理中汤合四神丸加减联合FOLFIRI方案化疗对老年晚期结肠癌脾肾阳虚证患者的临床研究

Clinical study of Lizhong decoction and Sishen pill modified and subtracted combined with FOLFIRI chemotherapy on elderly patients with advanced colon cancer with spleen and kidney Yang deficiency syndrome

目的:探讨理中汤合四神丸加减联合FOLFIRI方案化疗对老年晚期结肠癌脾肾阳虚证患者的临床疗效及对免疫功能的影响。方法:收集2014年7月—2020年4月收治的晚期结肠癌88例患者,按随机数字表法分为对照组和观察组,每组均为44例,2组均接受FOLFIRI方案化疗,2周为1个周期,共4个周期。观察组在对照组治疗基础上采取理中汤合四神丸加减,1剂/d, 2次/d。连续治疗8周后,比较2组脾肾阳虚证症状评分、近期临床疗效、毒副反应以及血清T淋巴细胞亚群水平。结果:治疗后,观察组患者的脾肾阳虚证症状评分明显减少,且显著低于对照组(P<0.01);对照组治疗前后脾肾阳虚证症状评分差异无统计学意义(P>0.05);观察组和对照组的近期总有效率分别为47.73%和25.58%,差异有统计学意义(P<0.05);观察组的白细胞减少、血小板减少、肝肾功能损伤的发生率均显著低于对照组(P<0.05);治疗后,2组患者的CD3~+、CD4~+水平明显降低,CD8~+显著增加(P<0.01);治疗后,观察组患者的CD3~+、CD4~+明显显著高于对照组,CD8~+显著低于对照组(P<0.01)。结论:理中汤合四神丸加减联合FOLFIRI方案化疗治疗老年晚期结肠癌脾肾阳虚证患者有明显增效作用,改善患者的中医证候,并发挥抗毒副反应和免疫保护作用。

Objective:To investigate the efficacy of Lizhong decoction and Sishen pill combined with FOLFIRI chemotherapy in treating advanced colon cancer patients with syndrome of spleen-kidney Yang deficiency and its effect on immune function.Methods:A total of 88 patients with advanced colon cancer admitted to our hospital from July 2014 to April 2020 were collected and divided into a control group and an observation group according to the random number table method.Each group was 44 cases,and both groups received FOLFIRI regimen chemotherapy.2 weeks is 1 cycle,a total of 4 cycles.The observation group took Lizhong decoction and Sishen Pills on the basis of treatment in the control group,1 dose/d,2 times/d.After continuous treatment for 8 weeks,the symptom scores,short-term clinical efficacy,toxic and side effects,and serum T-lymphocyte subsets levels of spleen-kidney-yang deficiency syndrome were compared between the two groups.Results:After treatment,symptom scores of syndrome of spleen-kidney yang deficiency was significantly reduced in the observation group and was significantly lower than that in the control group(P<0.01).There was no statistically significant difference in symptom scores of syndrome of spleen-kidney yang deficiency before and after treatment in the control group(P>0.05).The total effective rate of observation group and control group was 47.73%and 25.58%,respectively,with no statistically significant difference(P<0.05).The incidence of leukopenia,thrombocytopenia,and liver and kidney function injury in the observation group was significantly lower than the control group(P<0.05).After treatment,CD3+and CD4+for observation group were significantly higher than control group,while CD8+was significantly lower,than the control group(P<0.01).Conclusion:Lizhong decoction and sishen pill combined with FOLFIRI chemotherapy in the treatment of advanced colon cancer patients with syndrome of spleen-kidney Yang deficiency have obvious synergistic effect,improve the traditional Chinese medicine,and play an anti-toxic side and immune protection effect.