胃癌患者脾虚证与生物学行为的关系及健脾益气中药对其的影响

Relationship Between Splenic Deficiency Syndrome and Biological Behavior in Patients with Gastric Carcinoma: the Clinical Curative Effects of Shenqifuzheng Injection

目的 研究中医脾虚证与胃癌病人临床生物学行为之间的关系 ,探讨健脾益气中药参芪扶正注射液对其的影响。方法 根据中医辨证标准 ,将 10 2例患者分为胃癌无脾虚证和有脾虚证两组。分析统计胃癌浸润深度、分化程度、淋巴结转移以及PTNM分期等。并将有脾虚组患者分为单纯手术组与手术 +健脾治疗组 ,分别检测红细胞C3b受体花环 (RBC C3bRR)、免疫复合物花环 (RBC ICR)、T淋巴细胞嗜银蛋白含量以及NK细胞活性。结果 10 2例胃癌患者中有 6 3例 (6 1 8% )合并不同程度的脾虚证。脾虚组与无脾虚组患者相比 ,其肿瘤浸润深度、分化程度、淋巴结转移以及PTNM分期的构成比不同 ,有脾虚证组T3～T4、低分化腺癌以及 3、4站淋巴结转移患者较多 ,PTNM分期Ⅲ、Ⅳ期者较多 (P <0 0 1)。脾虚组胃癌患者手术 +健脾治疗组较单纯手术组RBC C3bRR、T淋巴细胞嗜银蛋白含量、NK细胞活性显著升高 ,RBC ICR显著降低 (P <0 0 1)。结论 胃癌患者脾虚证与其临床生物学行为之间有较密切的关系 ,合并脾虚证患者的预后比不合并脾虚证患者差。脾虚型胃癌患者术后合并应用健脾益气中药可明显改善其免疫功能。

Objective To investigate the relationship between splenic deficiency syndrome (SDS) and biological behavior in patients with gastric carcinoma, and to observe the effects of Shenqifuzheng Injection (SI) on the gastric carcinoma of SDS type. Methods 102 Patients of gastric carcinoma were divided into non SDS group and SDS group according to the criteria of TCM syndrome differentiation. The depth of infiltration, degree of differentiation, metastatic lymph nodes, and PTNM calssification of gastric carcinoma were evaluated by the statistical method. The patients in the SDS group were further divided into the operation group and the operation SI group; and the red blood cell C3b receptor rosette (RBC C3bRR), red blood cell immune complex rosette (RBC ICR), T lymphocyte Ag NORs and NK cell activity were detected. Results Of 102 patients with gastric carcinoma, 63 cases were complicated by SDS in different degrees. As compared with non-SDS group, the SDS group showed that more patients with T3 - T4, with poorly-differentiated adenocarcinoma, in station 3 and station 4 lymphocytic metastasis, and in stage Ⅲ and stage Ⅳ according to PTNM classification ( P <0 01). As compared with those in the patients in the operation group, RBC C3bRR, T lymphocyte Ag NORs and NK cell activity markedly increased, and RBC ICR markedly decreased ( P <0 01) in the patients in the operation SI group. Conclusion There is a close relationship between SDS and the clinical biological behavior in the patients with gastric carcinoma. The prognosis of the patients complicated by SDS is not as good as that of the patients without the syndrome; SI can markedly improve the immune functions in the patients with gastric carcinoma of SDS type after their operation.