【摘要】 目的观察补气益肠方联合化疗治疗结直肠癌术后患者的临床疗效及对其免疫功能的影响。方法收集46例结直肠癌术后患者为研究对象,按随机数字表法分为研究组(23例,给予自拟补气益肠方联合卡培他滨及奥沙利铂治疗)和对照组(23例,给予卡培他滨联合奥沙利铂治疗)。观察治疗6个疗程后两组临床疗效及不良反应发生情况,并统计两组患者治疗前及治疗6个疗程后中医证候积分、肿瘤标志物[糖类抗原19-9(CA19-9)和胚抗原(CEA)]、免疫功能[T淋巴细胞总值(CD3~+)及其亚群(CD4~+、CD8~+)]、血清miR-19a、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平。结果两组主症、次症及总中医证候积分均低于本组治疗前,且研究组治疗后主症、次症及总中医证候积分均低于对照组(P <0.05)。研究组临床疗效明显高于对照组(P <0.05)。两组CEA、CA19-9水平均较本组治疗前下降,且研究组治疗后CEA、CA19-9水平均低于对照组(P <0.05)。两组CD3~+、CD4·+、CD4~+/CD8~+水平均较本组治疗前升高,CD8~+水平降低,且研究组治疗后CD3~+、CD4~+、CD4+/CD8~+水平均高于对照组,CD8~+水平低于对照组(P <0.05)。两组IL-6、TNF-α、miR-19a水平均较本组治疗前降低,研究组治疗后IL-6、TNF-α、miR-19a水平均低于对照组(P <0.05)。在治疗过程中,两组患者均未出现4度以上不良反应,且全程无死亡病例。两组患者在治疗期间出现的不良反应,均给予对症治疗后好转,且继续完成了6个周期的治疗。在治疗过程中,研究组手足综合征、过敏及腹泻不良反应发生级别均低于对照组(P <0.05);两组肝功能、肾功能、血常规、神经病变、恶心呕吐不良反应发生情况比较差异无统计学意义(P> 0.05)。结论自拟补气益肠方联合化疗治疗结直肠癌术后患者疗效较好,且可改善患者机体免疫功能。更多还原

【Abstract】 Objective To observe the effect of Buqi Yichang Decoction in the treatment of postoperative patients with colorectal cancer and its influence on immune function. Methods 56 patients with colorectal cancer after surgery were collected as the research objects. According to the random number table,they were divided into study group( 23 cases,given self-made Buqi Yichang prescription combined with capecitabine and oxaliplatin) and control group( 23 cases were treated with capecitabine combined with oxaliplatin). The clinical efficacy and adverse reactions of the two groups were observed after 6 courses of treatment. Statistical analysis was performed on the the scores of TCM syndromes,tumor markers[carbohydrate antigen 19-9( CA19-9) and carbohydrate antigen 19-9( CA19-9) and Embryonic antigen( CEA) ],immune function[total value of T lymphocytes( CD3~+) and its subgroups( CD4~+,CD8~+) ],serum miR-19 a,tumor necrosis factor-α( TNF-α),interleukin-6( IL)-6) Level. Results After 6 courses of treatment,the scores of the main symptoms,secondary symptoms,and total TCM syndromes of the two groups were lower than those before treatment,and the scores of the main symptoms,secondary symptoms,and total TCM syndromes of the study group were lower than those of the control group( P < 0. 05). After 6 courses of treatment,the clinical efficacy of the study group was significantly higher than that of the control group( P < 0. 05). After 6 courses of treatment,the levels of CEA and CA19-9 in the two groups were lower than those before treatment,and the levels of CEA and CA19-9 in the study group were lower than those in the control group( P < 0. 05). After 6 courses of treatment,the levels of CD3~+,CD4~+,CD4~+/CD8~+in the two groups were higher than those before the treatment,and the level of CD8~+ decreased. The CD3~+,CD4~+,CD4~+/CD8~+ levels in the study group were higher than those in the control group,and the CD8~+ levels were lower than control group( P <0. 05). After 6 courses of treatment,the levels of IL-6,TNF-α,and miR-19 a in the two groups were lower than before treatment. The levels of IL-6,TNF-α and miR-19 a in the study group were lower than those in the control group( P <0. 05). During the course of treatment,there was no toxic reaction above 4 degree in both groups,and there was no death in the whole course. The adverse reactions that occurred during the treatment of the two groups of patients improved after being given symptomatic treatment,and continued to complete 6 cycles of treatment. During the course of treatment,the grades of adverse reactions such as hand-foot syndrome,allergy and diarrhea in the study group were lower than those in the control group( P < 0. 05). Comparison of adverse reactions in the two groups in liver function,renal function,blood routine,neuropathy,nausea and vomiting,the difference was not statistically significant( P > 0. 05). Conclusion Modified Buqi Yichang Decoction can effectively treat patients with colorectal cancer after surgery,and can improve the immune function of the body.更多还原