滋阴化痰方联合化疗治疗晚期胃癌的疗效观察

Curative effect of Ziyin Huatan Recipe combined with chemotherapy on advanced gastric cancer

目的:探究滋阴化痰方联合化疗治疗晚期胃癌的临床疗效。方法:以2011年3月—2017年10月痰瘀互结证晚期胃癌患者为研究对象,采用随机数字表法将其分为化疗组和中西医结合组,每组各40例患者。化疗组首先选用SOX方案,完成2个周期的治疗后,疾病进展者换用替吉奥胶囊(S-1)+多西他赛或CapeOX为主的方案治疗。中西医结合组在化疗基础上联用滋阴化痰方。比较两组疾病控制率(DCR)、客观有效率(RR)及治疗前后中医症候积分、Karnofsky活动状况量表(KPS)评分。观察两组患者治疗前后免疫功能指标及肿瘤炎性因子水平变化情况,并统计两组治疗后3年的生存情况。结果:中西医结合组RR高于化疗组(P<0.05),两组DCR差异无统计学意义。治疗后,中西医结合组中医症候积分评分低于化疗组,KPS评分高于化疗组(P<0.05)。中西医结合组低氧诱导因子-1α(HIF-1α)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、单核细胞趋化蛋白-1(MCP-1)水平低于化疗组(P<0.05);中西医结合组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)值高于化疗组(P<0.05)。两组1年、2年、3年生存率对比差异无统计学意义,中西医结合组与化疗组中位总生存期(OS)分别为20.15个月、16.7个月。结论:滋阴化痰方联合化疗治疗晚期胃癌不仅能提高临床疗效,改善患者免疫功能,减轻炎症反应,还能提高患者生活质量,并能延长生存期。

Objective:To explore the clinical curative effect of Ziyin Huatan Recipe combined with chemotherapy on advanced gastric cancer.Methods:The patients with advanced gastric cancer of stasis-phlegm syndrome were enrolled as the research objects from March 2011 to October 2017.They were divided into chemotherapy group and integrated traditional Chinese and Western medicine group(integrated group)by random number table method,40 cases in each group.In chemotherapy group,SOX regimen was applied firstly,after completing 2 cycles of treatment,the patients with advanced disease switched to tegafur gimeracil oteracil potassium capsule(S-1)+docetaxel or CapeOX based regimen treatment.The integrated group was additionally treated with Ziyin Huatan Recipe.The disease control rate(DCR)and objective response rate(RR),scores of TCM syndromes and Karnofsky performance status(KPS)before and after treatment were compared between the two groups.Changes in levels of immune function indexes and tumor inflammatory factors before and after treatment in both groups were observed.The survival status of patients was statistically analyzed.Results:RR in integrated group was higher than that in chemotherapy group(P<0.05).There was no significant difference in DCR between the two groups.After treatment,scores of TCM syndromes in integrated group was lower than those in chemotherapy group,while KPS score was higher than that in chemotherapy group(P<0.05).After treatment,levels of hypoxia inducible factor-1α(HIF-1α),tumor necrosis factor-α(TNF-α),interleukin-10(IL-10)and monocyte chemoattractant protein-1(MCP-1)were lower than those in chemotherapy group(P<0.05).After treatment,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in integrated group were higher than those in chemotherapy group(P<0.05).There was no significant difference in 1-year,2-year and 3-year survival rates between the two groups.The median OS in integrated group and chemotherapy group was 20.15 months and 16.7 months,respectively.Conclusions:Ziyin Huatan recipe combined with chemotherapy can not only improve clinical effect and immune function,relieve inflammation response,but also improve quality of life,prolong survival of patients with advanced gastric cancer.