参萸养胃汤联合XELOX方案化疗治疗中晚期胃癌临床研究

Clinical Study on Shenyu Yangwei Decoction Combined with XELOX Chemotherapy Regimen for Advanced Gastric Cancer

目的:观察参萸养胃汤联合卡培他滨与奥沙利铂(XELOX)方案化疗治疗中晚期胃癌对化疗毒副反应及癌因性疲乏的影响。方法:选取95例中晚期胃癌患者,采用随机信封法分为对照组47例和观察组48例。对照组采用XELOX方案化疗治疗,观察组采用参萸养胃汤联合XELOX方案化疗治疗。比较2组临床疗效、中医证候评分、免疫功能、毒副反应、癌因性疲乏(Piper疲乏量表评分)情况。结果:观察组总有效率97.92%,高于对照组87.24%,差异有统计学意义(P<0.05)。治疗后,2组胃脘隐痛、食少腹胀、呃逆嗳气、消瘦乏力、畏寒肢冷、大便溏薄、小便清长等中医证候评分较治疗前降低(P<0.05),且观察组上述各项评分均低于对照组(P<0.05)。治疗后,2组T淋巴细胞CD4+、自然杀伤细胞(NK)水平较治疗前升高(P<0.05),且观察组CD4+、NK水平均高于对照组(P<0.05);CD8+水平较治疗前降低(P<0.05),而2组CD8+水平比较,差异无统计学意义(P>0.05)。观察组毒副反应发生率33.33%,低于对照组57.45%,差异有统计学意义(P<0.05)。治疗后,2组Piper疲乏量表中情感疲乏、行为疲乏、认知疲乏、感觉疲乏评分均较治疗前降低(P<0.05),且观察组上述各项评分均低于对照组(P<0.05)。结论:参萸养胃汤联合XELOX方案化疗治疗中晚期胃癌,能提高临床疗效,有效改善患者中医证候、免疫功能、毒副反应及癌因性疲乏状态。

Objective:To observe the effect of Shenyu Yangwei Decoction combined with a chemotherapy regimen of capecitabine plus oxaliplatin(XELOX)on toxic and side effects of chemotherapy and cancer-related fatigue in the treatment of advanced gastric cancer.Methods:A total of 95 cases of patients with advanced gastric cancer were selected and divided into the control group and the observation group by random envelope method,with 47 and 48 cases in each group respectively.The control group was treated with the XELOX regimen,and the observation group was treated with Shenyu Yangwei Decoction and XELOX regimen.Clinical effects,traditional Chinese medicine(TCM)syndrome scores,immune function,toxic and side effects,and cancer-related fatigue(Piper Fatigue Scale)were compared between the two groups.Results:The total effective rate was 97.92%in the observation group,which was higher than that of 87.24%in the control group,the difference being significant(P<0.05).After treatment,TCM syndrome scores of pain in the stomach cavity,reduction of food intake and abdominal distention,hiccup and belching,marasmus and lack of strength,fear of cold and cold limbs,loose stool,profuse clear urine in the two groups were declined when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of T lymphocytes(CD4+)and natual killer cell(NK)in the two groups were elevated when compared with those before treatment(P<0.05),and the levels of CD4+and NK in the observation group were higher than those in the control group(P<0.05);the levels of CD8+were reduced when compared with those before treatment(P<0.05),and there was no significant difference in the comparison of CD8+levels between the two groups(P>0.05).The incidence of toxic and side effects was 33.33%in the observation group,which was lower than that of 57.45%in the control group,the difference being significant(P<0.05).After treatment,the scores of affective fatigue,behavioral fatigue,cognitive fatigue,and sensory fatigue in the Piper Fatigue Scale in the two groups were declined when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).Conclusion:Shenyu Yangwei Decoction combined with XELOX regimen for advanced gastric cancer can better enhance clinical effects,and effectively improve patients'TCM syndromes,immune function,toxic and side effects,and the condition of cancer-related fatigue.