平胃散防治消化系统肿瘤化疗后毒副作用中应用效果

Application effect of Pingwei powder in preventing and treating toxic and side effects after chemotherapy for gastrointestinal tumors

目的研究平胃散在防治消化系统肿瘤化疗后毒副作用中的应用效果及对患者免疫功能的影响。方法选取2020-09-01-2022-10-20漯河市第六人民医院收治的86例消化系统肿瘤患者作为研究对象,采用随机数字表法将患者分为对照组和观察组,每组各43例。对照组采用XELOX(奥沙利铂、卡培他滨)化疗方案治疗,观察组在对照组基础上加用平胃散治疗。比较2组临床疗效、治疗前、治疗3个化疗周期后肿瘤患者的生活质量评分(QOL)、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK)、血清癌胚抗原(CEA)、糖链抗原125(CA125)、程序化细胞死亡分子5(PDCD5)、Ⅳ型胶原蛋白α3(COL4A3)水平、毒副作用程度。结果治疗3个化疗周期后,观察组肿瘤缓解率72.09%(31/43)高于对照组51.16%(22/43),χ^(2)=3.983,P=0.046;观察组QOL评分(44.52±5.08)分高于对照组(36.18±4.73)分,差异有统计学意义,F=6.823,P<0.001;观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK水平分别为(46.91±4.71)%、(31.68±3.22)%、(1.26±0.15)、(11.12±2.17)%,高于对照组的(33.19±4.28)%、(22.46±3.01)%、(0.88±0.12)、(8.03±2.06)%,差异有统计学意义,F值分别为11.527、10.394、10.291、5.889、P值分别为<0.001、<0.001、<0.001、0.014;观察组血清CEA、CA125、COL4A3水平分别为(8.96±2.03)μg/L、(22.64±5.38)U/mL、(2.58±0.53)ng/mL,低于对照组的(13.71±3.49)μg/L、(31.62±6.19)U/mL、(4.16±1.07)U/mL,PDCD5水平为(68.43±5.84)pg/mL,高于对照组的(59.26±6.17)pg/mL,差异有统计学意义,F值分别为5.239、6.774、8.038、7.125,均P<0.001;观察组毒副作用程度Ⅰ度48.84%(21/43)、Ⅱ度27.91%(12/43)、Ⅲ度13.95%(6/43)、Ⅳ度9.30%(4/43)低于对照组Ⅰ度23.26%(10/43)、Ⅱ度25.58%(11/43)、Ⅲ度27.91%(12/43)、Ⅳ度23.26%(10/43),差异有统计学意义,u=2.776,P=0.003。结论平胃散辅助治疗消化系统肿瘤患者疗效显著,可有效提高生活质量,调节免疫功能。促进病情恢复,降低化疗毒副作用程度。

Objective To study the application effect of Pingwei Powder in preventing and treating toxic and side effects after chemotherapy for gastrointestinal tumors and its impact on patients'immune function.Methods A total of eighty-six patients with digestive system tumors admitted to the Sixth Peoples Hospital of Luohe from September 1,2020 to Octo-ber 20,2022 were selected as the study subjects.The patients were divided into control group and observation group by random number table method,with 43 cases in each group.The control group was treated with XELOX(oxaliplatin,capecitabine)chemotherapy regimen,and the observation group was treated with Pingwei Powder on the basis of the con-trol group.The clinical efficacy,quality of life(QOL)score of tumor patients,immune function indicators(CD3^(+),CD4^(+),CD4^(+)/CD8^(+),NK),serum carcinoembryonic antigen(CEA),carbohydrate antigen 125(carbohydrate antigen 125,CA125),programed cell death5(PDCD5),type IV collagenα3(COL4A3)levels before treatment and after 3 cycles of chemotherapy,and degree of toxicity were compared between the two groups.Results After 3 cycles of chemotherapy,the tumor remission rate in the observation group was 72.09%(31/43),which was higher than that in the control group 51.16%(22/43),χ^(2)=3.983,P=0.046.After 3 cycles of chemotherapy,the QOL score in the observation group was(44.52±5.08)points,which was higher than that in the control group(36.18±4.73)points,F=6.823,P<0.001.After 3 cycles of chemotherapy,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)and NK in the observation group were(46.91±4.71)%,(31.68±3.22)%,(1.26±0.15),(11.12±2.17)%,respectively,which were higher than those in the control group(33.19±4.28)%,(22.46±3.01)%,(0.88±0.12),(8.03±2.06)%,F values were 11.527,10.394,10.291,5.889,respectively,Pvalues were<0.001,<0.001,<0.001,0.014;After 3cycles of chemotherapy,the serum levels of CEA,CA125 and COL4A3 in the observation group were(8.96±2.03)μg/L,(22.64±5.38)U/mL,(2.58±0.53)ng/mL,respectively,which were lower than those in the control group(13.71±3.49)μg/L,(31.62±6.19)U/mL,(4.16±1.07)U/mL.PDCD5 level was(68.43±5.84)pg/mL,which was higher than that of the control group(59.26±6.17)pg/mL,F values were 5.239,6.774,8.038,7.125,respectively,all P<0.00l;after 3 cycles of chemotherapy,theⅠ,Ⅱ,Ⅲ,Ⅳdegree of toxicity in the observation group were 48.84%(21/43),27.91%(12/43),13.95%(6/43),9.30%(4/43),respectively,which were lower than those in the control group 23.26%(10/43),25.58%(11/43),27.91%(12/43)and 23.26%(10/43),u=2.776,P=0.003.Conclusion Pingwei Powder is effective in the adjuvant treatment of patients with digestive system tumors,which can effectively improve the quality of life,regulate the immune function,promote disease recovery,and reduce the degree of toxicity.