加味人参养荣汤治疗正虚毒结型胃癌晚期患者的效果观察

Observation on the Effect of Modified Renshen Yangrong Decoction in Treating Advanced Gastric Cancer Patients with Healthy Qi Deficiency with Toxin Accumulation Type

目的:探究加味人参养荣汤治疗正虚毒结型胃癌晚期患者的效果。方法:将淮安市第二人民医院2021年2月—2022年2月收诊的84例晚期胃癌患者随机分为研究组和对照组,每组42例,对照组采用奥沙利铂+替吉奥治疗,研究组在对照组基础上联合加味人参养荣汤治疗。治疗3个月后,比较两组患者的癌胚抗原(CEA)、组织多肽特异性抗原(TPS)、糖类抗原125(CA125)、中医证候、客观缓解率、疾病控制率及不良反应发生率,随访12个月,记录患者无进展生存(PFS)和总生存(OS)状况。结果:治疗后,两组患者的CEA、TPS及CA125水平均降低,研究组低于对照组(P<0.05);治疗后,两组患者的CD4+/CD8+、NK细胞及IgG水平均升高,研究组高于对照组(P<0.05);治疗后,两组的VEGF、TGF-β1水平均降低,研究组低于对照组(P<0.05)。治疗后,两组患者的主症评分及次症评分均降低,研究组低于对照组(P<0.05)。研究组客观缓解例数低于对照组(P<0.05)。两组疾病控制例数比较,差异无统计学意义(P>0.05)。研究组患者的胃肠道反应发生率低于对照组(P<0.05),两组患者的血小板减少、粒细胞减少、神经毒性(乏力、嗜睡)、脱发、肝损伤、手足综合征发生率比较,差异无统计学意义(P>0.05)。两组PFS曲线、OS曲线比较差异有统计学意义(P<0.05,P<0.01)。结论:加味人参养荣汤治疗正虚毒结型胃癌晚期患者,有助于改善患者的临床症状、胃肠道反应及免疫水平,降低肿瘤标志物及血管生长调节因子水平,延长无进展生存时间,具有一定的推广价值。

Objective:To investigate the effect of Modified Renshen Yangrong decoction in treating late-stage gastric cancer patients with healthy Qi deficiency with toxin accumulation syndrome.Methods:A total of 84 patients with late-stage gastric cancer admitted to Huai an Second People s Hospital from February 2021 to February 2022 were randomly divided into a study group and a control group,with 42 cases in each group.The control group was treated with oxaliplatin and tegafur,while the study group received additionally Modified Renshen Yangrong decoction.After 3 months of treatment,the levels of carcinoembryonic antigen(CEA),tissue polypeptide-specific antigen(TPS),carbohydrate antigen 125(CA125),TCM syndrome scores,objective response rate(ORR),disease control rate(DCR),and adverse reaction rate were compared between the two groups.The patients were followed up for 12 months,and progression-free survival(PFS)and overall survival(OS)were recorded.Results:After treatment,the levels of CEA,TPS,and CA125 in both groups decreased,with lower levels in the study group compared to the control group(P<0.05).The levels of CD4+/CD8+,NK cells,and IgG in both groups increased,with higher levels in the study group(P<0.05).The levels of VEGF and TGF-β1 in both groups decreased,with lower levels in the study group(P<0.05).The main symptom scores and secondary symptom scores of both groups decreased,with lower scores in the study group(P<0.05).The ORR in the study group was lower than that in the control group(P<0.05).There was no statistically significant difference in DCR between the two groups(P>0.05).The incidence of gastrointestinal reactions in the study group was lower than that in the control group(P<0.05).There were no statistically significant differences in the incidence of thrombocytopenia,granulocytopenia,neurotoxicity(fatigue,drowsiness),hair loss,liver injury,or hand-foot syndrome between the two groups(P>0.05).There were significant differences in the PFS and OS curves between the two groups(P<0.05).Conclusion:Modified Renshen Yangrong decoction can help improve clinical symptoms,gastrointestinal reactions,and immune levels in late-stage gastric cancer patients with healthy Qi deficiency with toxin accumulation syndrome.It can reduce tumor markers and levels of angiogenic regulatory factors,prolong progression-free survival time,and has certain promotional value.