胃肠安方治疗胃癌前病变的疗效及对患者外周血T淋巴细胞亚群和生活质量的影响
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摘要
目的:探讨胃肠安方治疗胃癌前病变的疗效及对患者外周血T淋巴细胞亚群和生活质量的影响。方法:选择符合观察标准的胃癌前病变患者90例,采用随机数字表将其分成2组,每组45例。对照组服用叶酸片,观察组予胃肠安方,两组均连续用药3个月。疗程结束,比较两组患者中医证候疗效及胃镜下胃黏膜慢性炎症及腺体萎缩、肠上皮化生与异型增生病理的改善情况。于治疗前后抽取外周静脉血,采用流式细胞仪检测外周血T淋巴细胞亚群变化情况;同时采用简明健康状况调查表(SF-36)评价两组患者的生活质量。结果:疗效评价显示,观察组中医证候疗效、胃镜下黏膜慢性炎症及病理改善情况的总有效率分别为91.1%、93.3%、88.9%,对照组分别为64.4%、62.2%、62.2%,观察组均显著高于对照组(P<0.01)。治疗后观察组CD3~+、CD4~+、CD4~+/CD8~+比值均较治疗前明显上升(P<0.05),对照组仅CD4~+、CD4~+/CD8~+比值较治疗前明显上升(P<0.05),其中观察组CD3~+、CD4~+、CD4~+/CD8~+比值均显著高于对照组(P<0.05)。治疗后两组患者SF-36总分均较治疗前明显增加(P<0.01),其中观察组SF-36总分明显高于对照组(P<0.01)。结论:胃肠安方治疗胃癌前病变可有效增强细胞免疫功能,改善患者的生活质量,疗效确切。
Objective: To investigate the efficacy of Weichang'an Recipe on precancerous lesions of gastric cancer and its influence on the T-lymphocyte subsets in peripheral blood and life qualify of patients. Methods: Ninety patients with precancerous lesions of gastric cancer who met the observation criteria were selected and divided into two groups according to random number table,45 cases in each group. The control group was treated with folic acid tablets,while the observation group was treated with Weichang'an Recipe,with a course of 3 months. At the end of treatment,the efficacy of Chinese medical syndromes,the chronic mucosal inflammation under gastroscopy,and the pathological improvement on gland atrophy,intestinal metaplasia and dysplasia were compared between the two groups. The peripheral venous blood was collected before and after treatment,and T lymphocyte subsets in peripheral blood were detected by flow cytometry. Meanwhile,the life quality of patients in the two groups was evaluated by concise health questionnaire SF-36.Results: The efficacy evaluation showed that the total effective rates of Chinese medical syndromes,chronic mucosal inflammation and pathological improvement were 91.1%,93.3% and 88.9% in the observation group,and 64.4%,62.2% and 62.2% in the control group,respectively. The effective rates of the observation group were significantly increased than those of the control group(P<0.01). Compared with treatment before,the levels of CD3~+ and CD4~+ and the ratio of CD4~+ to CD8~+ in the observation group were obviously increased after treatment(P<0.05),while the CD4~+ level and the ratio of CD4~+ to CD8~+ in the control group were obviously increased after treatment ( P<0.05). After treatment,the levels of CD3+and CD4+and the ratio of CD4+to CD8+in the observation group were significantly higher than those in the control group( P<0.05). Compared with treatment before,the total score of SF-36 in the two groups was significantly increased after treatment( P<0.01),and the total score of SF-36 in the observation group was significantly higher than that in the control group( P<0.01). Conclusion: Weichang'an Recipe can effectively enhance the cellular immune function and improve the life quality of patients with precancerous lesions of gastric cancer,which shows definite efficacy.
Objective: To investigate the efficacy of Weichang'an Recipe on precancerous lesions of gastric cancer and its influence on the T-lymphocyte subsets in peripheral blood and life qualify of patients. Methods: Ninety patients with precancerous lesions of gastric cancer who met the observation criteria were selected and divided into two groups according to random number table,45 cases in each group. The control group was treated with folic acid tablets,while the observation group was treated with Weichang'an Recipe,with a course of 3 months. At the end of treatment,the efficacy of Chinese medical syndromes,the chronic mucosal inflammation under gastroscopy,and the pathological improvement on gland atrophy,intestinal metaplasia and dysplasia were compared between the two groups. The peripheral venous blood was collected before and after treatment,and T lymphocyte subsets in peripheral blood were detected by flow cytometry. Meanwhile,the life quality of patients in the two groups was evaluated by concise health questionnaire SF-36.Results: The efficacy evaluation showed that the total effective rates of Chinese medical syndromes,chronic mucosal inflammation and pathological improvement were 91.1%,93.3% and 88.9% in the observation group,and 64.4%,62.2% and 62.2% in the control group,respectively. The effective rates of the observation group were significantly increased than those of the control group(P<0.01). Compared with treatment before,the levels of CD3~+ and CD4~+ and the ratio of CD4~+ to CD8~+ in the observation group were obviously increased after treatment(P<0.05),while the CD4~+ level and the ratio of CD4~+ to CD8~+ in the control group were obviously increased after treatment ( P<0.05). After treatment,the levels of CD3+and CD4+and the ratio of CD4+to CD8+in the observation group were significantly higher than those in the control group( P<0.05). Compared with treatment before,the total score of SF-36 in the two groups was significantly increased after treatment( P<0.01),and the total score of SF-36 in the observation group was significantly higher than that in the control group( P<0.01). Conclusion: Weichang'an Recipe can effectively enhance the cellular immune function and improve the life quality of patients with precancerous lesions of gastric cancer,which shows definite efficacy.
引文
[1] 谢晶日,李柏.益气健脾养阴法治疗胃癌前病变临床观察[J].辽宁中医杂志,2013,40(9):1731- 1732.
[2] PIAZUELO M B,CAMARGO M C,MERA R M,et al. Tu1280 Biopsy Sampling of the Incisura Angularis for the Diagnosis of Gastric Precancerous Lesions[J].Gastroenterol,2016,150(4):S863.
[3] 王志坤,李博林,刘启泉,等.罗英化浊解毒方治疗胃癌前病变的临床疗效[J].中国老年学杂志,2014,34(11):2935- 2937.
[4] 杨阔,刘华一,王秀娟,等.胃转安方治疗胃癌前病变患者临床观察及胃蛋白酶原(SP)的影响[J].中华中医药学刊,2016,34(10):2464- 2467.
[5] 马燕,陈久红,薛金洲,等.活血养阴益气法治疗胃癌前病变临床研究[J].中医学报,2016,31(8):1093- 1095.
[6] 王志坤,刘启泉,李博林,等.小归芍化浊解毒方治疗胃癌前病变的临床疗效及对患者生存质量的影响[J].四川中医,2014,32(1):91- 93.
[7] 赵海磊.邱佳信治疗胃癌临床经验探析[J].上海中医药杂志,2006,40(8):21- 22.
[8] 朱莹杰,孟丹,王浩.胃肠安方加减联合化疗治疗Ⅳ期老年结直肠癌临床研究[J].上海中医药杂志,2017,51(6):52- 54.
[9] 陶丽,朱莹杰,顾缨.基于生存分析的胃肠安方辨证治疗对不可切除性结直肠癌肝转移预后影响的双向队列研究[J].上海中医药杂志,2017,51(1):48- 55.
[10] 中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2006,11(11):674- 684.
[11] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:124- 129.
[12] 邓绿.中药辨证分型治疗胃癌前病变临床研究[J].四川中医,2015,33(7):55- 57.
[13] 白宇宁,张平,李理,等.健脾通络解毒方对胃癌前病变患者胃黏膜COX- 2、NF- κBp65及Bcl- 2表达的影响[J].中国中西医结合杂志,2015,35(2):167- 173.
[14] 李佃贵,杜艳茹,郭敏,等.化浊解毒方治疗胃癌前病变临床疗效及对微量元素的影响[J].中药材,2011,34(1):158- 160.
[15] 黄铭涵,黄健,李思汉,等.复方胃炎合剂逆转胃癌前病变的临床研究[J].中国中医药信息杂志,2016,23(4):20- 23.
[16] 李超.徐景藩教授治疗脾胃病经验[J].中医学报,2012,27(2):162- 163.
[17] 宋厚盼,谢梦洲,胡志希,等.白术、黄芪、党参促进IEC- 6细胞损伤后的快速修复[J].中成药,2015,37(6):1170- 1175.
[18] 黄小波,陈文强,王宁群,等.陈皮- 半夏对内皮细胞损伤保护机制的研究[J].北京中医药,2014,33(11):868- 871.
[19] 王江,周永学,谢勇波.半夏泻心汤及其拆方对胃溃疡大鼠胃黏膜bFGF、PDGF表达的影响及方中寒热并用配伍意义的研究[J].中华中医药杂志,2016,31(7):2728- 2731.
[20] CHOI S W,MASON J B. Folate status:effects on pathways of colorectal carcinogenesis[J].J Nutr,2002,132 (Suppl 8):2413S - 2418S.
[21] JAVADI L,POURGHASSEM G B,SALEKZAMAM S,et al. Folate and Homocysteine Levels and Their Association with Dietary Intakes in Iranian Patients Infected with Helicobacter pylori:a Case- Control Study[J].Acta Medica Iranica,2015,53 (3):162- 167.
[2] PIAZUELO M B,CAMARGO M C,MERA R M,et al. Tu1280 Biopsy Sampling of the Incisura Angularis for the Diagnosis of Gastric Precancerous Lesions[J].Gastroenterol,2016,150(4):S863.
[3] 王志坤,李博林,刘启泉,等.罗英化浊解毒方治疗胃癌前病变的临床疗效[J].中国老年学杂志,2014,34(11):2935- 2937.
[4] 杨阔,刘华一,王秀娟,等.胃转安方治疗胃癌前病变患者临床观察及胃蛋白酶原(SP)的影响[J].中华中医药学刊,2016,34(10):2464- 2467.
[5] 马燕,陈久红,薛金洲,等.活血养阴益气法治疗胃癌前病变临床研究[J].中医学报,2016,31(8):1093- 1095.
[6] 王志坤,刘启泉,李博林,等.小归芍化浊解毒方治疗胃癌前病变的临床疗效及对患者生存质量的影响[J].四川中医,2014,32(1):91- 93.
[7] 赵海磊.邱佳信治疗胃癌临床经验探析[J].上海中医药杂志,2006,40(8):21- 22.
[8] 朱莹杰,孟丹,王浩.胃肠安方加减联合化疗治疗Ⅳ期老年结直肠癌临床研究[J].上海中医药杂志,2017,51(6):52- 54.
[9] 陶丽,朱莹杰,顾缨.基于生存分析的胃肠安方辨证治疗对不可切除性结直肠癌肝转移预后影响的双向队列研究[J].上海中医药杂志,2017,51(1):48- 55.
[10] 中华医学会消化病学分会.中国慢性胃炎共识意见[J].胃肠病学,2006,11(11):674- 684.
[11] 郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:124- 129.
[12] 邓绿.中药辨证分型治疗胃癌前病变临床研究[J].四川中医,2015,33(7):55- 57.
[13] 白宇宁,张平,李理,等.健脾通络解毒方对胃癌前病变患者胃黏膜COX- 2、NF- κBp65及Bcl- 2表达的影响[J].中国中西医结合杂志,2015,35(2):167- 173.
[14] 李佃贵,杜艳茹,郭敏,等.化浊解毒方治疗胃癌前病变临床疗效及对微量元素的影响[J].中药材,2011,34(1):158- 160.
[15] 黄铭涵,黄健,李思汉,等.复方胃炎合剂逆转胃癌前病变的临床研究[J].中国中医药信息杂志,2016,23(4):20- 23.
[16] 李超.徐景藩教授治疗脾胃病经验[J].中医学报,2012,27(2):162- 163.
[17] 宋厚盼,谢梦洲,胡志希,等.白术、黄芪、党参促进IEC- 6细胞损伤后的快速修复[J].中成药,2015,37(6):1170- 1175.
[18] 黄小波,陈文强,王宁群,等.陈皮- 半夏对内皮细胞损伤保护机制的研究[J].北京中医药,2014,33(11):868- 871.
[19] 王江,周永学,谢勇波.半夏泻心汤及其拆方对胃溃疡大鼠胃黏膜bFGF、PDGF表达的影响及方中寒热并用配伍意义的研究[J].中华中医药杂志,2016,31(7):2728- 2731.
[20] CHOI S W,MASON J B. Folate status:effects on pathways of colorectal carcinogenesis[J].J Nutr,2002,132 (Suppl 8):2413S - 2418S.
[21] JAVADI L,POURGHASSEM G B,SALEKZAMAM S,et al. Folate and Homocysteine Levels and Their Association with Dietary Intakes in Iranian Patients Infected with Helicobacter pylori:a Case- Control Study[J].Acta Medica Iranica,2015,53 (3):162- 167.