安康欣胶囊辅助小切口胃癌根治术治疗胃癌患者的疗效研究

Efficacy Study of Ankangxin Capsules-Assisted Small Incision Radical Gastrectomy for Gastric Cancer Patients

目的观察安康欣胶囊辅助小切口胃癌根治术治疗胃癌(Gastric carinoma,GC)的临床疗效。方法选取2021年8月-2022年8月期间河北省唐山市人民医院收治的70例胃癌患者,按随机数字表法分为对照组和观察组,每组各35例。对照组予以小切口胃癌根治术,术后进行营养干预,观察组在对照组基础上加用安康欣胶囊。两组疗程均为4周。观察比较两组患者治疗前后中医证候积分(纳食呆滞、胃脘部隐痛、恶心反酸、腹部肿块、大便稀溏)、营养指标[前白蛋白(Prealbumin,PA)、血红蛋白(Hemoglobin,Hb)、总蛋白(Total protein,TP)、白蛋白(Albumin,Alb)、转铁蛋白(Transferrin,TRF)]、胃肠功能指标(肠鸣音恢复时间、首次排气时间、饮食恢复时间、首次排便时间)、肿瘤标志物[癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原-724(Carbohydrate antigen-724,CA-724)、糖类抗原-199(Carbohydrate antigen-199,CA-199)、恶性肿瘤生长因子(Malignant tumor growth factor,TSGF)]、复发转移指标[基质金属蛋白酶-2(Matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(Matrix metalloproteinase-9,MMP-9)、血管内皮生长因子(Vascular endothelial growth factor-A,VAGF-A)及VAGF-C]、免疫功能[T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))]的变化情况,随访记录生存期及复发转移率。结果治疗后两组患者中医主症纳食呆滞、胃脘部隐痛、恶心反酸、腹部肿块、大便稀溏证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组纳食呆滞、胃脘部隐痛、恶心反酸、腹部肿块、大便稀溏证候积分均明显低于对照组,差异有统计学意义(P<0.01)。治疗后观察组肠鸣音恢复时间、首次排气时间、饮食恢复时间和首次排便时间均明显优于对照组,差异有统计学意义(P<0.01)。治疗后两组患者血清PAB、Hb、TP、Alb和TRF指标均较治疗前升高,差异有统计学意义(P<0.05);且观察组血清PAB、Hb、TP、Alb和TRF指标均明显高于对照组,差异有统计学意义(P<0.01)。治疗后两组患者肿瘤标志物血清TSGF、CEA、CA-724及CA-199水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组肿瘤标志物血清TSGF、CEA、CA-724及CA-199水平均明显低于对照组,差异有统计学意义(P<0.01)。治疗后两组患者血清MMP-2、MMP-9、VAGF-A及VAGF-C指标均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组血清MMP-2、MMP-9、VAGF-A及VAGF-C指标均明显低于对照组,差异有统计学意义(P<0.01)。治疗后对照组免疫功能指标与治疗前比较,差异无统计学意义(P>0.05),观察组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)指标均较治疗前升高,CD8^(+)较治疗前降低,差异有统计学意义(P<0.05);且观察组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显高于对照组,CD8^(+)明显低于对照组,差异有统计学意义(P<0.01)。两组患者复发率和转移率比较,差异有统计学意义(χ^(2)=5.535、5.878,P=0.019、0.015)。结论安康欣胶囊辅助小切口胃癌根治术能控制胃癌患者病情,促进胃功能恢复,改善营养状况及免疫功能,下调肿瘤标志物及复发转移相关指标,延长生存期,减少复发和转移。

Objective To observe the clinical efficacy of Ankangxin capsules-assisted small incision radical gastrectomy for gastric cancer(GC).Methods From August 2021 to August 2022,70 patients with gastric cancer admitted to Tangshan People′s Hospital in Hebei Province were selected as the study subjects.They were divided into a control and an observation group using the random number table method,with 35 patients in each group.The control group received small incision radical gastrectomy followed by nutritional intervention,while the observation group received Ankangxin capsules based on the control group.Both groups were treated for 4 weeks.Changes in traditional Chinese medicine(TCM)symptom scores[sluggish eating,dull pain in epigastrium,nausea and acid reflux,abdominal masses,loose stools],nutritional indicators[prealbumin(PA),hemoglobin(Hb),total protein(TP),albumin(Alb),transferrin(TRF)],gastrointestinal function indicators[bowel sound recovery time,first flatus time,dietary recovery time,first defecation time],tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen-724(CA-724),carbohydrate antigen-199(CA-199),malignant tumor growth factor(TSGF)],recurrence and metastasis indicators[matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9),vascular endothelial growth factor-A(VAGF-A)and(VAGF-C)],and immune function[T lymphocyte subsets(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))]were observed and compared before and after treatment between the two groups.Survival period,recurrence,and metastasis rate were recorded during follow-up.Results After treatment,TCM main syndrome scores of sluggish eating,dull pain in epigastric,nausea and acid reflux,abdominal masses,and loose stools in both groups were significantly lower than before treatment,with a statistically significant difference(P<0.05).The TCM syndrome scores of the observation group were significantly lower than those of the control group,with a statistically significant difference(P<0.01).The observation group showed significantly better outcomes in bowel sound recovery time,first flatus time,dietary recovery time,and first defecation time than the control group,with a statistically significant difference(P<0.01).After treatment,serum levels of PAB,Hb,TP,Alb,and TRF were significantly higher in both groups than before treatment,with a statistically significant difference(P<0.05).The observation group showed significantly higher levels than the control group,with a statistically significant difference(P<0.01).After treatment,tumor marker levels of TSGF,CEA,CA-724,and CA-199 decreased significantly in both groups,with a statistically significant difference(P<0.05).The observation group showed significantly lower levels than the control group,with a statistically significant difference(P<0.01).After treatment,serum levels of MMP-2,MMP-9,VAGF-A,and VAGF-C were significantly lower in both groups than before treatment,with a statistically significant difference(P<0.05).The observation group showed significantly lower levels than the control group,with a statistically significant difference(P<0.01).There were no statistically significant differences in immune function indicators between the two groups before and after treatment(P>0.05),whereas CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels increased and CD8^(+)levels decreased significantly in the observation group compared to before treatment,with a statistically significant difference(P<0.05).Furthermore,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)levels were significantly higher,and CD8^(+)levels were significantly lower in the observation group than in the control group(P<0.01).The comparison of recurrence and metastasis rates between the two groups showed significant differences(χ^(2)=5.535,5.878,P=0.019,0.015).Conclusion Ankangxin capsule-assisted small incision radical gastrectomy can effectively control the condition of gastric cancer patients,promote gastrointestinal function recovery,improve nutritional status and immune function,downregulate tumor markers and indicators of recurrence and metastasis,prolong survival,and reduce recurrence and metastasis.