中药穴位贴敷联合化疗治疗中晚期食管癌的疗效观察

Therapeutic Effect of TCM Acupoint Application Combined with Chemotherapy on Advanced Esophageal Cancer

目的:观察中药穴位贴敷联合化疗治疗中晚期食管癌的疗效及安全性。方法:90例中晚期食管癌患者随机分为对照组和观察组,各45例。对照组给予双联方案化疗与基础护理,观察组在对照组治疗的基础上给予中药穴位贴敷,疗程均为6周。观察治疗前后两组患者临床症状[生活质量评估量表(QLQ-C30)、Karnofsky功能状态量表(KPS)],细胞免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)),体液免疫指标[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)],肿瘤标志物[糖类抗原125(CA125)、糖类抗原199(CA199)、癌胚抗原(CEA)]。观察两组患者临床疗效及不良反应。结果:研究期间脱落6例。观察组总有效率88.4%(38/43),高于对照组的73.2%(30/41)(P<0.05)。与对照组治疗后比较,观察组治疗后QLQ-C30、CD4^(+)、CD4^(+)/CD8^(+)、CA125、CA199、CEA降低更明显(P<0.05),KPS、CD8^(+)、IgA、IgG、IgM升高更明显(P<0.05)。观察组不良反应发生率为34.9%(15/43),低于对照组的75.6%(31/41)(P<0.05)。结论:中药穴位贴敷联合化疗可明显提高中晚期食管癌患者的生存质量,改善免疫功能,抑制肿瘤细胞增殖。

Objective:To observe the efficacy and safety of traditional Chinese medicine(TCM)acupoint application combined with chemotherapy on the treatment of middle and late stage esophageal cancer.Methods:90 patients with middle and late stage esophageal cancer were randomly divided into the control group and the observation group,45 cases in each group.The control group was given dual chemotherapy and basic nursing,and the observation group was given TCM acupoint application on the basis of the treatment of control group for 6 weeks.The clinical symptoms[Quality of Life Questionnaire core 30(QLQ-C30),Karnofsky Performance Scale(KPS)],cellular immune index(CD4^(+),CD8^(+),CD4^(+)/CD8^(+)),humoral immune index[Immunoglobulin A(IgA),Immunoglobulin G(IgG),Immunoglobulin M(IgM)],tumor markers[carbohydrate antigen 125(CA125),carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA)]were observed before and after the treatment.The clinical efficacy and adverse reactions of the two groups were compared.Results:6 cases dropped out during the study.The total effective rate was 88.4%(38/43)in the observation group,which was higher than that 73.2%(30/41)in the control group(P<0.05).Compared with the control group after treatment,QLQ-C30,CD4^(+),CD4^(+)/CD8^(+),CA125,CA199 and CEA reduced more significantly in the observation group(P<0.05),and KPS,CD8^(+),IgA,IgG and IgM increased more significantly in the observation group(P<0.05).The incidence of adverse reactions was 34.9%(15/43)in the observation group,which was lower than 75.6%(31/41)in the control group(P<0.05).Conclusion:TCM acupoint application combined with chemotherapy can significantly improve the quality of life of patients with advanced esophageal cancer,improve immune function,and inhibit the proliferation of tumor cells.