芪贞归脾汤辅助治疗对食管癌伴锁骨上淋巴结转移患者细胞E-cadherin表达的影响

Effect of Qizhen Guipi Decoction(芪贞归脾汤)on Expression of E-cadherin in Esophageal Cancer Patients with Supraclavicular Lymph Node Metastasis

目的探讨芪贞归脾汤辅助治疗对食管癌伴锁骨上淋巴结转移患者细胞钙黏素(E-cadherin)表达的影响。方法选取2016年1月—2021年1月食管癌伴锁骨上淋巴结转移病例96例,随机编号方法分两组,各48例,对照组采用常规放疗;在此基础上,观察组采用芪贞归脾汤辅助治疗,持续治疗8周。治疗前后评价中医证候积分、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、免疫功能、细胞角蛋白19片段(cytokeratin 19 fragment,CYFRA21-1)、癌胚抗原(carcinoembryonic antigen,CEA)、癌抗原(cancer antigen 125,CA125)、E-cadherin和不良反应情况。结果观察组治疗后咽下困难、胸闷不舒、形体消瘦、气短乏力等积分低于对照组,差异有统计学意义(均P<0.05)。观察组治疗后睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍等评分低于对照组,差异有统计学意义(均P<0.05)。观察组治疗后CD^(+)_(3)、CD^(+)_(4)、CD^(+)_(4)/CD^(+)_(8)高于对照组,CD^(+)_(8)低于对照组,差异有统计学意义(均P<0.05)。观察组治疗后血清CYFRA21-1、CEA、CA125低于对照组,差异有统计学意义(均P<0.05)。观察组治疗后E-cadherin阳性率72.92%高于对照组54.17%,差异有统计学意义(P<0.05)。两组放射性皮炎、恶心呕吐、白细胞减少、肝功能异常、神经毒性等不良反应比较,差异无统计学意义(均P>0.05)。结论芪贞归脾汤辅助治疗可以提高食管癌伴锁骨上淋巴结转移患者的免疫功能和睡眠质量,降低肿瘤标志物及E-cadherin的表达,安全性高。

Objective To investigate the effect of Qizhen Guipi Decoction(芪贞归脾汤)on the expression of E-cadherin in esophageal cancer patients with supraclavicular lymph node metastasis.Methods Ninety-six cases of esophageal cancer with supraclavicular lymph node metastasis from January 2016 to January 2021 were randomly divided into two groups,48 cases in each group.The control group was treated with conventional radiotherapy.On this basis,the observation group was treated with Qizhen Guipi Decoction for 8 weeks.TCM syndrome scores,Pittsburgh sleep quality index(PSQI),immune function,cytokeratin 19 fragment(CYFRA21-1),carcinoembryonic antigen(CEA),cancer antigen 125(CA125),E-cadherin and adverse reactions were evaluated before and after treatment..Results The scores of dysphagia,chest tightness,weight loss,shortness of breath and fatigue in the observation group were significantly lower than those in the control group(all P<0.05).The scores of sleep quality,sleep time,sleep time,sleep efficiency,sleep disorder,hypnotic drugs and daytime dysfunction in the observation group were significantly lower than those in the control group(all P<0.05).After treatment,the levels of CD^(+)_(3),CD^(+)_(4)and CD^(+)_(4)/CD^(+)_(8)in the observation group were higher than those in the control group,and the levels of CD^(+)_(8)was lower than that in the control group(all P<0.05).After treatment,the levels of serum CYFRA21-1,CEA and CA125 in the observation group were significantly lower than those in the control group(all P<0.05).The positive rate of E-cadherin in the observation group was 72.92%,higher than 54.17%in the control group(P<0.05).There was no significant difference in the adverse reactions of radiation dermatitis,nausea and vomiting,leucopenia,abnormal liver function or neurotoxicity between the two groups(all P>0.05).Conclusion Qizhen Guipi Decoction can improve the immune function and sleep quality of patients with esophageal cancer with supraclavicular lymph node metastasis,reduce the expressions of tumor markers and E-cadherin,and has high safety.