四君子汤联合雷替曲塞和奥沙利铂治疗晚期肝癌的疗效及对免疫功能的影响
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摘要
目的探讨四君子汤联合雷替曲塞和奥沙利铂治疗晚期肝癌的疗效及对免疫功能的影响。方法将104例晚期肝癌患者分为观察组和对照组。对照组采用雷替曲塞和奥沙利铂治疗,观察组在对照组治疗基础上加用四君子汤治疗,21 d为1个化疗周期,治疗2个周期。采用RECIST标准评估2组的疗效,检测2组治疗前后CD3~+、CD4~+、CD8~+、CD4~+/CD8~+、NK细胞水平,采用原发性肝癌症状分级量化表评估2组治疗前后中医症状评分,记录2组不良反应发生情况。结果 2组缓解率比较差异无统计学意义(P>0.05);观察组的有效率明显高于对照组(P<0.05);2组治疗后CD3~+、CD4~+、CD4~+/CD8~+、NK细胞均显著升高(P均<0.05),且观察组治疗后CD3~+、CD4~+、CD4~+/CD8~+、NK细胞均明显高于对照组(P均<0.05);2组治疗后胁痛、神疲乏力、腹胀、纳呆食少、胁下痞块、大便溏泄、少气懒言、恶心、呕吐、口粘不欲饮、舌象、脉象评分及中医症状评分均显著降低(P均<0.05),且观察组治疗后上述评分均明显低于对照组(P均<0.05);观察组胃肠道反应、白细胞降低、发热、贫血发生率均明显低于对照组(P均<0.05)。结论四君子汤可明显提高晚期肝癌的疗效,改善免疫功能。
Objective It is to investigate the efficacy of Sijunzi Decoction combined with raltitrexed and oxaliplatin in the treatment of advanced liver cancer and its effect on immune function. Methods 104 patients with advanced liver cancer were divided into observation group and control group. The control group was treated with raltitrexed and oxaliplatin. The observation group was treated with Sijunzi Decoction on the basis of the control group. 21 days as one chemotherapy cycle, they were treated for 2 cycles. The efficacy of the two groups was evaluated by RECIST criteria. The levels of CD3~+, CD4~+, CD4~+/CD8~+ and NK cells were measured, the scores of TCM symptoms before and after treatment were evaluated by the primary liver cancer symptom classification table in the two groups, the occurrence of side effects were recorded. Results There was no significant difference in the remission rate between the two groups(P>0.05). The effective rate of the observation group was significantly higher than that of the control group(P<0.05). The levels of CD3~+, CD4~+, CD4~+/CD8~+ and NK cells were significantly increased after treatment in the two groups(P<0.05), and the levels of CD3~+, CD4~+, CD4~+/CD8~+ and NK cells in the observation group were significantly higher than those in the control group(P<0.05). The scores of costalgia, fatigue, abdominal distension, anepithymia, loose stool, nausea, vomiting, mouth sticking, tongue image, pulse image were significantly decreased(P<0.05), and the scores of every symptom in the observation group after treatment were significantly lower than those in the control group(P<0.05). The incidence of gastrointestinal reactions, leukopenia, fever and anemia were significantly lower in the observation group than that in the control group(P<0.05). Conclusion Sijunzi Decoction can improve the efficacy on advanced liver cancer and improve immune function.
Objective It is to investigate the efficacy of Sijunzi Decoction combined with raltitrexed and oxaliplatin in the treatment of advanced liver cancer and its effect on immune function. Methods 104 patients with advanced liver cancer were divided into observation group and control group. The control group was treated with raltitrexed and oxaliplatin. The observation group was treated with Sijunzi Decoction on the basis of the control group. 21 days as one chemotherapy cycle, they were treated for 2 cycles. The efficacy of the two groups was evaluated by RECIST criteria. The levels of CD3~+, CD4~+, CD4~+/CD8~+ and NK cells were measured, the scores of TCM symptoms before and after treatment were evaluated by the primary liver cancer symptom classification table in the two groups, the occurrence of side effects were recorded. Results There was no significant difference in the remission rate between the two groups(P>0.05). The effective rate of the observation group was significantly higher than that of the control group(P<0.05). The levels of CD3~+, CD4~+, CD4~+/CD8~+ and NK cells were significantly increased after treatment in the two groups(P<0.05), and the levels of CD3~+, CD4~+, CD4~+/CD8~+ and NK cells in the observation group were significantly higher than those in the control group(P<0.05). The scores of costalgia, fatigue, abdominal distension, anepithymia, loose stool, nausea, vomiting, mouth sticking, tongue image, pulse image were significantly decreased(P<0.05), and the scores of every symptom in the observation group after treatment were significantly lower than those in the control group(P<0.05). The incidence of gastrointestinal reactions, leukopenia, fever and anemia were significantly lower in the observation group than that in the control group(P<0.05). Conclusion Sijunzi Decoction can improve the efficacy on advanced liver cancer and improve immune function.
引文
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[10] 何光彬,栗艳,朱小鹏,等.四君子汤及生脉饮配合射频消融治疗肝癌32例[J].陕西中医,2010,31(1):5-6
[11] 陈燕,胡浩,张诗军,等.四君子汤对原发性肝癌术后患者T淋巴细胞和NK细胞的影响及意义[J].中西医结合肝病杂志,2017,20(1):931-934
[12] 孙娜,徐钢,徐珊,等.人参炮制对其化学成分和药理作用的影响[J].中国药房,2016(6):857-859
[13] 沈国庆,何法霖,李凤新,等.白术挥发油化学成分及抗肿瘤实验研究[J].北京中医药大学学报,2009,32(6):276-279
[14] 徐硕,姜文清,邝咏梅,等.茯苓的化学成分及生物活性研究进展[J].西北药学杂志,2016,31(3):327-330
[15] 赵雨坤,李立,刘学,等.基于系统药理学探索甘草有效成分甘草甜素的药理作用机制[J].中国中药杂志,2016,41(10):1130-1132
[16] 陈佳佳,万磊,刘建军,等.原发性肝癌患者T淋巴细胞亚群变化及其与CTCs、TTV及HBV-DNA的关系[J].现代消化及介入诊疗,2016,21(2):190-193
[17] 万磊,陈佳佳,刘建军,等.原发性肝癌患者CTCs与CD4+/CD8+、NLR、TTV及肿瘤分期的相关性研究[J].中国病理生理杂志,2016,32(6):1192-1194
[18] 张赫,邹寒冰,刘喆,等.50例肝癌患者外周血淋巴细胞亚群比例与肝功能损伤的关系[J].肝脏,2017,22(11):821-824
[19] 李淑群,李淑群,翁俊,等.GP73在肝癌患者外周血CD4+ T淋巴细胞中的异常表达及其相关机制研究[J].重庆医学,2017,46(33):4667-4669
[20] 李晓云,于晓辉,王维,等.肝细胞肝癌患者外周血中T细胞亚群和NK细胞的变化[J].肝脏,2016,21(5):381-383
[2] 崔贤杰,范春花,汤小玉.雷替曲塞在TACE治疗中晚期原发性肝癌中疗效观察[J].现代仪器与医疗,2016,22(1):113-115
[3] 杨朝旭,秦叔逵.奥沙利铂治疗原发性肝癌的临床研究进展[J].临床肿瘤学杂志,2010,15(9):845-855
[4] 宋慧娴,乔飞,邵铭.中医药治疗原发性肝癌的研究进展[J].临床肝胆病杂志,2016,32(1):174-177
[5] 中华人民共和国卫生和计划生育委员会医政医管局.原发性肝癌诊疗规范(2017年版)[J].传染病信息,2017,16(3):705-720
[6] Eisenhauer EA,Verweij J.11 New response evaluation criteria in solid tumors:RECIST GUIDELINE VERSION 1.1[J].Eur J Cancer Supplements,2009,7(2):5
[7] 赵荣荣,邓永东,袁宏.236例原发性肝癌患者流行病学及临床特点分析[J].临床肝胆病杂志,2016,32(8):810-813
[8] 沈永奇,黄军,陈超庭,等.雷替曲塞联合奥沙利铂与FOLFOX4方案治疗中晚期原发性肝癌的疗效评价[J].实用临床医药杂志,2017,21(7):39-42;46
[9] 沈永奇,黄军,陈超庭,等.雷替曲塞联合奥沙利铂治疗中晚期原发性肝癌的临床研究[J].川北医学院学报,2017,32(1):57-59;63
[10] 何光彬,栗艳,朱小鹏,等.四君子汤及生脉饮配合射频消融治疗肝癌32例[J].陕西中医,2010,31(1):5-6
[11] 陈燕,胡浩,张诗军,等.四君子汤对原发性肝癌术后患者T淋巴细胞和NK细胞的影响及意义[J].中西医结合肝病杂志,2017,20(1):931-934
[12] 孙娜,徐钢,徐珊,等.人参炮制对其化学成分和药理作用的影响[J].中国药房,2016(6):857-859
[13] 沈国庆,何法霖,李凤新,等.白术挥发油化学成分及抗肿瘤实验研究[J].北京中医药大学学报,2009,32(6):276-279
[14] 徐硕,姜文清,邝咏梅,等.茯苓的化学成分及生物活性研究进展[J].西北药学杂志,2016,31(3):327-330
[15] 赵雨坤,李立,刘学,等.基于系统药理学探索甘草有效成分甘草甜素的药理作用机制[J].中国中药杂志,2016,41(10):1130-1132
[16] 陈佳佳,万磊,刘建军,等.原发性肝癌患者T淋巴细胞亚群变化及其与CTCs、TTV及HBV-DNA的关系[J].现代消化及介入诊疗,2016,21(2):190-193
[17] 万磊,陈佳佳,刘建军,等.原发性肝癌患者CTCs与CD4+/CD8+、NLR、TTV及肿瘤分期的相关性研究[J].中国病理生理杂志,2016,32(6):1192-1194
[18] 张赫,邹寒冰,刘喆,等.50例肝癌患者外周血淋巴细胞亚群比例与肝功能损伤的关系[J].肝脏,2017,22(11):821-824
[19] 李淑群,李淑群,翁俊,等.GP73在肝癌患者外周血CD4+ T淋巴细胞中的异常表达及其相关机制研究[J].重庆医学,2017,46(33):4667-4669
[20] 李晓云,于晓辉,王维,等.肝细胞肝癌患者外周血中T细胞亚群和NK细胞的变化[J].肝脏,2016,21(5):381-383