加味小陷胸汤联合替吉奥与奥沙利铂化疗方案治疗胃癌的疗效分析及对血清胃蛋白酶原、外周血循环肿瘤细胞的影响

Effect of Modified Xiaoxianxiong Decoction(加味小陷胸汤)Combined with Tegafur-Gimeracil-Oteracil Potassium Capsules and Oxaliplatin Chemotherapy in Treatment of Gastric Cancer and Its Effect on Serum Pepsinogen and Circulating Tumor Cells in Peripheral Blood

目的探讨加味小陷胸汤联合吉奥与奥利沙铂化疗方案治疗胃癌的疗效以及对血清胃蛋白酶原、外周血循环肿瘤细胞(CTC)水平的影响。方法将医院所收治患有胃癌的86例患者,按随机数字表法随机分为对照组(43例)与观察组(43例),对照组患者采用替吉奥与奥沙利铂化疗方案治疗,观察组在对照组的基础上加服加味小陷胸汤。分析两组方案对于胃癌患者的疗效以及对血清胃蛋白酶原、CTC的影响。结果治疗前两组的主要中医证候评分差异均无统计学意义(P>0.05),治疗后两组评分观察组显著低于对照组,差异具有统计学意义(P<0.05);两组患者经过治疗,观察组实体瘤的临床疗效总有效率为83.72%(36/43),显著高于对照组65.12%(28/43),差异具有统计学意义(P<0.05);观察组治疗后的PGⅠ显著高于对照组,观察组治疗后的PGⅠ/PGⅡ显著高于对照组,差异具有统计学意义(P<0.05);观察组患者CTC阳性率为58.14%(25/43),显著低于对照组74.42%(32/45),差异具有统计学意义(P<0.05);观察组的不良反应发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论使用加味小陷胸汤联合替吉奥与奥沙利铂化疗在治疗胃癌的过程中有着良好作用,不仅能缓解胃癌的临床症状,又能有效清除病灶,显著降低两种化疗药物所带来的各种不良反应。通过检验得出,血清胃蛋白酶原中PGⅠ与PGⅡ的比值有显著提高,并且患者的CTC阳性率显著降低,使得病情逐渐转好,值得在临床中推广与应用。

Objective To analyze the effect of Modified Xiaoxianxiong Decoction(加味小陷胸汤)combined with tegafur-gi⁃meracil-oteracil potassium capsules(S-1)and oxaliplatin chemotherapy in the treatment of gastric cancer and its effect on ser⁃um pepsinogen(PG)and circulating tumor cells(CTC)in peripheral blood.Methods Eighty-six patients with gastric cancer in the hospital were randomly divided into two groups according to random number table methods,each with 43 cases.The control group received S-1 combined with oxaliplatin chemotherapy.Based on this,the observation group received Modified Xiaoxianx⁃iong Decoction.Then the clinical efficacy,serum pepsinogen and CTC in peripheral blood were compared between two groups.Results The main TCM syndrome scores yielded no significant difference between two groups before treatment(P>0.05).The post-treatment TCM syndrome score was significantly lower in the observation group than that in the control group(P<0.05).The clinical efficacy rate was 83.72%(36/43)in the observation group,which was significantly higher than 65.12%(28/43)in the control group,with statistical difference(P<0.05).After treatment,the observation group had significantly higher PGⅠcon⁃tent and larger PGⅠ/PGⅡratio compared with the control group,with statistical difference(P<0.05).The positive rate of CTC was 58.14%(25/43)in the observation group,which was significantly lower than 74.42%(32/45)in the control group,with statistical difference(P<0.05).The adverse reaction rate was significantly lower in the observation group than that in the control group(P<0.05).Conclusion Application of Modified Xiaoxianxiong Decoction combined with S-1 and oxaliplatin chemothera⁃py in the treatment of gastric cancer can effectively alleviate the clinical symptoms and improve the clearance rate of the lesions with low side effects rate.The clinical tests also denote that patients have an increase in PGⅠ/PGⅡratio and decrease in CTC positive rate.It is worthy of recommendation.