香砂六君子汤联合化疗对晚期胃癌患者KPS评分及生存周期的影响

Effect of Xiangsha Liujunzi Decoction Combined with Chemotherapy on KPS Score and Survival of Patients with Advanced Gastric Cancer

目的探讨香砂六君子汤联合化疗对晚期胃癌患者身体卡氏(KPS)评分及生存周期的影响,以期为临床治疗方法的选择提供参考。方法选取2016年1月—2019年1月期间在内蒙古自治区肿瘤医院收治的晚期胃癌患者100例,按照随机数字表法分为对照组和观察组,各50例。对照组患者给予常规化疗治疗,观察组患者给予香砂六君子汤联合化疗治疗。2周为1个疗程,连续治疗4个疗程后,观察比较两组患者化疗效果、健康状况(KPS评分)、癌因性疲乏[Piper疲乏量表(RPFS)]、T淋巴细胞水平(CD4^(+)、CD8^(+)细胞水平及CD4^(+)/CD8^(+)值)、生存周期及不良反应发生率。结果治疗后观察组治疗有效率38.00%(19/50)、疾病控制率80.00%(40/50)均明显高于对照组治疗有效率16.00%(8/50)、疾病控制率48%(24/50),差异有统计学意义(P<0.05)。治疗后两组患者KPS评分明显高于治疗前,RPFS评分明显低于治疗前,差异有统计学意义(P<0.05);且观察组KPS评分明显高于对照组,RPFS评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后对照组CD4^(+)、CD4^(+)/CD8^(+)水平均明显低于治疗前,CD8^(+)水平明显高于治疗前;观察组CD4^(+)、CD4^(+)/CD8^(+)水平均明显高于治疗前,CD8^(+)水平明显低于治疗前,差异有统计学意义(P<0.05);且观察组CD4^(+)、CD4^(+)/CD8^(+)水平明显高于对照组,CD8^(+)水平明显低于对照组,差异有统计学意义(P<0.05)。观察组患者的生存周期明显高于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者肝肾损伤、神经毒性、腹泻等不良反应发生率比较,差异无统计学意义(P>0.05);观察组骨髓抑制反应程度(低白细胞、贫血、低血小板)明显优于对照组,差异有统计学意义(P<0.05)。结论采用香砂六君子汤联合化疗治疗晚期胃癌患者疗效显著,可有效改善患者机体免疫功能,抑制肿瘤生长,在提高化疗效果的基础上减轻化疗对机体造成的不良反应,缓解癌因性疲乏,提高患者生存质量,延长生存周期。

Objective To investigate the effect of Xiangsha Liujunzi Decoction combined with chemotherapy on the Karnofsky Performance Scale(KPS)score and survival of patients with advanced gastric cancer,and thus to provide a reference for the selection of the rapies in clinical practice.Methods A total of 100 patients with advanced gastric cancer who were diagnosed and treated in Inner Mongolia Cancer Hospital from January 2016 to January 2019 were included and divided into the control group(n=50)and observation group(n=50)according to a random number table.Patients in the control group were treated with conventional chemotherapy,and those in the observation group were treated with XiangshaLiujunzi Decoction and conventional chemotherapy(2 weeks/course,4 courses).The efficacy of chemotherapy,health status(KPS score),cancer-related fatigue[Revised Piper Fatigue Scale(RPFS)score],levels of T lymphocytes(CD4^(+),CD8^(+),and CD4^(+)/CD8^(+)),survival,and incidence of adverse reactions were compared between the two groups.Results The effective rate and disease control rate of the observation group were 38.00%(19/50)and 80.00%(40/50),respectively,as compared with the 16.00%(8/50)and 48%(24/50)of the control group(P<0.05).After treatment,the KPS score was higher than that before treatment and RPFS score was lower than that before treatment in both groups(P<0.05).Moreover,the KPS score was higher in the observation group than in the control group,and RPFS score was lower than that in the control group(P<0.05).After treatment,the levels of CD4^(+)and CD4^(+)/CD8^(+)were lower than those before treatment and CD8^(+)level was higher than that before treatment in the control group(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)were higher than those before treatment and CD8^(+)level was lower than that before treatment in the observation group(P<0.05).The levels of CD4^(+)and CD4^(+)/CD8^(+)were higher in the observation group than in the control group and CD8^(+)level was lower in the observation group than in the control group(P<0.05).The survival of patients in the observation group was longer than that in the control group(P<0.05).During the treatment,the indigence of adverse reactions,such as liver and kidney injury,neurotoxicity,and diarrhea showed no significant difference between the two groups(P>0.05).The degree of bone marrow suppression(low white blood cell,anemia,low platelet)in the observation group was lower than that in the control group(P<0.05).Conclusion The combination of Xiangsha Liujunzi Decoction and chemotherapy is effective for advanced gastric cancer,which canimprove the immune function,inhibit the growth of tumor,reduce the side effects of chemotherapy,and enhance the chemotherapy effect.Moreover,it alleviates the cancer-related fatigue,improves the quality of life of patients,and prolongs the survival.