瑞戈非尼联合健脾消癌方对结直肠癌的临床疗效及免疫功能的影响

Clinical efficacy and impact on immune function of regorafenib combined with Jianpi Xiaoai Formula in treating colorectal cancer

目的研究瑞戈非尼联合健脾消癌方治疗结直肠癌的临床疗效及其对免疫功能的影响。方法采用随机数字表法将2022年2月至2023年12月南京中医药大学附属南京医院(南京市第二医院)肿瘤科接收的结直肠癌患者70例进行分组,观察组(35例)服用瑞戈非尼联合健脾消癌方,对照组(35例)予以瑞戈非尼口服,均用药28 d。评价总有效率;检测治疗前后T淋巴细胞(CD3^(+))、辅助性T细胞(CD4^(+))、CD4^(+)/细胞毒性T细胞(CD8^(+))、糖类抗原(CA125、CA19-9、CA242)、癌胚抗原(carcinoembryonic antigen,CEA)、白细胞介素(interleukin,IL)-6、IL-10、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α);统计不良反应(恶心呕吐、手足皮肤反应、腹泻、肝肾功能等)。结果观察组总有效率为57.14%,高于对照组的42.86%(P<0.05)。治疗后,两组患者CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均明显高于治疗前(P<0.05),且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均高于对照组(P<0.05)。治疗后,两组CA125、CA19-9、CA242、CEA水平均低于治疗前(P<0.05),且观察组CA125、CA19-9、CA242、CEA水平均低于对照组(P<0.05)。治疗后,两组血清IL-6、IL-10、TNF-α水平均低于治疗前(P<0.05),且观察组IL-6、IL-10、TNF-α均低于对照组(P<0.05)。治疗期间,两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论瑞戈非尼联合健脾消癌方对结直肠癌有较好疗效,可减轻炎性反应、调节免疫能力、降低肿瘤标志物水平,且不良反应少,值得临床推广。

Objective To study the clinical efficacy and impact on immune function of regorafenib combined with Jianpi Xiaoai Formula(JPXAF)in treating colorectal cancer.Methods A total of 70 patients with colorectal cancer admitted to Oncology Department of Nanjing Hospital of Nanjing University of Chinese Medicine(The Second Hospital of Nanjing)from February 2022 to December 2023 were divided into two groups according to the random number table method.The observation group(n=35)was treated with regorafenib combined with JPXAF,while the control group(n=35)were administered with only regorafenib.Both groups were treated for 28 days.The total effective rate was evaluated.Before and after treatment,T lymphocyte(CD3^(+)),helper T cells(CD4^(+)),CD4^(+)/cytotoxic T cells(CD8^(+)),carbohydrate antigens(CA125,CA19-9,CA242),carcinoembryonic antigen(CEA),interleukin-6(IL-6),interleukin-10(IL-10),and tumor necrosis factor-α(TNF-α)were measured.The adverse reactions(such as nausea and vomiting,skin reaction of hands and feet,diarrhea,abnormal function of liver and kidney)were recorded.Results The total effective rate of the observation group was 57.14%,which was higher than the 42.86%in the control group(P<0.05).After treatment,the levels of serum CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in both groups were significantly higher than those before treatment(P<0.05),and the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the observation group were all higher than those in the control group(P<0.05).After treatment,the levels of CA125,CA19-9,CA242,and CEA in both groups were lower than those before treatment(P<0.05),and the levels of CA125,CA19-9,CA242,and CEA in the observation group were all lower than those in the control group(P<0.05).Post-treatment,the levels of serum IL-6,IL-10,and TNF-αwere lower in both groups than before treatment(P<0.05),and the levels of IL-6,IL-10,and TNF-αin the observation group were all lower than those in the control group(P<0.05).During the treatment,there was no statistically significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Regorafenib combined with JPXAF has a good therapeutic effect on colorectal cancer,which can reduce inflammatory response,regulate immune function,and lower tumor marker levels,with few adverse reactions.Therefore,it is worthy of clinical promotion.