六君子汤加减方辅治脾气虚弱型晚期胃癌的临床效果与安全性

Clinical effect and safety of modified Liujunzi decoction in the treatment of advanced gastric cancer of spleen weakness type

目的 观察六君子汤加减方治疗脾气虚弱型晚期胃癌的临床效果与安全性。方法 选取2019年1月-2020年6月常德市第四人民医院收治的脾气虚弱型晚期胃癌患者60例,依照随机分组对照原则分为观察组和对照组,各30例。对照组予阿帕替尼联合甲氧氯普胺治疗,观察组在对照组基础上辅以六君子汤加减方治疗。比较2组治疗效果,治疗前后肿瘤标志物[糖类抗原(CA125)与癌胚抗原(CEA)]与免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞)水平及不良反应(脱发、恶心、呕吐、皮疹及骨髓抑制)发生情况。结果 治疗3个月,观察组总有效率为96. 67%,高于对照组的76. 66%(χ^(2)=5. 192,P=0. 023);治疗3个月后,2组肿瘤标志物与免疫功能指标均较治疗前改善,且观察组改善程度大于对照组(P均<0.01);观察组不良反应总发生率为3.33%,低于对照组的26.67%(χ^(2)=4. 706,P=0. 026)。结论 对脾气虚弱型晚期胃癌患者采用六君子汤加减方进行治疗,药物疗效更佳,用药安全性得到保障,控制患者病情发展的同时,延长患者的生存期。

Objective To observe the clinical effect and safety of modified Liujunzi decoction in the treatment of advanced gastric cancer of spleen weakness type.Methods Sixty patients with advanced gastric cancer of spleen weakness type in the Fourth People's Hospital of Changde City were selected from January 2019 to June 2020.They were randomly divided into observation group and control group with 30 cases in each group.The control group was treated with apatinib combined with metoclopramide,and the observation group was treated with modified Liujunzi decoction on the basis of the control group.The therapeutic effects,the levels of tumor markers(CA125 and CEA)and immune function indexes(CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK cells)before and after treatment,as well as the occurrence of adverse reactions(alopecia,nausea,vomiting,rash and myelosuppression)were compared between the two groups.Results After 3 months of treatment,the total effective rate of the observation group was 96.67%,which was higher than 76.66%of the control group(χ^(2)=5.192,P=0.023);After 3 months of treatment,the tumor markers and immune function indexes of the two groups were improved,and the improvement degree of the observation group was greater than that of the control group(P all<0.01);The total incidence of adverse reactions in the observation group was 3.33%,which was lower than 26.67%in the control group(χ^(2)=4.706,P=0.026).Conclusion Modified Liujunzi decoction is more effective and safe in the treatment of patients with advanced gastric cancer of spleen weakness type.It can control the development of the disease and prolong the survival time of patients.