扶正抑瘤方联合EMA-CO化疗方案治疗绒毛膜癌的疗效观察以及对患者免疫功能的影响
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摘要
目的观察扶正抑瘤方联合EMA-CO化疗方案治疗绒毛膜癌的疗效以及对患者免疫功能的影响。方法选取绒毛膜癌患者92例作为研究对象,按照随机数字表法分为治疗组和对照组各46例,两组均给予健康教育、饮食、运动等基础干预,在此基础上对照组给予EMA-CO化疗方案治疗,治疗组在对照组基础上联合扶正抑瘤方治疗。观察两组中医证候积分、临床疗效、免疫功能、不良反应情况。结果治疗后两组患者中医证候积分显著低于治疗前(P <0. 05),且治疗组显著低于对照组(P <0. 05)。治疗组总有效率(73. 91%)显著高于对照组(47. 83%),差异有统计学意义(P <0. 05)。治疗后治疗组CD3+、CD4+、CD4+/CD8+水平显著高于对照组(P <0. 05),CD8+水平显著低于对照组(P <0. 05)。治疗组恶心呕吐、骨髓抑制、脱发、白细胞减少、口腔溃疡发生率显著低于对照组(P <0. 05)。结论扶正抑瘤方联合EMA-CO化疗方案可有效降低绒毛膜癌患者不良反应发生率,提高免疫功能和临床疗效。
Objective To observe the therapeutic effects on choriocarcinoma treated with fuzheng yiliu formula and EMA-CO chemotherapy and the impacts on immune function in the patients. Methods A total of 92 eligible patients of choriocarcinoma were selected as the subjects and divided into an treatment group and a control group( n = 46 in each one) according to the random number table. The basic intervention was applied in both of the two groups,such as health education,diet and exercise. Additionally,EMA-CO chemotherapy was used in the control group. On the base of the treatment as the control group,fuzheng yiliu formula was combined. TCM symptom score,clinical effects,immune function and adverse reaction were observed in the two groups. Results After treatment,TCM symptom score was lower significantly than the score before treatment in the two groups( P < 0. 05). The score in the treatment group was lower significantly than the control group( P < 0. 05). The total effective rate in the treatment group( 73. 91%) was higher significantly than the control group( 47. 83%),indicting the significant difference( P < 0. 05). After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the treatment group were higher significantly than the levels in the control group( P < 0. 05) and the level of CD8+was lower significantly than the control group( P < 0. 05). In the treatment group,the incidence rates of nausea,vomiting,myelosuppression,hair loss,leucopenia and dental ulcer were lower significantly than the rates of the control group( P <0. 05). Conclusion Fuzheng yiliu formula combined with EMA-CO chemotherapy effectively reduces the incident rate of the adverse reactions and improves the immune function and clinical effects in the patients with choriocarcinoma.
Objective To observe the therapeutic effects on choriocarcinoma treated with fuzheng yiliu formula and EMA-CO chemotherapy and the impacts on immune function in the patients. Methods A total of 92 eligible patients of choriocarcinoma were selected as the subjects and divided into an treatment group and a control group( n = 46 in each one) according to the random number table. The basic intervention was applied in both of the two groups,such as health education,diet and exercise. Additionally,EMA-CO chemotherapy was used in the control group. On the base of the treatment as the control group,fuzheng yiliu formula was combined. TCM symptom score,clinical effects,immune function and adverse reaction were observed in the two groups. Results After treatment,TCM symptom score was lower significantly than the score before treatment in the two groups( P < 0. 05). The score in the treatment group was lower significantly than the control group( P < 0. 05). The total effective rate in the treatment group( 73. 91%) was higher significantly than the control group( 47. 83%),indicting the significant difference( P < 0. 05). After treatment,the levels of CD3+,CD4+and CD4+/CD8+in the treatment group were higher significantly than the levels in the control group( P < 0. 05) and the level of CD8+was lower significantly than the control group( P < 0. 05). In the treatment group,the incidence rates of nausea,vomiting,myelosuppression,hair loss,leucopenia and dental ulcer were lower significantly than the rates of the control group( P <0. 05). Conclusion Fuzheng yiliu formula combined with EMA-CO chemotherapy effectively reduces the incident rate of the adverse reactions and improves the immune function and clinical effects in the patients with choriocarcinoma.
引文
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[8]王勇.晚期恶性肿瘤患者化疗前后外周血T淋巴细胞亚群监测及临床意义[J].蚌埠医学院学报,2016,41(11):1452-1454.
[9]冯丽霞,王秀云,戴智慧. EMA-CO化疗方案治疗高危绒毛膜癌患者护理体会[J].中国实用医药,2011,6(35):232-233.
[10]施琰红.长春新碱放线菌D依托泊苷氟脲苷治疗高危型妊娠滋养细胞肿瘤的疗效观察[J].中国肿瘤临床与康复,2016,23(5):559-562.
[11]吴樱,凌文.不同化疗方案治疗恶性滋养细胞肿瘤的临床应用分析[J].现代医药卫生,2015,31(1):111-112.
[12]陈娅莉,徐亿力. MAC与EMA-CO方案治疗妊娠滋养细胞肿瘤肺转移的疗效对比分析[J].现代肿瘤医学,2016,24(2):291-294.
[13]石小凤,聂子良,韩咏梅,等. EMA/CO化疗方案治疗恶性滋养细胞肿瘤的临床疗效观察[J].现代生物医学进展,2014,14(11):2088-2091.
[14]张晶,刘开江,刘青,等. EMA/CO方案治疗高危妊娠滋养细胞肿瘤32例临床疗效观察[J].中国妇幼保健,2013,28(31):5152-5154.
[15]蒋琼,周芳.扶正抑瘤方联合TC化疗方案对卵巢癌腹腔镜术后患者疗效及生存质量的影响[J].现代中西医结合杂志,2017,26(8):845-847.
[16]刘红卫,熊咀英,漆满华.中西医结合治疗妇科恶性肿瘤化疗后白细胞下降疗效观察[J].中医临床研究,2012,4(24):85-86.
[17]郑东英,许鹏飞,李惠敏.郑伟达运用慈丹胶囊配合参灵胶囊治疗中晚期恶性肿瘤的经验[J].世界中医药,2011,6(5):420-422.
[18]程为功.中西医结合治疗各种恶性肿瘤的相关进展分析[J].中医临床研究,2015,7(21):121-122.
[19]佟玉涛,李庆芬,李丽艳,等.甘麦大枣汤治疗妇科恶性肿瘤放化疗后白细胞减少症临床研究[J].中医学报,2015,30(5):624-625.
[20]黄军,李国洪,孔祥应,等.扶正抑瘤汤对宫颈癌患者外周血CD68和CD83表达的影响[J].现代诊断与治疗,2014,25(11):2442-2444.
[2]赵敏敏,卢苏.扶正升白汤对妇科恶性肿瘤首次化疗后骨髓抑制的临床效果观察[J].中医药信息,2016,33(6):79-81.
[3]王忠亮.八珍汤联合鲨肝醇治疗妇科恶性肿瘤化疗后白细胞下降55例[J].河南中医,2016,36(7):1201-1202.
[4]中华医学会妇产科学会,中华妇产科杂志编辑委员会.妇科常见恶性肿瘤诊断与治疗规范(草案)[J].中华妇产科杂志,1998,33(11):694-704.
[5]张玉珍.中医妇科学[M].北京:中国中医药出版社,2005:313-320.
[6]杨学宁,吴一龙.实体瘤治疗疗效评价标准———RECIST[J].循证医学,2004,4(2):85-90.
[7]施爱军,吴晓柳,沈宗丽,等.常见恶性肿瘤患者机体淋巴细胞亚群和活化T淋巴细胞的分析[J].国际(下转第93页)检验医学杂志,2014,35(20):2758-2759.
[8]王勇.晚期恶性肿瘤患者化疗前后外周血T淋巴细胞亚群监测及临床意义[J].蚌埠医学院学报,2016,41(11):1452-1454.
[9]冯丽霞,王秀云,戴智慧. EMA-CO化疗方案治疗高危绒毛膜癌患者护理体会[J].中国实用医药,2011,6(35):232-233.
[10]施琰红.长春新碱放线菌D依托泊苷氟脲苷治疗高危型妊娠滋养细胞肿瘤的疗效观察[J].中国肿瘤临床与康复,2016,23(5):559-562.
[11]吴樱,凌文.不同化疗方案治疗恶性滋养细胞肿瘤的临床应用分析[J].现代医药卫生,2015,31(1):111-112.
[12]陈娅莉,徐亿力. MAC与EMA-CO方案治疗妊娠滋养细胞肿瘤肺转移的疗效对比分析[J].现代肿瘤医学,2016,24(2):291-294.
[13]石小凤,聂子良,韩咏梅,等. EMA/CO化疗方案治疗恶性滋养细胞肿瘤的临床疗效观察[J].现代生物医学进展,2014,14(11):2088-2091.
[14]张晶,刘开江,刘青,等. EMA/CO方案治疗高危妊娠滋养细胞肿瘤32例临床疗效观察[J].中国妇幼保健,2013,28(31):5152-5154.
[15]蒋琼,周芳.扶正抑瘤方联合TC化疗方案对卵巢癌腹腔镜术后患者疗效及生存质量的影响[J].现代中西医结合杂志,2017,26(8):845-847.
[16]刘红卫,熊咀英,漆满华.中西医结合治疗妇科恶性肿瘤化疗后白细胞下降疗效观察[J].中医临床研究,2012,4(24):85-86.
[17]郑东英,许鹏飞,李惠敏.郑伟达运用慈丹胶囊配合参灵胶囊治疗中晚期恶性肿瘤的经验[J].世界中医药,2011,6(5):420-422.
[18]程为功.中西医结合治疗各种恶性肿瘤的相关进展分析[J].中医临床研究,2015,7(21):121-122.
[19]佟玉涛,李庆芬,李丽艳,等.甘麦大枣汤治疗妇科恶性肿瘤放化疗后白细胞减少症临床研究[J].中医学报,2015,30(5):624-625.
[20]黄军,李国洪,孔祥应,等.扶正抑瘤汤对宫颈癌患者外周血CD68和CD83表达的影响[J].现代诊断与治疗,2014,25(11):2442-2444.