自拟健脾养胃汤加味治疗胃癌临床疗效观察及对中医证候积分、血清PGⅠ、PGⅡ的影响

Clinical efficacy of modified self-made Jianpi Yangweidecoction on gastric cancer and its influence on TCM syndromes scores,serum PGI and PGII

目的:探究自拟健脾养胃汤加味治疗胃癌临床疗效观察及对中医证候积分、血清胃蛋白酶原I(PGI)、胃蛋白酶Ⅱ(PGⅡ)的影响。方法:按简单随机化分组法将2021.1~2023.1期间就诊的脾胃虚寒型中晚期原发性胃癌患者分为观察组和对照组,各60例。对照组接受常规化疗治疗;观察组接受自拟健脾养胃汤加味治疗,均连续治疗6个月。治疗6个月后,比较两组患者的临床疗效和毒副反应发生情况。并于治疗前和治疗6个月后,比较两组患者的中医证候积分、胃肠激素指标变化水平[胃蛋白酶原I(PGI)、胃蛋白酶Ⅱ(PGⅡ)、胃液素(GAS)]、肿瘤标志物指标变化水平[糖类抗原19~9(CA19-9)、糖类抗原72-4(CA72-4)、癌胚抗原(CEA)]和生活质量[胃癌测定量表(QLASTCM-Ga)]。结果:观察组的总有效率显著高于对照组(P<0.05),观察组的毒副反应发生率显著低于对照组(P<0.05)。治疗6个月后,两组患者的中医证候积分、CA19-9、CA72-4、CEA和QLASTCM-Ga评分较治疗前显著下降,且观察组低于同期对照组(P均<0.05);两组患者的PGI、PGⅡ和GAS较治疗前显著提高,且观察组高于同期对照组(P均<0.05)。结论:自拟健脾养胃汤加味能够有效治疗脾胃虚寒型胃癌患者,显著改善患者中医证候积分、胃肠激素指标、肿瘤标志物指标和生活质量,降低毒副反应的发生。

ObjectiveTo explore the clinical efficacy of modified self-made Jianpi Yangwei decoction in the treatment of gastric cancer and its influence on TCM syndromes scores,serum pepsinogen I(PGI)and pepsinogen II(PGII).Methods According to the simple randomization grouping method,patients with advanced primary gastric cancer of spleen-stomach deficiencycold type from January 2021to January 2023were divided into observation group and control group,with 60cases in each group.The control group received conventional chemotherapy while the observation group was treated with modified self-made Jianpi Yangwei decoction,and both groups were continuously treated for 6months.The clinical efficacy and occurrence of toxic and side effects after 6months of treatment and TCM syndromes scores,gastrointestinal hormones[PGI,PGII,gastrin(GAS)],tumor markers[carbohydrate antigen 19~9(CA19~9),carbohydrate antigen 72~4(CA72~4),carcinoembryonic antigen(CEA)]and quality of life[Quality of Life Assessment Instrument for Gastric Cancer(QLASTCM-Ga)]before treatment and after 6months of treatment were compared between both groups of patients.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).The observation group had significantly lower incidence rates of toxic and side effects(P<0.05).After 6months of treatment,the TCM syndromes scores,levels of CA19~9,CA72~4and CEA and QLASTCM-Ga scores in the two groups were significantly reduced compared with those before treatment,and the scores and levels in observation group were lower(all P<0.05).The levels of PGI,PGII and GAS were significantly enhanced in the two groups than those before treatment,and the levels in observation group were higher compared to control group(all P<0.05).Conclusion Modified self-made Jianpi Yangwei decoction can effectively treat patients with gastric cancer of spleen-stomach deficiency-cold type,and can significantly improve the TCM syndromes scores,gastrointestinal hormones,tumor markers and quality of life,and reduce the occurrence of toxic and side effects.