【摘要】 目的 探讨补肾健脾药方联合FOLFOX化疗方案治疗脾肾阳虚型大肠癌患者的临床疗效。方法 选取2019年8月—2021年8月期间昆明市中医医院收治的辨证为脾肾阳虚型的中晚期大肠癌患者92例，按随机数字表法分为对照组和治疗组，每组各46例。对照组接受单纯FOLFOX化疗方案治疗，治疗组患者接受FOLFOX化疗方案+健脾补肾法治疗，21 d为1个化疗周期。治疗3个周期后，观察比较两组患者临床疗效[疾病控制率(Disease control rate, DCR)]、化疗毒副作用发生及分级情况，治疗前后的中医症状积分、生活质量[生活质量问卷(Quality of life, QOL)、KPS评分量表(Karnofsky, KPS)]以及肿瘤标志物[血清癌胚抗原(Carcinoembryonic antigen, CEA)以及血清糖类抗原199(Carbohydrate antigen199,CA199)]水平。结果 治疗后治疗组DCR为93.33%(42/45)明显高于对照组75.00%(33/44),差异有统计学意义(P<0.05)。治疗后两组患者中医症状积分较治疗前降低，差异有统计学意义(P<0.05);且治疗组中医症状积分较对照组明显降低，差异有统计学意义(P<0.05)。治疗后两组患者QOL、KPS评分均较治疗前升高，差异有统计学意义(P<0.05);且治疗组QOL、KPS评分均较对照组明显升高，差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、CA199水平均较治疗前降低，差异有统计学意义(P<0.05);且治疗组血清CEA、CA199水平均较对照组明显降低，差异有统计学意义(P<0.05)。治疗期间，两组患者均未出现Ⅳ级程度的毒副作用。两组患者分级进行比较结果显示，对照组在恶心呕吐、腹泻这两项的反应剧烈程度高于治疗组，差异有统计学意义(P<0.05);两组患者在白细胞减少、血小板降低、转氨酶升高以及肌酐升高方面比较，差异无统计学意义(P>0.05)。结论 FOLFOX化疗方案联合健脾补肾法治疗在改善中晚期大肠癌患者症状表现、生活质量，降低血清肿瘤标志物水平等方面更具优势，疗效佳，且能够降低化疗导致的胃肠道反应的剧烈程度，是治疗中晚期大肠癌的有效方案。更多还原

【Abstract】 Objective To investigate the clinical effect of tonifying kidney and invigorating spleen combined with FOLFOX chemotherapy on mid-and late-stage colorectal cancer patients with spleen-kidney yang deficiency.Methods A total of 92 mid-and late-stage patients with spleen-kidney yang deficiency who were treated in Kunming Municipal Hospital of Traditional Chinese Medicine from August 2019 to August 2021 were included in the trail.They were divided into a control group and a treatment group according to random number table method, with 46 in each group.The control group received single FOLFOX chemotherapy, while the treatment group received FOLFOX chemotherapy+tonifying kidney and strengthening spleen for 3 treatment cycles, with 21 days as one treatment cycle.After completion of treatment, the two groups were compared in terms of clinical effect[disease control rate(DCR)],the occurrence and grading of toxic side effects of chemotherapy as well as traditional Chinese medicine(TCM)symptom score, quality of life[Quality of Life Questionnaire(QOL)score, Karnofsky(KPS)score],tumor marker level[carcinoembryonic antigen(CEA)],and carbohydrate antigen199(CA199)before and after treatment.Results The DCR of the treatment group was 93.33%(42/45)higher than 75.00%(33/44)of the control group(P<0.05).After treatment, the TCM symptom score and the serum levels of CEA and CA199 in both groups were lowered while QOL and KPS scores were increased compared with those before treatment(all P<0.05),and the treatment group had more decreases and increases than the control group(all P<0.05).No toxic side effects of Ⅳ grade occurred in the two groups during treatment, and the treatment group had less severe reactions to nausea, vomiting and diarrhea than the control group(P<0.05).There were no significant differences between the two groups in reduced white blood cells, lowered blood platelet, and elevated transaminases and creatinine(P>0.05).Conclusion FOLFOX chemotherapy combined with tonifying kidney and invigorating spleen is advantageous and effective in alleviating the symptoms, improving quality of life and reducing serum tumor marker levels of mid-and late-stage colorectal cancer patients.It can reduce the severity of gastrointestinal reactions caused by chemotherapy, and thus is an effective treatment option for mid-to late-stage colorectal cancer.更多还原