祛邪消积汤联合放化疗治疗胃癌根治术后腹腔淋巴结转移癌临床观察及对免疫指标的影响
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摘要
目的:观察祛邪消积汤联合放化疗治疗胃癌根治术后腹腔淋巴结转移癌患者的临床效果及对免疫功能的影响。方法:选取胃癌根治术后腹腔淋巴转移癌患者70例,随机分为对照组及观察组,对照组采用放化疗,观察组在放化疗的基础上联合使用祛邪消积汤治疗,连续治疗6周。观察比较治疗前后两组患者外周血T淋巴细胞及NK细胞的比例,血清肿瘤标志物(VEGF、CEA和CA19-9)的水平;绘制生存曲线,比较两组患者PFS及OS;采用KPS评分评价两组患者的生存质量;比较治疗后两组的临床疗效及不良反应。结果:治疗后两组患者外周血T淋巴细胞及NK均明显高于治疗前,并且观察组患者各项指标显著高于对照组(P<0.05)。观察组治疗6周后、最后1次复诊时血清中VEGF、CA19-9、CEA水平均显著低于治疗前,并且明显较对照组低(P<0.05)。对照组患者的中位PFS为14个月,中位OS为29个月,观察组患者的中位PFS为20个月,中位OS为40个月,两组比较差异显著(P<0.05)。观察组的临床疗效高于对照组(P<0.05),观察组的生存质量也明显优于对照组(P<0.05),不良反应明显少于对照组(P>0.05)。结论:祛邪消积汤联合放化疗治疗胃癌根治术后腹腔淋巴转移癌具有良好的临床疗效,提高机体免疫功能,延长患者生存期,提高生存质量,值得在临床上推广。
Objective: To observe the clinical effect of Quxie Xiaoji Decoction combined with radiotherapy and chemotherapy on patients with abdominal lymph node metastasis after radical gastrectomy. Methods: Seventy patients with lymph node metastasis after radical gastrectomy were randomly divided into control group and observation group. The control group received radiotherapy and chemotherapy. The observation group was treated with Quxie Xiaoji Decoction on the basis of radiotherapy and chemotherapy. Continuous treatment lasted for 6 weeks. The ratios of peripheral blood T lymphocytes and NK cells, serum tumor markers(VEGF, CEA and CA19-9) were compared between the two groups before and after treatment. The survival curves were compared and the PFS and OS were compared between the two groups. The KPS score was used to evaluate the scores. The quality of life of the two groups' patients,the clinical efficacy and adverse reactions of the two groups after treatment were compared. Results: T lymphocytes and NK in peripheral blood of the two groups were significantly higher than those before treatment, and the indexes of the observation group were significantly higher than those of the control group(P<0.05). The serum levels of VEGF, CA19-9 and CEA in the observation group were significantly lower than those before treatment after 6 weeks treatment and at the last time, and were significantly lower than those of the control group(P<0.05). The median PFS was 14 months in the control group and the median OS was 29 months. The median PFS was 20 months and the median OS was 40 months in the observation group. The difference between the two groups was significant(P<0.05).. The clinical efficacy of the observation group was higher than that of the control group(P<0.05). The quality of life of the observation group was also significantly better than that of the control group(P<0.05), and the adverse reactions were significantly less than those of the control group(P>0.05). Conclusion: Quxie Xiaoji Decoction combined with radiotherapy and chemotherapy for the treatment of gastric lymph node metastasis after radical gastrectomy has good clinical efficacy, and can improve the body's immune function, prolong the survival of patients and improve the quality of life. It is worthy of clinical promotion.
Objective: To observe the clinical effect of Quxie Xiaoji Decoction combined with radiotherapy and chemotherapy on patients with abdominal lymph node metastasis after radical gastrectomy. Methods: Seventy patients with lymph node metastasis after radical gastrectomy were randomly divided into control group and observation group. The control group received radiotherapy and chemotherapy. The observation group was treated with Quxie Xiaoji Decoction on the basis of radiotherapy and chemotherapy. Continuous treatment lasted for 6 weeks. The ratios of peripheral blood T lymphocytes and NK cells, serum tumor markers(VEGF, CEA and CA19-9) were compared between the two groups before and after treatment. The survival curves were compared and the PFS and OS were compared between the two groups. The KPS score was used to evaluate the scores. The quality of life of the two groups' patients,the clinical efficacy and adverse reactions of the two groups after treatment were compared. Results: T lymphocytes and NK in peripheral blood of the two groups were significantly higher than those before treatment, and the indexes of the observation group were significantly higher than those of the control group(P<0.05). The serum levels of VEGF, CA19-9 and CEA in the observation group were significantly lower than those before treatment after 6 weeks treatment and at the last time, and were significantly lower than those of the control group(P<0.05). The median PFS was 14 months in the control group and the median OS was 29 months. The median PFS was 20 months and the median OS was 40 months in the observation group. The difference between the two groups was significant(P<0.05).. The clinical efficacy of the observation group was higher than that of the control group(P<0.05). The quality of life of the observation group was also significantly better than that of the control group(P<0.05), and the adverse reactions were significantly less than those of the control group(P>0.05). Conclusion: Quxie Xiaoji Decoction combined with radiotherapy and chemotherapy for the treatment of gastric lymph node metastasis after radical gastrectomy has good clinical efficacy, and can improve the body's immune function, prolong the survival of patients and improve the quality of life. It is worthy of clinical promotion.
引文
[1] 胡宗涛,吕东来,王崇,等.伽玛刀联合替吉奥治疗腹腔淋巴结转移癌近期疗效观察[J].安徽医药,2012,16(12):1861-1862.
[2] 杨波.三维适形放疗联合SOX方案治疗胃癌术后腹腔淋巴结转移疗效观察[J].山东医学高等专科学校学报,2016,38(1):63-65.
[3] 朱晓虹,赵爱光,李宏伟,等.基于健脾为基础的辨证治疗方案对ⅢC期胃癌根治术后患者无病生存期的影响[J].中国肿瘤,2016,25(7):569-574.
[4] 张艳.放化疗同步治疗胃癌根治术后腹腔淋巴结转移瘤的临床疗效及安全性[J].临床合理用药杂志,2017,10(6):19-20.
[5] 张功平.替吉奥同步放疗序贯化疗治疗胃癌根治术后腹腔淋巴结转移瘤的疗效[J].临床医药文献电子杂志,2017,4(25):4903-4904.
[6] 陆蓓娜,王飞芳,黄瑛.参芪扶正注射液对晚期胃癌化疗患者免疫功能及生活质量的影响[J].中国生化药物杂志,2017,37(7):136-137.
[7] 方璐,梁慧,刘大妹,等.理中汤加味联合食疗方减轻胃癌化疗后消化道副反应30例[J].江西中医药,2018,49(4):55-56.
[8] 刘玉刚.三维适形放射在腹腔淋巴结转移癌治疗中的临床应用价值分析[J].河南医学研究,2016,25(8):1498-1499.
[9] 于龙珍,吴少兵,柏会明,等.调强放疗联合化疗治疗食管癌术后腹腔淋巴结转移的疗效[J].肿瘤基础与临床,2016,29(1):51-54.
[10] 魏林,赵大齐.三维适形放射疗法联合高强度聚焦超声治疗腹膜后淋巴结转移癌疗效观察[J].中华消化病与影像杂志(电子版),2013,3(4):22-25.
[11] 高钧,孙英华,贾立红,等.立体适形放射治疗辅以中医中药治疗腹腔淋巴结转移癌的疗效观察[J].中国当代医药,2010,17(17):93-94.
[12] 刘会民,赵敏杰.太子参临床应用及研究进展[J].中国医院用药评价与分析,2015,15(3):430-432.
[13] 褚书豪,汪小彩,冯良.太子参化学成分及其药理作用研究进展[J].光明中医,2016,31(7):1047-1048.
[14] ZHUANG M,LIU D,CHEN Y,et al.Inhibitory effect and the mechanism of Astragalus polysaccharide combined with cisplatin on growth of inplanted Lewis lung carcinoma in mice[J].Xi Bao Yu FenZi MianYiXue ZaZhi,2017,33(4):503-507.
[15] 田芳.复方化浊解毒汤联合DCF化疗方案对中晚期胃癌患者血清VEGF及COX-2水平的影响[J].现代中西医结合杂志,2017,26(24):2698-2700.
[16] 汪质良,崔海忠,潘军武,等.原发性胃癌根治术后化疗对外周血T细胞亚群、NK细胞的影响及意义[J].海南医学院学报,2015,21(1):1-3.
[17] 徐本玲,袁龙,袁鹏,等.胃癌患者外周及肿瘤组织中CD4～+T淋巴细胞上Tim-3的表达及其临床意义[J].实用医学杂志,2017,33(1):108-112.
[18] 吴姗姗,严峰,邓玉玲,等.小细胞和非小细胞肺癌晚期患者CD+3CD+4及CD+3CD+8T淋巴细胞亚群的差异[J].中国免疫学杂志,2015,31(1):114-116.
[19] 沈建康,袁建明,蔡中瑞.CEA、CA199、CA724及HSP60在胃癌患者血清中的表达及应用价值[J].川北医学院学报,2016,31(6):848-850.
[20] 张智燕.CEA、CA199、CA724在胃癌新辅助化疗疗效评估中的应用[J].系统医学,2018,3(7):4-6.
[21] 修丽娟,刘龙,刘煊,等.胃癌组织中VEGF-C、VEGF-D、VEGFR-3蛋白表达及其临床意义[J].第二军医大学学报,2017,38(11):1458-1461.
[2] 杨波.三维适形放疗联合SOX方案治疗胃癌术后腹腔淋巴结转移疗效观察[J].山东医学高等专科学校学报,2016,38(1):63-65.
[3] 朱晓虹,赵爱光,李宏伟,等.基于健脾为基础的辨证治疗方案对ⅢC期胃癌根治术后患者无病生存期的影响[J].中国肿瘤,2016,25(7):569-574.
[4] 张艳.放化疗同步治疗胃癌根治术后腹腔淋巴结转移瘤的临床疗效及安全性[J].临床合理用药杂志,2017,10(6):19-20.
[5] 张功平.替吉奥同步放疗序贯化疗治疗胃癌根治术后腹腔淋巴结转移瘤的疗效[J].临床医药文献电子杂志,2017,4(25):4903-4904.
[6] 陆蓓娜,王飞芳,黄瑛.参芪扶正注射液对晚期胃癌化疗患者免疫功能及生活质量的影响[J].中国生化药物杂志,2017,37(7):136-137.
[7] 方璐,梁慧,刘大妹,等.理中汤加味联合食疗方减轻胃癌化疗后消化道副反应30例[J].江西中医药,2018,49(4):55-56.
[8] 刘玉刚.三维适形放射在腹腔淋巴结转移癌治疗中的临床应用价值分析[J].河南医学研究,2016,25(8):1498-1499.
[9] 于龙珍,吴少兵,柏会明,等.调强放疗联合化疗治疗食管癌术后腹腔淋巴结转移的疗效[J].肿瘤基础与临床,2016,29(1):51-54.
[10] 魏林,赵大齐.三维适形放射疗法联合高强度聚焦超声治疗腹膜后淋巴结转移癌疗效观察[J].中华消化病与影像杂志(电子版),2013,3(4):22-25.
[11] 高钧,孙英华,贾立红,等.立体适形放射治疗辅以中医中药治疗腹腔淋巴结转移癌的疗效观察[J].中国当代医药,2010,17(17):93-94.
[12] 刘会民,赵敏杰.太子参临床应用及研究进展[J].中国医院用药评价与分析,2015,15(3):430-432.
[13] 褚书豪,汪小彩,冯良.太子参化学成分及其药理作用研究进展[J].光明中医,2016,31(7):1047-1048.
[14] ZHUANG M,LIU D,CHEN Y,et al.Inhibitory effect and the mechanism of Astragalus polysaccharide combined with cisplatin on growth of inplanted Lewis lung carcinoma in mice[J].Xi Bao Yu FenZi MianYiXue ZaZhi,2017,33(4):503-507.
[15] 田芳.复方化浊解毒汤联合DCF化疗方案对中晚期胃癌患者血清VEGF及COX-2水平的影响[J].现代中西医结合杂志,2017,26(24):2698-2700.
[16] 汪质良,崔海忠,潘军武,等.原发性胃癌根治术后化疗对外周血T细胞亚群、NK细胞的影响及意义[J].海南医学院学报,2015,21(1):1-3.
[17] 徐本玲,袁龙,袁鹏,等.胃癌患者外周及肿瘤组织中CD4～+T淋巴细胞上Tim-3的表达及其临床意义[J].实用医学杂志,2017,33(1):108-112.
[18] 吴姗姗,严峰,邓玉玲,等.小细胞和非小细胞肺癌晚期患者CD+3CD+4及CD+3CD+8T淋巴细胞亚群的差异[J].中国免疫学杂志,2015,31(1):114-116.
[19] 沈建康,袁建明,蔡中瑞.CEA、CA199、CA724及HSP60在胃癌患者血清中的表达及应用价值[J].川北医学院学报,2016,31(6):848-850.
[20] 张智燕.CEA、CA199、CA724在胃癌新辅助化疗疗效评估中的应用[J].系统医学,2018,3(7):4-6.
[21] 修丽娟,刘龙,刘煊,等.胃癌组织中VEGF-C、VEGF-D、VEGFR-3蛋白表达及其临床意义[J].第二军医大学学报,2017,38(11):1458-1461.
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