健脾养血方联合化疗治疗胃癌的临床效果

Clinical observation of the effect of Jianpi Yangxue Decoction combined with chemotherapy of gastric cancer

目的探讨健脾养血方与卡培他滨联合奥沙利铂(CAPOX)化疗方案联合对胃癌患者的疗效及安全性。方法选择2018年1月至2020年12月湖北省中医院收治的120例胃癌患者作为研究对象,采用抽签法将其分为观察组(健脾养血方+CAPOX化疗方案)、对照组(CAPOX化疗方案),每组各60例。2个疗程后,比较两组中医证候评分、美国东部肿瘤协作组(ECOG)评分、肿瘤标志物[癌胚抗原(CEA)、糖类抗原19-9(CA19-9)]水平及化疗毒副作用发生情况[Ⅱ~Ⅳ度骨髓抑制(白细胞、血小板、血红蛋白)、肝肾功能、胃肠道反应、外周神经毒性]。结果观察组脱落6例,对照组脱落5例,最终纳入109例研究对象。治疗后,两组中医证候评分及CEA、CA19-9水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗前后ECOG评分比较,差异无统计学意义(P>0.05)。治疗后,对照组ECOG评分高于治疗前,观察组ECOG评分低于对照组,差异有统计学意义(P<0.05)。观察组血红蛋白Ⅱ~Ⅳ度骨髓抑制、胃肠道反应、外周神经毒性发生率低于对照组,差异有统计学意义(P<0.05)。结论胃癌化疗患者加用健脾养血方后,能改善中医症候、生活质量及肿瘤标志物表达,减轻化疗所致不良反应,起增效减毒的作用。

Objective To explore the efficacy and safety evaluation of Jianpi Yangxue Decoction combined with Capecitabine and Oxaliplatin(CAPOX)chemotherapy for patients with gastric cancer.Methods A total of 120 gastric cancer patients admitted to Hubei Provincial Hospital of Traditional Chinese Medicine from January 2018 to December 2020 were selected as the research subjects,and they were divided by lottery into observation group(Jianpi Yangxue Decoction+CAPOX chemotherapy regimen)and control group(CAPOX chemotherapy regimen),with 60 patients in each group.After two sessions,traditional Chinses medicine syndrome score,the Eastern Cooperative Oncology Group(ECOG)score,tumor markers(carcinoembryonic antigen[CEA]and carbohydrate antigen 19-9[CA19-9])levels,and the occurrence of adverse reaction of chemotherapy(Ⅱ-Ⅳ degrees of bone marrow supression[white blood cells,platelets,hemoglobin],liver and kidney function,gastrointestinal reaction,and peripheral nerve toxicity)were compared in two groups.Results There were six cases of detachment in the observation group and five cases in the control group,and 109 cases were included in the study.After treatment,traditional Chinses medicine syndrome score,CEA,and CA19-9 levels in both groups were lower than those before the treatment,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).ECOG score of observation group before and after treatment had no statistical significance(P>0.05).After treatment,the ECOG score of the control group was higher than that before the treatment,and observation group was lower than the control group,the differences were statistically significant(P<0.05).The incidences of hemoglobin Ⅱ-Ⅳ degrees of bone marrow supression,gastrointestinal reaction,and peripheral neurotoxicity in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion After the addition of Jianpi Yangxue Decoction to gastric cancer patients receiving chemotherapy,it can improve the traditional Chinses medicine symptoms,quality of life,and the expression of tumor markers,reduce the adverse reactions caused by chemotherapy,and play a synergistic and toxic role.