注射用黄芪多糖辅助原发性肝癌化疗的应用及安全性研究

Application and safety study of astragalus polysaccharides for injection assisted chemotherapy for primary liver cancer

目的观察注射用黄芪多糖在原发性肝癌含奥沙利铂化疗方案中的应用及对骨髓抑制的防治效果。方法本文为随机对照试验。选取2020年1月至2021年10月期间在商丘市第一人民医院接受化疗的120例原发性肝癌患者为研究对象,通过抽签法对患者进行随机分组,每组60例。对照组男40例,女20例,年龄(50.33±1.26)岁,予以含奥沙利铂化疗方案;观察组男38例,女22例,年龄(51.42±1.35)岁,在对照组化疗基础上采用注射用黄芪多糖配合治疗。比较两组患者化疗情况及外周血象指标变化情况;对所有患者开展为期1年的随访,比较两组患者化疗后骨髓抑制的发生情况、毒性反应分度。采用χ^(2)检验、t检验。结果治疗后,观察组的疾病控制率高于对照组[83.33%(50/60)比58.33%(35/60)],1个月内化疗定时、定量完成率高于对照组[93.33%(56/60)比75.00%(45/60)],差异均有统计学意义(χ^(2)=9.076、9.190;均P<0.05);治疗后,观察组的白细胞计数高于对照组[(6.25±2.44)×10^(9)/L比(4.39±1.33)×10^(9)/L],中性粒细胞百分比高于对照组[(53.34±8.31)%比(48.45±5.42)%],T淋巴细胞亚群CD3+CD4+高于对照组[(29.11±8.43)%比(25.42±5.36)%]、CD3+CD8+低于对照组[(25.45±5.44)%比(28.76±5.16)%],差异均有统计学意义(t=5.185、3.818、2.861、3.420;均P<0.05);随访期间,观察组的骨髓抑制总发生率低于对照组[25.00%(15/60)比46.67%(28/60)],差异有统计学意义(χ^(2)=6.125,P<0.05)。结论注射用黄芪多糖配合含奥沙利铂化疗对改善原发性肝癌患者外周血象指标、降低骨髓抑制发生率均有积极意义。

Objective To observe the application of astragalus polysaccharides for injection in oxaliplatin chemotherapy regimen for primary liver cancer and its preventive and therapeutic effects on bone marrow depression.Methods This was a randomized controlled trial.A total of 120 patients with primary liver cancer who received chemotherapy in Shangqiu First People's Hospital from January 2020 to October 2021 were selected as the research objects,and were divided into two groups by drawing lots.In the control group,40 males and 20 females,aged(50.33±1.26)years,were treated with oxaliplatin chemotherapy regimen.In the observation group,38 males and 22 females,aged(51.42±1.35)years,were treated with astragalus polysaccharides for injection on the basis of chemotherapy regimen in the control group.The chemotherapy and changes of peripheral hemogram indexes were compared between the two groups.All the patients were followed up for 1 year to compare the occurrence of bone marrow depression and the degree of toxic reaction after chemotherapy between the two groups.χ^(2)test and t test were used.Results After treatment,the disease control rate of the observation group was higher than that of the control group[83.33%(50/60)vs.58.33%(35/60)],and the timed and quantitative completion rate of chemotherapy within 1 month was higher than that of the control group[93.33%(56/60)vs.75.00%(45/60)],with statistically significant differences(χ^(2)=9.076 and 9.190,both P<0.05).After treatment,the white blood cell count in the observation group was higher than that in the control group[(6.25±2.44)×10^(9)/L vs.(4.39±1.33)×10^(9)/L],the percentage of neutrophils was higher than that in the control group[(53.34±8.31)%vs.(48.45±5.42)%],the T lymphocyte subsets CD3+CD4+was higher than that in the control group[(29.11±8.43)%vs.(25.42±5.36)%],and the CD3+CD8+was lower than that in the control group[(25.45±5.44)%vs.(28.76±5.16)%],with statistically significant differences(t=5.185,3.818,2.861,and 3.420;all P<0.05).During the follow-up period,the incidence of bone marrow suppression in the observation group was lower than that in the control group[25.00%(15/60)vs.46.67%(28/60)],with a statistically significant difference(χ^(2)=6.125,P<0.05).Conclusion Astragalus polysaccharides for injection combined with oxaliplatin chemotherapy regimen has positive significance in improving the peripheral hemogram indexes and reducing the incidence of bone marrow depression in patients with primary liver cancer.