人参大黄汤联合吴茱萸外敷治疗晚期胃癌临床研究

Clinical Study on Renshen Dahuang Decoction Combined with External Application with Euodiae Fructus for Advanced Gastric Cancer

目的:观察人参大黄汤联合吴茱萸外敷对晚期胃癌患者肠胃功能和免疫功能的影响。方法:选取晚期胃癌患者79例,根据治疗方法不同分为观察组47例和对照组32例。对照组在基础化疗上采取吴茱萸外敷,观察组在对照组基础上加用人参大黄汤治疗。评价2组临床疗效,比较2组首次排气时间、首次排便时间、肠鸣恢复时间,比较2组治疗前后胃肠道功能评分(GSRS)、血清中胃动素(MTL)、血管活性肠肽(VIP)、中医证候评分和T细胞亚群水平,观察2组胃肠道并发症及治疗后7、14、28 d的生活质量评分(QOL)。结果:观察组胃肠功能恢复优良率高于对照组,差异有统计学意义(P<0.05)。观察组首次排气时间、首次排便时间、肠鸣恢复时间均短于对照组(P<0.05)。治疗后,2组GSRS评分、MTL水平较治疗前降低,VIP水平较治疗前升高(P<0.05);且观察组GSRS评分、MTL水平低于对照组,VIP水平高于对照组(P<0.05)。治疗后,2组各项中医证候评分低于治疗前(P<0.05),且观察组各项中医证候评分低于对照组(P<0.05)。治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较治疗前升高,CD8^(+)较治疗前降低(P<0.05);且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组(P<0.05)。观察组治疗后14、28 d的QOL评分高于对照组(P<0.05)。观察组胃肠道并发症发生率低于对照组(P<0.05)。结论:人参大黄汤联合吴茱萸外敷治疗能够有效改善胃癌患者化疗期间胃肠道功能及机体免疫功能,提高生活质量。

Objective:To observe the effect of Renshen Dahuang Decoction combined with external application with Euodiae Fructus on gastrointestinal function and immune function in patients with advanced gastric cancer.Methods:A total of 79 cases of patients with advanced gastric cancer were selected and divided into the observation group and the control group according to different treatment methods,with 47 and 32 cases in each group respectively.The control group was treated with the external application with Euodiae Fructus based on basic chemotherapy,and the observation group was additionally treated with Renshen Dahuang Decoction based on the treatment of the control group.Clinical effects were evaluated in the two groups.The time of first exhaust,the time of first defecation,the recovery time of borborygmus,the scores of Gastrointestinal Symptom Rating Scale(GSRS),serum motilin(MTL),and vasoactive intestinal peptide(VIP)in serum,traditional Chinese medicine(TCM)syndrome scores and T cell subgroup levels were compared between the two groups before and after treatment.The scores of Quality of Life(QOL)at 7,14,and 28 days after treatment and gastrointestinal complications were observed in the two groups.Results:The excellent and good rate of gastrointestinal function recovery in the observation group was significantly higher than that in the control group,the difference being significant(P<0.05).The time of first exhaust,the time of first defecation,and the recovery time of borborygmus in the observation group were shorter than those in the control group(P<0.05).After treatment,GSRS scores and MTL levels in the two groups were decreased when compared with those before treatment,VIP levels were increased when compared with those before treatment(P<0.05);GSRS scores and MTL levels in the observation group were lower than those in the control group,and the VIP level was higher than that in the control group(P<0.05).After treatment,TCM syndrome scores in the two groups were lower than those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the two groups were increased when compared with those before treatment,and the levels of CD8^(+)were decreased when compared with those before treatment(P<0.05);the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,and CD8^(+)level in the observation group was lower than that in the control group(P<0.05).The QOL scores at 14 and 28 days after treatment in the observation group were higher than those in the control group(P<0.05).The incidence of gastrointestinal complications in the observation group was lower than that in the control group(P<0.05).Conclusion:Renshen Dahuang Decoction combined with external application with Euodiae Fructus can effectively improve gastrointestinal function,immune function and quality of life in patients with advanced gastric cancer during chemotherapy.