复方斑蝥胶囊结合mFOLFOX6化疗治疗晚期结肠癌的临床疗效及对细胞免疫功能的影响

Clinical Efficacy of Compound Cantharis Capsule(复方斑蝥胶囊)Combined with Modified mFOLFOX6 Chemotherapy in Treatment of Advanced Colon Cancer and Its Effect on Cellular Immune Function

目的评价复方斑蝥胶囊结合mFOLFOX6化疗治疗晚期结肠癌的临床疗效及细胞免疫功能的影响。方法以2018年2月—2020年2月医院收治的85例晚期结肠癌患者为研究对象,依据治疗方式的不同分为观察组45例和对照组40例,对照组患者采用mFOLFOX6化疗,观察组患者采用mFOLFOX6化疗+复方斑蝥胶囊治疗。2周为1个周期,最少治疗6周,最多治疗24周。比较两组治疗后实体瘤治疗疗效,比较两组治疗前后中医证候积分、KPS评分、T淋巴细胞亚群CD^(+)_(3)、CD^(+)_(4)和CD^(+)_(4)/CD^(+)_(8)水平、WHOQOL-BREF评分和不良反应发生情况。结果观察组治疗总有效率为77.78%(35/45),对照组治疗总有效率为57.50%(23/40),观察组治疗疗效优于对照组(P<0.05);两组治疗后中医证候积分较治疗前降低,KPS评分较治疗前升高。且观察组改善幅度优于对照组(P<0.05);观察组治疗后T淋巴细胞亚群CD^(+)_(3)、CD^(+)_(4)和CD^(+)_(4)/CD^(+)_(8)水平较治疗前升高,对照组治疗后T淋巴细胞亚群CD^(+)_(3)、CD^(+)_(4)和CD^(+)_(4)/CD^(+)_(8)水平较治疗前降低,观察组治疗后T淋巴细胞亚群CD^(+)_(3)、CD^(+)_(4)和CD^(+)_(4)/CD^(+)_(8)水平高于对照组(P<0.05);两组治疗后心理领域、生理领域、社会领域、环境领域评分较治疗前升高,且观察组升高幅度优于对照组(P<0.05);观察组血小板下降、白细胞下降、肝肾异常、骨髓异常、胃肠道反应和乏力发生率低于对照组(P<0.05)。结论复方斑蝥胶囊结合mFOLFOX6化疗能改善晚期结肠癌患者的临床症状,提高患者的免疫力,降低不良反应发生率,提高化疗耐受性和生活质量,值得临床借鉴。

Objective To evaluate the clinical efficacy and cellular immune function of Compound Cantharis Capsule(复方斑蝥胶囊)combined with modified mFOLFOX6 chemotherapy in the treatment of advanced colon cancer.Methods A total of 85 patients with advanced colon cancer in our hospital from February 2018 to February 2020 were divided into observation group 45 cases and control group 40 cases according to different treatment methods.The control group was treated with modified mFOLFOX6 chemotherapy,and the observation group was treated with modified mFOLFOX6 chemotherapy+Compound Cantharis Capsule.Two weeks was a cycle,with a minimum of 6 weeks and a maximum of 24 weeks.After treatment,the curative effect of solid tumor,TCM symptom score,KPS score,T lymphocyte subsets CD^(+)_(3),CD^(+)_(4) and CD^(+)_(4)/CD^(+)_(8),WHOQOL-BREF score and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 77.78%(35/45),and that of the control group was 57.50%(23/40).The curative effect of the observation group was better than that of the control group(P<0.05).After treatment,the TCM symptom score of the two groups was lower than that before treatment,and the KPS score was higher than that before treatment.And the improvement of the observation group was better than that of the control group(P<0.05).The levels of T lymphocyte subsets CD^(+)_(3),CD^(+)_(4) and CD^(+)_(4)/CD^(+)_(8) in the observation group after treatment were higher than those before treatment.The levels of T lymphocyte subsets CD^(+)_(3),CD^(+)_(4) and CD^(+)_(4)/CD^(+)_(8) in the control group after treatment were lower than those before treatment.The levels of T lymphocyte subsets CD^(+)_(3),CD^(+)_(4) and CD^(+)_(4)/CD^(+)_(8) in the observation group after treatment were higher than those in the control group(P<0.05).After treatment,the scores of psychological field,physiological field,social field and environmental field in the two groups were higher than those before treatment,and the increase range in the observation group was better than that in the control group(P<0.05).The incidence of thrombocytopenia,leucopenia,liver and kidney abnormalities,bone marrow abnormalities,gastrointestinal reactions and fatigue in the observation group were lower than those in the control group(P<0.05).Conclusion Compound Cantharis Capsule combined with modified mFOLFOX6 chemotherapy can improve the clinical symptoms and the immunity of patients with advanced colon cancer,reduce the incidence of adverse reactions,improve chemotherapy tolerance and quality of life,which is worthy of clinical reference.