桂枝茯苓丸治疗肾虚督寒型宫颈癌

Guizhi Fuling Pill in the Treatment of Cervical Carcinoma of Kidney Deficiency and Duhan Syndrome

目的:观察桂枝茯苓丸对肾虚督寒型宫颈癌(cervical carcinoma,CC)患者的生存期及肿瘤标记物(tumor marker,TM)的影响。方法:63例肾虚督寒型宫颈癌患者随机分为观察组及对照组。对照组给予常规西医治疗,观察组在对照组治疗基础上给予桂枝茯苓丸。采用Kaplan-meier法分析两组患者的生存期并比较TM水平。结果:观察组末次随访时鳞状上皮癌细胞抗原(squamous cell cancer antigen,SCC)明显低于治疗前(P<0.05),且该组SCC、癌胚抗原(carcino-embryonic antigen,CEA)及CA125均明显低于对照组(P<0.05)。观察组有17例患者删失(56.67%),对照组有10例删失(30.30%),两组删失率比较,差异无统计学意义(χ~2=0.143,P=0.705)。观察组生存期的算术均数及中位数分别为57.37、54个月,而对照组分别为43.39、43个月;Kaplan-Meier生存分析显示,两组患者的生存期差异有统计学意义(χ~2=4.670,P=0.031)。CEA及CA125与生存期无显著相关性,而SCC与生存期呈显著负相关性(r=-0.812,P=0.017)。结论:SCC可能是肾虚督寒型CC患者的血清免疫物质基础,且SCC可能是桂枝茯苓丸的作用靶点,对肾虚督寒型CC患者使用桂枝茯苓丸有助于降低其肿瘤标记物SCC水平并延长生存期。

Objective: To observe the effect of Guizhi Fuling Pill on survival time and tumor marker( TM) of patients with cervical carcinoma( CC) of kidney deficiency and Duhan syndrome. Methods: 63 cases of cervical carcinoma with kidney deficiency and Duhan syndrome were randomly divided into observation group and control group. The control group was treated with conventional western medicine,while the observation group was treated with Guizhi Fuling Pill on the basis of the control group. Kaplan-meier method was used to analyze the survival time of two groups of patients and compare TM level. Results: At the last follow-up,squamous cell cancer antigen( SCC) in the observation group was significantly lower than that before treatment( P < 0. 05),and SCC,carcino-embryonic antigen( CEA) and CA125 in the observation group were significantly lower than those in the control group( P < 0. 05). There were 17 deletions( 56. 67%) in the observation group and 10 deletions( 30. 30%) in the control group. There was no significant difference in the deletion rate between the two groups( χ2= 0. 143,P = 0. 705). The arithmetic mean and median survival time of the observation group were 57. 37 and 54 months respectively,while those of the control group were 43. 39 and43 months respectively. Kaplan-Meier survival analysis showed that there was significant difference between the two groups( χ2=4. 670,P = 0. 031). CEA and CA125 had no significant correlation with survival,but SCC had significant negative correlation with survival( r =-0. 812,P = 0. 017). Conclusion: SCC may be the basis of serum immune substances in CC patients with kidney deficiency and Duhan syndrome,and SCC may be the target of Guizhi Fuling Pill. The use of Guizhi Fuling Pill in CC patients with kidney deficiency and Duhan syndrome can help to reduce the level of SCC,the tumor marker,and prolong the survival time.