基于中医肿瘤疗效评价体系探讨复元和中汤对胃癌免疫功能的影响

Effect of Fuyuan Hezhong Decoction on Immune Function of Gastric Cancer Patients: Based on Efficacy Evaluation System of TCM for Tumor

目的 基于中医肿瘤疗效评价体系探讨复元和中汤对胃癌免疫功能的影响。方法 选取2016年6月—2017年6月期间山东省潍坊市中医院肿瘤五科收治的胃癌患者84例,按随机数字表法分为对照组和观察组,每组各42例。对照组采用SOX化疗方案治疗,在此基础上观察组采用复元和中汤治疗,持续治疗4个周期。对两组中医肿瘤疗效评价体系(包括瘤体变化、临床症状、体力状况和生存期共4个方面)和免疫功能指标进行分析和比较。结果 治疗后观察组中医肿瘤总有效率为85.71%(36/42)、客观缓解率为50.00%(21/42),与对照组总有效率66.67%(28/42)、客观缓解率26.19%(11/42)比较,差异有统计学意义(P<0.05)。治疗后观察组瘤体变化总有效率为85.71%(36/42)、客观缓解率为47.62%(20/42)与对照组瘤体变化总有效率66.67%(28/42)、客观缓解率23.81%(10/42)比较,差异有统计学意义(P<0.05)。治疗后观察组上腹胀满、食欲减退和恶心、呕吐改善情况优于对照组,差异有统计学意义(P<0.05)。治疗后观察组体力状况改善无效率4.76%(2/42)明显优于对照组无效率28.57%(12/42),差异有统计学意义(P<0.05)。观察组生存时间及其所计分值均高于对照组,差异有统计学意义(P<0.05)。观察组治疗2、4个周期后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)指标均较治疗前明显升高,CD8^(+)均较治疗前明显降低,差异有统计学意义(P<0.05);对照组治疗2、4个周期后免疫功能指标均无明显变化,差异无统计学意义(P>0.05);观察组治疗后免疫功能指标均优于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率为14.29%,对照组不良反应发生率为33.33%,两组比较差异有统计学意义(P<0.05)。结论 复元和中汤可以提升胃癌的治疗效果,增强胃癌患者的免疫功能,降低化疗期间不良反应发生率。

Objective To explore the effect of Fuyuan Hezhong Decoction on the immune function of gastric cancer patients based on Efficacy Evaluation System of TCM for Tumor.Methods The 84 patients with gastric cancer who were admitted to our hospital from June 2016 to June 2017 were classified into the control group(42)and observation group(42)with the random number table method.Control group was treated with SOX regimen, and the observation group with Fuyuan Hezhong Decoction and SOX regimen, 4 cycles in total.The two groups were then compared in TCM evaluation dimensions for tumor(tumor change, clinical symptoms, physical condition, and survival)and immune function indexes.Results The total effective rate(85.71%)and objective response rate(50.00%)in the observation group were higher than those(66.67% and 26.19%,respectively)in the control group(P<0.05).The total effective rate(85.71%)in the changes of tumor and objective response rate(47.62%)in the observation group were different from those(66.67% and 23.81%,respectively)in the control group(P<0.05).After treatment, the distension and fullness in the upper abdomen, poor appetite, nausea, and vomiting in the observation group were significantly improved as compared with those in the control group(P<0.05),and the KPS score in the observation group was higher than that in the control group(P<0.05).Moreover, the survival and survival score in observation group were longer/higher than those in control group(P<0.05).In the observation group, CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)were increased after 2 and 4 cycles of treatment compared with those before treatment, while CD8^(+)was decreased compared with that before treatment(P<0.05).No obvious variation inimmune function indexes was found in the control group after 2 and 4 cycles of treatment(P>0.05),and the difference in these indexes was significant between the two groups after treatment(P<0.05).The incidence of adverse events was 14.29% in observation group as compared with the 33.33% in control group(χ;=4.20,P<0.05).Conclusion Fuyuan Hezhong Decoction can improve the therapeutic effect on gastric cancer, enhance immune function, and reduce the incidence of adverse reactions during chemotherapy.