通膈一号方联合化疗一线治疗晚期瘀血阻膈型食管癌疗效观察

Observation on the Efficacy of Tongge No.1 Prescription Combined with Chemotherapy in the First-line Treatment of Advanced Esophageal Cancer with Blood Stasis and Diaphragm Obstruction

目的:该研究旨在观察通膈一号方联合化疗一线治疗晚期瘀血阻膈型食管癌的疗效及安全性。方法:选取符合标准的瘀血阻膈型晚期食管癌患者80例,对其临床资料进行回顾性分析。分为试验组(n=40)和对照组(n=40)。试验组一线治疗采用化疗联合本院院内制剂通膈一号方,对照组一线治疗采用单纯化疗。统计分析2组患者的客观缓解率(ORR)、疾病控制率(DCR)、疼痛数字评分法(NRS)、体力状态评分(KPS)、中医证候积分、血液中鳞状上皮细胞癌(SCC)、癌胚抗原(CEA)水平变化及化疗相关毒副反应发生率。结果:试验组和对照组DCR分别为82.5%与62.5%,试验组较对照组明显提高(P<0.05)。治疗后试验组和对照组患者NRS评分均明显降低(P<0.05),且试验组较对照组降低更明显(P<0.05)。治疗后试验组患者KPS评分无明显变化(P>0.05),而对照组患者KPS评分明显下降(P<0.05),且试验组明显高于对照组(P<0.05)。治疗后试验组和对照组患者部分中医证候积分明显降低(P<0.05),且试验组降低程度明显高于对照组(P<0.05)。治疗后试验组任何级别的骨髓抑制、胃肠道反应发生率及血液中SCC、CEA的水平明显低于对照组(P<0.05)。结论:通膈一号方联合化疗一线治疗晚期瘀血阻膈型食管癌可能会提高食管癌的DCR,减轻食管癌相关疼痛,改善部分中医证候,降低血液中SCC、CEA水平,减轻化疗相关的毒副反应,一定程度上改善患者的生活质量。

This study aims to observe the efficacy and safety of Tongge No.1 formula combined with firstline chemotherapy in the treatment of advanced stage esophageal cancer with blood stasis obstruction.Method:A retrospective analysis was conducted on the clinical data of 80 patients with advanced esophageal cancer who met the criteria of blood stasis obstruction.Divided into an experimental group(n=40)and a control group(n=40).The experimental group received firstline treatment with chemotherapy combined with our hospital&apos;s Tongge No.1 formula,while the control group received firstline treatment with simple chemotherapy.Statistical analysis was conducted on the objective response rate(ORR),disease control rate(DCR),pain numerical score(NRS),physical condition score(KPS),traditional Chinese medicine syndrome score,changes in blood levels of squamous cell carcinoma(SCC),carcinoembryonic antigen(CEA),and incidence of chemotherapy related toxic side effects in two groups of patients.Result:The DCR of the experimental group and the control group were 82.5% and 62.5%,respectively,and the experimental group showed a significant improvement compared to the control group(P<0.05).After treatment,both the experimental group and the control group showed a significant decrease in NRS scores(P<0.05),and the experimental group showed a more significant decrease compared to the control group(P<0.05).After treatment,there was no significant change in the KPS score of the experimental group patients(P>0.05),while the KPS score of the control group patients decreased significantly(P<0.05),and the experimental group was significantly higher than the control group(P<0.05).After treatment,some patients in the experimental group and control group showed a significant decrease in traditional Chinese medicine syndrome scores(P<0.05),and the degree of reduction in the experimental group was significantly higher than that in the control group(P<0.05).The incidence of bone marrow suppression,gastrointestinal reactions,and levels of SCC and CEA in the blood of the experimental group were significantly lower than those of the control group at any level after treatment(P<0.05).Conclusion:The combination of Tongge No.1 formula and firstline chemotherapy may improve the DCR of advanced stage blood stasis obstructed esophageal cancer,alleviate pain related to esophageal cancer,improve some traditional Chinese medicine syndromes,lower the levels of SCC and CEA in the blood,alleviate chemotherapy related toxic side effects,and to some extent improve the quality of life of patients.