参莲抗癌合剂联合化疗治疗结肠癌晚期患者临床研究

Clinical Study on Shenlian Anti-cancer Mixture Combined with Chemotherapy for Patients with Advanced Colon Cancer

目的:观察参莲抗癌合剂联合化疗对结肠癌晚期患者的临床效果,探讨其可能的作用机制。方法:选取104例晚期结肠癌患者作为研究对象,按照随机数字表法分为对照组和观察组各52例。对照组给予FOLFIRI方案化疗,观察组则在对照组基础上加用自拟参莲抗癌合剂内服治疗,2周为1个疗程,连续治疗4个疗程。观察2组患者的近期临床疗效,治疗前后检测免疫功能相关指标T淋巴细胞亚群、免疫球蛋白水平,采用欧洲癌症研究治疗组织的生命质量核心问卷(EORTC QLQ-C30)评价生活质量,监测血清白细胞介素-17 (IL-17)、低氧诱导因子-1α(HIF-1α)、血管内皮生长因子(VEGF)水平,记录2组患者的不良反应。结果:观察组的近期疗效总有效率为51.92%,高于对照组的28.85%,差异有统计学意义(χ~2=7.329,P <0.05)。治疗后,2组T淋巴细胞群指标CD4^+、CD4^+/CD8^+及免疫球蛋白IgA、IgG、IgM水平较治疗前明显升高,且观察组各项指标均高于对照组,差异均有统计学意义(P <0.05);CD8^+水平较治疗前明显降低,且观察组低于对照组,差异有统计学意义(P <0.05)。治疗后,2组症状量表评分较治疗前明显降低,功能量表评分较治疗前明显升高;且观察组症状量表评分低于对照组,功能量表评分高于对照组;差异均有统计学意义(P <0.05)。治疗后,2组血清IL-17、HIF-1α、VEGF水平较治疗前降低,且观察组各项指标均低于对照组,差异均有统计学意义(P <0.05)。观察组白细胞减少、贫血、血小板减少、恶心呕吐、口腔溃疡、肝功能异常、神经毒性等不良反应的发生率明显低于对照组(P <0.05)。结论:参莲抗癌合剂联合化疗能明显提高患者的机体免疫功能及生活质量,减毒增效作用突出,其机制可能与通过降低血清IL-17、HIF-1α、VEGF水平而抑制炎症反应、抑制肿瘤血管增殖有关,有一定的临床推广运用价值。

Objective:To observe the clinical effect of Shenlian anti-cancer mixture combined with chemotherapy on patients with advanced colon cancer,and to explore its possible mechanism.Methods:Selected 104 cases of patients with advanced colon cancer as the study subjects,and divided them into the control group and the observation group according to the random number table,with 52 patients in each group.The control group received FOLFIRI regimen for chemotherapy,while the observation group was additionally treated with the oral application of self-made Shenlian anti-cancer mixture,2 weeks as 1 cycle,continuously for 4 cycles.Observed the short-term clinical effect of patients in the two groups.Measured the immune function related indexes like T lymphocyte subsets and immunoglobulin levels before and after treatment.Assessed the quality of life by applying European Organization for Research on Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC QLQ-C30),monitored the levels of serum interleukins-17(IL-17),hypoxia-inducible factor-1α(HIF-1α),and vascular endothelial growth factor(VEGF),and recorded adverse reactions of patients in the two groups.Results:The total effective rate of short-term effect in the observation group was 51.92%,being higher than that of28.85%in the control group,difference being significant(χ~2=7.329,P<0.05).After treatment,the levels of CD4^+,CD4^+/CD8^+and immunoglobulin IgA,IgG and IgM in the two groups were significantly higher than those before treatment;these indexes in the observation group were higher than those in the control group,differences being significant(P<0.05);CD8^+level was significantly lower than that before treatment,and this level in the observation group was lower than that in the control group,difference being significant(P<0.05).After treatment,the scores of symptom scales in the two groups were obviously lower than those before treatment,and the scores of the functional scales were evidently higher than those before treatment;the scores of the symptom scales in the observation group were lower than those in the control group,and the scores of the functional scales were higher than those in the control group;differences being significant(P<0.05).After treatment,the levels of serum IL-17,HIF-1αand VEGF in the two groups were lower than those before treatment,and these indexes in the observation group were lower than those in the control group,differences being significant(P<0.05).The incidence of adverse reactions such as leukopenia,anemia,thrombocytopenia,nausea and vomiting,oral ulcers,liver dysfunction,and neurotoxicity in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of Shenlian anti-cancer mixture combined with chemotherapy can significantly improve the body immune function and quality of life of patients,and highlight the role of attenuation and synergy.Its mechanism may be related to the inhibition of the inflammatory response and tumor vascular proliferation by lowering the levels of serum IL-17,HIF-1αand VEGF.It has certain value in clinical promotion and application.