苦参碱注射液对宫颈癌患者化疗增敏作用和生存质量、免疫功能的影响
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摘要
目的:探讨苦参碱注射液对宫颈癌患者化疗增敏作用和生存质量、免疫功能的影响。方法:选取2016年3月—2017年5月收治医院的70例宫颈癌患者,按照随机数字表法随机分成对照组和观察组,每组35例。对照组患者采用顺铂联合多西他赛化疗方案进行治疗,而观察组患者在采用顺铂联合多西他赛化疗方案进行治疗治疗的基础上,联合予以苦参碱注射液进行治疗。干预治疗12周后,分别对两组患者的临床疗效、增敏作用、免疫功能、生活质量以及不良反应发生情况进行比较。结果:①观察组患者的总治疗有效率为94.29%,显著高于对照组患者的总治疗有效率71.43%,差异有统计学意义(χ~2=4.928,P=0.026);②干预治疗后,两组患者的血清CA125水平、IL-6水平均较干预治疗前明显降低(t=9.364,27.737,2.826,8.067;均P<0.05),且观察组患者的降低水平更明显(t=25.469,4.951;均P<0.05);两组患者的血清IL-18、IFN-γ水平均较干预治疗前明显升高(t=-5.681,-13.721,-15.960,-14.464;均P<0.01),其观察组患者的升高水平更显著,差异有统计学意义(t=-7.560,-8.563;均P<0.01);③对照组患者的血清CD~+_3、CD~+_4、CD~+_8水平较干预治疗前降低,CD~+_4/CD~+_8较治疗前升高(t=5.245,4.019,9.400,3.101;均P<0.05);而观察组患者CD~+_3、CD~+_4、CD~+_8水平较干预治疗前显著升高,CD~+_4/CD~+_8较治疗前降低(t=-6.742,-14.260,-2.681,-10.205;均P<0.05);干预治疗后两组患者CD~+_3、CD~+_4、CD~+_8以及CD~+_4/CD~+_8水平比较差异均存在统计学意义(t=-11.688,-19.981,-10.908,-11.673;均P<0.05);④干预质量后两组患者的QOL评分以及KPS评分均较干预治疗前显著改善(t=-7.514,-16.664,-3.355,-7.328;均P<0.05),且观察组患者改善的情况显著优于对照组患者,差异均存在统计学意义(t=-8.773,-3.928;均P<0.05);⑤观察组患者的不良反应发生情况显著优于对照组患者(χ~2=4.690,4.629,4.644,7.295;P=0.030,0.031,0.031,0.007)。结论:采用苦参碱注射液用于宫颈癌化疗患者的辅助治疗中,不仅能够有效提高患者的机体免疫能力取得较佳的临床疗效,而且能够有效改善患者的生活质量,并减少不良反应的发生,值得临床上广泛推广。
Objective:To explore the effect of Matrine Injection on chemosensitivity, quality of life and immune function in patients with cervical cancer.Method:Seventy cases of cervical cancer in our hospital were admitted to our hospital in March 2016 to May 2016. The patients were randomly divided into the control group and the observation group according to the random number table method, with 35 cases in each group. The control group was treated with cisplatin plus docetaxel chemotherapy, while the observation group was treated with cisplatin combined with docetaxel chemotherapy. The treatment was combined with Matrine Injection. After 12 weeks of intervention, the clinical efficacy, sensitization, immune function, quality of life and the incidence of adverse reactions were compared in the two groups.Results:①The total effective rate of the patients in the observation group was 94.29%, which was significantly higher than that of the control group. The total effective rate was 71.43%, and the difference was statistically significant(χ~2=4.928,P=0.026). ②After intervention, the two groups' serum CA125 level and IL-6 level were significantly decreased(t=9.364,27.737, 2.826,8.067; P<0.05), and the patients in the observation group's decreased more obviously(t=25.469,4.951; P<0.05). The two groups' serum IL-18 and IFN-γ levels were significantly increased(t=-5.681,-13.721,-15.960,-14.464; P<0.01). The observation group's were significantly elevated and the difference was statistically significant(t=-7.560,-8.563; P<0.01). ③The control group's serum levels of CD~+_3, CD~+_4 and CD_8~(+ )were reduced after treatment and CD~+_4/CD~+_8 higher than that before treatment(t=5.245, 4.019, 9.400,3.101; P<0.05) and the observation group's CD~+_3 CD~+_4, CD~+_8 levels were significantly increased and CD4~+/CD8~+ was decreased(t=-6.742,-14.260,-2.681,-10.205 P<0.05). After intervention,the two groups' CD~+_3, CD~+_4, CD~+_8 and CD~+_4/CD~+_8 differences were statistically significant(t=-11.688,-19.981,-10.908,-11.673; P<0.05). ④The two groups' QOL score and KPS score were significantly improved(t=-7.514,-16.664,-3.355,-7.328; P<0.05), and the patients in the observation group improved significantly better than those in the control group(t=-8.773,-3.928; P<0.05). ⑤The adverse reactions of the patients in the observation group were significantly less than those in the control group(χ~2=4.690,4.629,4.644,7.295;P=0.030,0.031,0.031,0.007). Conclusion:Matrine Injection as the adjunctive treatment for patients with cervical cancer chemotherapy, not only can effectively improve the immune function of patients,but also can effectively improve the quality of life, and reduce the incidence of adverse reactions, worthy of clinical application.
Objective:To explore the effect of Matrine Injection on chemosensitivity, quality of life and immune function in patients with cervical cancer.Method:Seventy cases of cervical cancer in our hospital were admitted to our hospital in March 2016 to May 2016. The patients were randomly divided into the control group and the observation group according to the random number table method, with 35 cases in each group. The control group was treated with cisplatin plus docetaxel chemotherapy, while the observation group was treated with cisplatin combined with docetaxel chemotherapy. The treatment was combined with Matrine Injection. After 12 weeks of intervention, the clinical efficacy, sensitization, immune function, quality of life and the incidence of adverse reactions were compared in the two groups.Results:①The total effective rate of the patients in the observation group was 94.29%, which was significantly higher than that of the control group. The total effective rate was 71.43%, and the difference was statistically significant(χ~2=4.928,P=0.026). ②After intervention, the two groups' serum CA125 level and IL-6 level were significantly decreased(t=9.364,27.737, 2.826,8.067; P<0.05), and the patients in the observation group's decreased more obviously(t=25.469,4.951; P<0.05). The two groups' serum IL-18 and IFN-γ levels were significantly increased(t=-5.681,-13.721,-15.960,-14.464; P<0.01). The observation group's were significantly elevated and the difference was statistically significant(t=-7.560,-8.563; P<0.01). ③The control group's serum levels of CD~+_3, CD~+_4 and CD_8~(+ )were reduced after treatment and CD~+_4/CD~+_8 higher than that before treatment(t=5.245, 4.019, 9.400,3.101; P<0.05) and the observation group's CD~+_3 CD~+_4, CD~+_8 levels were significantly increased and CD4~+/CD8~+ was decreased(t=-6.742,-14.260,-2.681,-10.205 P<0.05). After intervention,the two groups' CD~+_3, CD~+_4, CD~+_8 and CD~+_4/CD~+_8 differences were statistically significant(t=-11.688,-19.981,-10.908,-11.673; P<0.05). ④The two groups' QOL score and KPS score were significantly improved(t=-7.514,-16.664,-3.355,-7.328; P<0.05), and the patients in the observation group improved significantly better than those in the control group(t=-8.773,-3.928; P<0.05). ⑤The adverse reactions of the patients in the observation group were significantly less than those in the control group(χ~2=4.690,4.629,4.644,7.295;P=0.030,0.031,0.031,0.007). Conclusion:Matrine Injection as the adjunctive treatment for patients with cervical cancer chemotherapy, not only can effectively improve the immune function of patients,but also can effectively improve the quality of life, and reduce the incidence of adverse reactions, worthy of clinical application.
引文
[1] 刘静,余梦红,张丛敏,等.紫杉醇联合洛铂经介入栓塞给药化疗宫颈癌的临床观察[J].中国药房,2017,28(17):2374-2377.
[2] Dessai SB, Adrash D, Geetha M, et al. Pattern of care in operable endometrial cancer treated at a rural-based tertiary care cancer center[J]. Indian J Cancer, 2016,53(3):416-419.
[3] 刘淑荣,廖革望.局部晚期宫颈癌化疗联合放疗最佳模式探讨[J].中华肿瘤防治杂志,2017,24(3):196-200.
[4] 张海平,赵慧峰,夏红蕾,等.贞芪扶正颗粒辅助治疗宫颈癌的临床观察[J].中国药房,2017,28(9):1174-1177.
[5] Kumabe A, Zenda S, Motegi A, et al. Long-term Clinical Results of Concurrent Chemoradiotherapy for Patients with Cervical Esophageal Squamous Cell Carcinoma[J]. Anticancer Res, 2017,37(9):5039-5044.
[6] 中华人民共和国国家卫生和计划生育委员会. 宫颈癌及癌前病变规范化诊疗指南(试行)[S]. 中国医学前沿杂志:电子版, 2013, 5(8):40-49.
[7] 周际昌. 实用肿瘤内科治疗:肿瘤内科治疗[M]. 北京:人民卫生出版社,2010.
[8] 陈琪珍,田淑娜,陈雄. 宫颈癌患者治疗后生活质量的影响因素分析[J]. 中国妇幼健康研究, 2017, 28(7):774-777.
[9] 周丽静,简红云. 心理干预对宫颈癌患者放疗期间生活质量的影响[J]. 中西医结合护理(中英文), 2017, 3(3):112-113.
[10] De Azevedo CRAS, LCS T, De Mello MJG, et al. Phase II trial of neoadjuvant chemotherapy followed by chemoradiation in locally advanced cervical cancer[J]. Gynecol Oncol, 2017,146(3):560-565.
[11] Salihi R, Leunen K, Moerman P, et al. Neoadjuvant Weekly Paclitaxel-Carboplatin Is Effective in Stage I-II Cervical Cancer[J]. Int J Gynecol Cancer, 2017,27(6):1256-1260.
[12] 杨红灵.加味人参养荣汤对宫颈癌化疗患者免疫功能和生存质量的影响[J].中医学报,2017,32(8):1377-1380.
[13] 朱小平,王燕.根治术后同步放化疗与放疗序贯化疗对老年宫颈癌患者生存情况的影响[J].中国老年学杂志,2017,37(19):4821-4823.
[14] Wolf B, Ganzer R, Stolzenburg JU, et al. Extended mesometrial resection (EMMR): Surgical approach to the treatment of locally advanced cervical cancer based on the theory of ontogenetic cancer fields[J]. Gynecol Oncol, 2017,146(2):292-298.
[15] 张艳萍,贺海霞,文希,等.心智觉知干预模式对宫颈癌化疗间歇期患者睡眠质量和心理状态的影响[J].中国医药导报,2017,14(20):144-147.
[16] 刘海霞.紫杉醇联合卡铂化疗同步放疗治疗中晚期宫颈癌近期疗效观察[J].山东医药,2017,57(6):83-84.
[17] Matsuo K, Shimada M, Aoki Y, et al. Comparison of adjuvant therapy for node-positive clinical stage IB-IIB cervical cancer: Systemic chemotherapy versus pelvic irradiation[J]. Int J Cancer, 2017,141(5):1042-1051.
[18] Gadducci A, Barsotti C, Laliscia C, et al. Dose-dense Paclitaxel- and Carboplatin-based Neoadjuvant Chemotherapy Followed by Surgery or Concurrent Chemo-radiotherapy in Cervical Cancer: a Preliminary Analysis[J]. Anticancer Res, 2017,37(3):1249-1255.
[19] 任永吉,李冬雷.苦参碱注射液对宫颈癌患者化疗增敏作用及对患者生存质量和免疫功能的影响[J].现代中西医结合杂志,2017,26(23):2535-2537,2615.
[20] 张竣,闫涛,徐静,等.宫颈癌术后脾多肽注射液联合化疗的临床疗效观察[J].现代肿瘤医学,2017,25(21):3494-3496.
[21] Cordeiro CN, Gemignani ML. Gynecologic Malignancies in Pregnancy: Balancing Fetal Risks With Oncologic Safety[J]. Obstet Gynecol Surv, 2017,72(3):184-193.
[22] 高山,王会霞,岳成山,等.参麦注射液应用于宫颈癌同期放化疗中的疗效观察[J].实用癌症杂志,2017,32(5):805-807,813.
[2] Dessai SB, Adrash D, Geetha M, et al. Pattern of care in operable endometrial cancer treated at a rural-based tertiary care cancer center[J]. Indian J Cancer, 2016,53(3):416-419.
[3] 刘淑荣,廖革望.局部晚期宫颈癌化疗联合放疗最佳模式探讨[J].中华肿瘤防治杂志,2017,24(3):196-200.
[4] 张海平,赵慧峰,夏红蕾,等.贞芪扶正颗粒辅助治疗宫颈癌的临床观察[J].中国药房,2017,28(9):1174-1177.
[5] Kumabe A, Zenda S, Motegi A, et al. Long-term Clinical Results of Concurrent Chemoradiotherapy for Patients with Cervical Esophageal Squamous Cell Carcinoma[J]. Anticancer Res, 2017,37(9):5039-5044.
[6] 中华人民共和国国家卫生和计划生育委员会. 宫颈癌及癌前病变规范化诊疗指南(试行)[S]. 中国医学前沿杂志:电子版, 2013, 5(8):40-49.
[7] 周际昌. 实用肿瘤内科治疗:肿瘤内科治疗[M]. 北京:人民卫生出版社,2010.
[8] 陈琪珍,田淑娜,陈雄. 宫颈癌患者治疗后生活质量的影响因素分析[J]. 中国妇幼健康研究, 2017, 28(7):774-777.
[9] 周丽静,简红云. 心理干预对宫颈癌患者放疗期间生活质量的影响[J]. 中西医结合护理(中英文), 2017, 3(3):112-113.
[10] De Azevedo CRAS, LCS T, De Mello MJG, et al. Phase II trial of neoadjuvant chemotherapy followed by chemoradiation in locally advanced cervical cancer[J]. Gynecol Oncol, 2017,146(3):560-565.
[11] Salihi R, Leunen K, Moerman P, et al. Neoadjuvant Weekly Paclitaxel-Carboplatin Is Effective in Stage I-II Cervical Cancer[J]. Int J Gynecol Cancer, 2017,27(6):1256-1260.
[12] 杨红灵.加味人参养荣汤对宫颈癌化疗患者免疫功能和生存质量的影响[J].中医学报,2017,32(8):1377-1380.
[13] 朱小平,王燕.根治术后同步放化疗与放疗序贯化疗对老年宫颈癌患者生存情况的影响[J].中国老年学杂志,2017,37(19):4821-4823.
[14] Wolf B, Ganzer R, Stolzenburg JU, et al. Extended mesometrial resection (EMMR): Surgical approach to the treatment of locally advanced cervical cancer based on the theory of ontogenetic cancer fields[J]. Gynecol Oncol, 2017,146(2):292-298.
[15] 张艳萍,贺海霞,文希,等.心智觉知干预模式对宫颈癌化疗间歇期患者睡眠质量和心理状态的影响[J].中国医药导报,2017,14(20):144-147.
[16] 刘海霞.紫杉醇联合卡铂化疗同步放疗治疗中晚期宫颈癌近期疗效观察[J].山东医药,2017,57(6):83-84.
[17] Matsuo K, Shimada M, Aoki Y, et al. Comparison of adjuvant therapy for node-positive clinical stage IB-IIB cervical cancer: Systemic chemotherapy versus pelvic irradiation[J]. Int J Cancer, 2017,141(5):1042-1051.
[18] Gadducci A, Barsotti C, Laliscia C, et al. Dose-dense Paclitaxel- and Carboplatin-based Neoadjuvant Chemotherapy Followed by Surgery or Concurrent Chemo-radiotherapy in Cervical Cancer: a Preliminary Analysis[J]. Anticancer Res, 2017,37(3):1249-1255.
[19] 任永吉,李冬雷.苦参碱注射液对宫颈癌患者化疗增敏作用及对患者生存质量和免疫功能的影响[J].现代中西医结合杂志,2017,26(23):2535-2537,2615.
[20] 张竣,闫涛,徐静,等.宫颈癌术后脾多肽注射液联合化疗的临床疗效观察[J].现代肿瘤医学,2017,25(21):3494-3496.
[21] Cordeiro CN, Gemignani ML. Gynecologic Malignancies in Pregnancy: Balancing Fetal Risks With Oncologic Safety[J]. Obstet Gynecol Surv, 2017,72(3):184-193.
[22] 高山,王会霞,岳成山,等.参麦注射液应用于宫颈癌同期放化疗中的疗效观察[J].实用癌症杂志,2017,32(5):805-807,813.