参苓白术散加减治疗脾虚湿盛型食管癌三野根治术后化疗患者疗效评估

Therapeutic Effect of Shenling Baizhu San on Esophageal Cancer Patients With Spleen Deficiency And Dampness

目的:运用参苓白术散联合化疗治疗脾虚湿盛型食管癌三野根治术后患者的临床疗效研究。方法:筛选60例2017年10月至2019年6月行化疗的食管癌三野根治术患者纳入研究,按入院住院号随机数字列表法随机分为试验组(n=30)和对照组(n=29),对照组予“紫杉醇175 mg/m^(2)+奈达铂80 mg/m^(2)”方案化疗。试验组服用参苓白术散加减联合“紫杉醇175 mg/m^(2)+奈达铂80 mg/m^(2)”,于化疗前1天以及化疗期间的每一天服用,早晚各1次,14 d为1周期,总共4周期,干预结束后比较两组中医症状、疗效、化疗毒副反应等方面,进行疗效对比分析。结果:(1)治疗后试验组骨髓抑制、消化系统的副反应发生率低于对照组(P<0.05);(2)第二、第三周期、第四周期,试验组KPS均显著高于对照组(P<0.05);疗程结束时,试验组KPS较本组化疗前升高(P<0.05),对照组KPS较本组化疗前减少(P<0.05);(3)治疗后对照组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均高于本组治疗前(P<0.05);治疗后试验组的CD4+高于对照组,CD3^(+)、CD8^(+)低于对照组(P<0.05);(4)治疗后试验组中医证候积分少于对照组(P<0.05);(5)两组的1年及2年的无病生存期比较差异无统计学意义(P>0.05)。结论:参苓白术散加减对脾虚湿盛型食管癌三野根治术后化疗的患者有减轻化疗毒副反应、提高患者体质、改善患者生活质量,且安全有效,值得临床上推广。

Objective:To study the clinical effect of Shenling Baizhu San combined with chemotherapy in the treatment of esophageal cancer with spleen deficiency and dampness.Methods:60 patients with esophageal cancer undergoing three field radical surgery from October 2017 to June 2019 were selected and included in the study.They were randomly divided into experimental group(n=30)and control group(n=29)according to the random number list method of admission number.The control group was treated with"paclitaxel 175 mg/m^(2)+nedaplatin 80 mg/m^(2)"chemotherapy.The experimental group took Shenling Baizhu San plus or minus"paclitaxel 175 mg/m2+nedaplatin 80 mg/m^(2)",one day before and every day during the chemotherapy,one time in the morning and one time in the evening,one cycle in 14 days,a total of four cycles.After the intervention,the two groups were compared in terms of symptoms,curative effects,toxic and side effects of chemotherapy,and the curative effects were compared and analyzed.Results:(1)After treatment,the side effects of myelosuppression and digestive system in the experimental group were lower than those in the control group(P<0.05);(2)In the second,third and fourth cycles,KPS in the experimental group was significantly higher than that in the control group(P<0.05).At the end of the course,KPS in the experimental group was higher than that before chemotherapy(P<0.05),KPS in the control group was lower than that before chemotherapy(P<0.05);(3)After treatment,CD4^(+),CD8^(+),CD4^(+)/CD8^(+)in the control group were higher than those before treatment(P<0.05);after treatment,CD4^(+)in the expermental group was higher than that in the control group,and CD3^(+),CD8^(+)were lower than that in the control group(P<0.05);(4)After treatment,the TCM syndrome score of the experimental group was less than that of the control group(P<0.05);(5)There was no significant difference in 1-year disease-free survival and 2 year disease-free survival between the two groups(P>0.05).Conclusion:The addition and subtraction of Shenling Baizhu San can reduce the side effects of chemotherapy,improve the patients'physique,improve the patients'quality of life and it is safe and effective,which is worthy of clinical promotion.