA、CA72-4水平均下降(P<0.05),且观察组患者各证候积分及CEA、CA72-4水平均明显低于对照组(P <0.01)。治疗后,观察组患者CD3^+、CD4^+、CD4^+/CD8^+水平均明显高于对照组,CD8^+水平明显低于对照组,差异均有统计学意义(P<0.01)。观察组患者治疗有效率为91.43%(32/35),明显高于对照组的68.57%(24/35),差异有统计学意义(P<0.01)。观察组患者白细胞减少、恶心呕吐、腹泻、血小板减少发生率均低于对照组,差异均有统计学意义(P<0.05)。结论结肠癌术后患者经参荅白术汤加减联合化疗治疗,疗效确切,临床症状改善明显,血清肿瘤标志物水平降低,减轻免疫抑制,不良反应少。

Objective To explore the clinical effect of Shenling Baizhu decoction combined with calcium folinate+oxaliplatin+5-fluorouracil(FOLFOX4)in treatment of colon cancer.Method A total of 70 patients undergoing postoperative chemotherapy for colorectal cancer were divided into the control group(n=35,treated with FOLFOX4)and observation group(n=35,treated with FOLFOX4+Shenling Baizhu decoction)according to random number table.The effective rate,traditional Chinese medicine(TCM)syndrome score,serum tumor marker level,inflammatory immune cell level,and adverse reactions were compared between the two groups.Result Before treatment,there were no statistically significant differences for TCM syndrome scores(anorexia,stupor,fatigue,and abdominal distension),levels of carcinoembryonic antigen(CEA),carbohydrate antigen 72-4(CA72-4),CD3^+,CD4^+,CD8^+and CD4^+/CD8^+between the two groups(P>0.05).After treatment,the score of each syndrome and the levels of CEA and CA72-4 of the two groups were significantly decreased(P<0.05),with significantly lower values for score of each syndrome,levels of CEA and CA72-4(P<0.01),higher levels of CD3^+,CD4^+,CD4^+/CD8^+,and lower level of CD8^+in the observation group than those in the control group(P<0.01).The effective rate in the observation group[91.43%(32/35)]was significantly higher than those in control group[68.57%(24/35)](P<0.01).The incidence of leukopenia,nausea and vomiting,diarrhea,and thrombocytopenia in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Shenling Baizhu decoction combined with chemotherapy in patients undergoing colon cancer surgery is significantly effective,with improved clinical symptoms,decreased serum tumor markers,reduced immune suppression and fewer adverse reactions.