参芪扶正注射液结合XELOX化疗方案对晚期胃癌肿瘤标志物的影响

Effect of Shenqi Fuzheng Injection(参芪扶正注射液) Combined with XELOX Chemotherapy on Tumor Markers in Patients with Advanced Gastric Cancer

目的探讨参芪扶正注射液结合XELOX化疗方案对晚期胃癌患者肿瘤标志物的影响。方法以2018年5月—2020年5月医院收治的晚期胃癌患者96例为研究对象,依据随机对照法将患者分为研究组和参照组,每组48例。两组患者均采用标准XELOX化疗治疗。具体如下:第1天静脉滴注奥沙利铂130 mg/m^(2),第1~14天,口服卡培他滨1000 mg/m^(2),2次/d。研究组在参照组治疗的基础上,静脉滴注参芪扶正注射液,250 mL/d,1次/d。每3周为1个治疗周期,治疗2个周期后评估疗效。治疗后随访1个月。比较两组治疗前后胃脘痞满、纳差、乏力和大便异常等中医证候积分,比较两组治疗前后肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9),比较两组治疗前后EORTC QLQ-C30生命质量量表评分和KPS评分,比较两组治疗后总有效率和疾病控制率,比较两组治疗过程中周围神经毒性、胃肠道反应和骨髓抑制的发生情况。结果观察组治疗总有效率高于参照组(P<0.05)。观察组疾病控制率高于参照组(P<0.05);研究组治疗后中医证候评分低于参照组(P<0.05);两组治疗后胃脘痞满、纳差、乏力和大便异常等中医证候积分较治疗前降低,且观察组降低幅度优于参照组(P<0.05);两组治疗后EORTC QLQ-C30生命质量量表评分和KPS评分较治疗前升高,且观察组升高幅度优于参照组(P<0.05);两组治疗后肿瘤标志物CEA、CA19-9水平较治疗前降低,且观察组治疗后降低幅度优于参照组(P<0.05);观察组治疗周围神经毒性、胃肠道反应和骨髓抑制的发生率低于参照组(P<0.05)。结论参芪扶正注射液结合XELOX化疗方案可显著改善晚期胃癌患者胃脘痞满、纳差、乏力和大便异常的临床症状,下调CEA、CA19-9水平,改善肿瘤内环境,提高患者的生活质量和体力,降低不良反应发生率,提升整体治疗疗效。

Objective To investigate the effect of Shenqi Fuzheng Injection(参芪扶正注射液)combined with XELOX chemotherapy regimen on tumor markers in patients with advanced gastric cancer.Methods A total of 96 patients with advanced gastric cancer admitted to our hospital from May 2018 to May 2020 were selected as the research subjects.According to the randomized control method,the patients were divided into study group and control group,with 48 cases in each group.Patients in both groups received standard XELOX chemotherapy.Details were as follows:intravenous infusion of oxaliplatin 130 mg/m^(2),day 1;from the 1 st to 14 th day,capecitabine 1000 mg/m^(2) was taken orally,twice a day.The research group was additionally given Shenqi Fuzheng Injection,250 mL per day,once per day,intravenously on the basis of the treatment in the control group.One treatment cycle was performed every 3 weeks,and the efficacy was evaluated after 2 cycles of treatment.The patients were followed up for 1 month after treatment.The scores of TCM symptoms such as epigastric fullness,anorexia,fatigue and abnormal stool were compared between the two groups before and after treatment.The tumor markers carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)were compared between the two groups before and after treatment.The scores of EORTC QLQ-C30 quality of life scale and KPS were compared between the two groups before and after treatment,and the total effective rate and disease control rate were compared.The peripheral neurotoxicity,gastrointestinal reaction and bone marrow suppression were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The disease control rate of the observation group was higher in the observation group than that in the control group(P<0.05).The scores of TCM symptoms in the study group were lower than those in the control group(P<0.05).After treatment,the scores of TCM symptoms of epigastric puff-filled stomach,poor tolerance,fatigue and abnormal stool in the two groups were lower than those before treatment,and the reduction rate in the observation group was better than that in the control group(P<0.05).After treatment,the scores of EORTC QLQ-C30 life quality scale and KPS were higher in the two groups than those before treatment,and the increase rate in the observation group was better than that in the control group(P<0.05).After treatment,the levels of tumor markers CEA and CA19-9 in the two groups were lower than those before treatment,and the reduction rate in the observation group was better than that in the control group(P<0.05).The observation group’s peripheral nerve toxicity and incidence of gastrointestinal reaction and bone marrow inhibition were lower than those of the control group(P<0.05).Conclusion Shenqi Fuzheng Injection combined with XELOX chemotherapy can significantly improve the clinical symptoms(epigastric fullness,anorexia,fatigue and abnormal stool)in patients with advanced gastric cancer,reduce the levels of CEA and CA19-9,improve the internal environment of tumor,improve the quality of life and physical strength of patients,reduce the incidence of adverse reactions and improve the overall treatment effect.