三棱莪术组方辅助治疗胃癌的临床效果研究
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摘要
目的探讨中医三棱莪术组方辅助治疗胃癌的临床效果。方法根据治疗方法不同将78例胃癌根治术后实施化疗的患者分为中医组和对照组,每组39例。两组患者术后均给予奥沙利铂+替吉奥化疗,中医组患者同时给予三棱莪术组方治疗。比较两组患者治疗前后的中医证候积分、外周血T淋巴细胞(CD3~+、CD4~+、CD8~+)水平及血清肿瘤相关标志物[血管内皮细胞生长因子(VEGF)、癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原724(CA724)]水平。结果治疗前,两组患者的食少纳呆、体倦乏力、食后腹胀、神疲懒言、恶心呕吐、排便异常积分比较,差异均无统计学意义(P>0.05);治疗后,中医组患者的食少纳呆、体倦乏力、食后腹胀、神疲懒言、恶心呕吐、排便异常积分均明显低于对照组(P<0.01)。治疗前,两组患者的外周血CD3~+、CD4~+、CD8~+水平比较,差异均无统计学意义(P>0.05);治疗后,中医组患者的外周血CD3~+、CD4~+水平均高于对照组,CD8~+水平低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者的血清VEGF、CEA、CA125、CA724水平比较,差异均无统计学意义(P>0.05);治疗后,中医组患者的血清VEGF、CEA、CA125、CA724水平均明显低于对照组(P<0.01)。结论中医三棱莪术组方辅助治疗有利于减轻胃癌患者化疗过程中的中医证候,降低肿瘤相关标志物水平,改善患者的免疫功能。
Objective To investigate the clinical effect of traditional Chinese medicine prescription of sparganii rhizoma and curcumae rhizoma as adjuvant chemotherapy in the treatment of gastric cancer. Method By different treatment administered for these patients, a total of 78 cases of gastric cancer who had completed radical gastrectomy were divided as traditional Chinese medicine(TCM) group and control group, with 39 cases in each. Both groups were given postoperative oxaliplatin + S-1, and the TCM group was treated with prescription of sparganii rhizoma and curcumae rhizoma additionally. The TCM syndromes scores, level of peripheral blood T lymphocytes(CD3~+, CD4~+, CD8~+), and serum tumor markers [serum vascular endothelial growth factor(VEGF), carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125) and carbohydrate antigen 724(CA724)] level in the two groups were compared before and after treatment. Result Before treatment, there were no statistically significant difference between the two groups in the light of TCM syndromes, such as decreased appetite, fatigue, abdominal distention, lethargy, nausea and vomiting, and abnormal defecation(P>0.05). After treatment, the patients in TCM group had lower scores of decreased appetite, fatigue, abdominal distention, lethargy, nausea and vomiting, and abnormal defecation than those in control group(P<0.05). Before treatment, the level of peripheral blood CD3~+, CD4~+ and CD8~+ in the two groups were similar(P>0.05); while the peripheral blood CD3~+and CD4~+ level in TCM group were increased, and CD8~+ level was decreased compared with control group after treatment(P<0.01). Before treatment, the serum VEGF, CEA, CA125, and CA724 level did not differ between the two groups(P>0.05); while those in TCM group were lower than that in control group after treatment(P<0.01). Conclusion The prescription of sparganii rhizoma and curcumae rhizoma are helpful in reducing the TCM syndromes during the course of chemotherapy, meanwhile the prescription may also lower the level of tumor related markers, and improve the immune function of the patients.
Objective To investigate the clinical effect of traditional Chinese medicine prescription of sparganii rhizoma and curcumae rhizoma as adjuvant chemotherapy in the treatment of gastric cancer. Method By different treatment administered for these patients, a total of 78 cases of gastric cancer who had completed radical gastrectomy were divided as traditional Chinese medicine(TCM) group and control group, with 39 cases in each. Both groups were given postoperative oxaliplatin + S-1, and the TCM group was treated with prescription of sparganii rhizoma and curcumae rhizoma additionally. The TCM syndromes scores, level of peripheral blood T lymphocytes(CD3~+, CD4~+, CD8~+), and serum tumor markers [serum vascular endothelial growth factor(VEGF), carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125) and carbohydrate antigen 724(CA724)] level in the two groups were compared before and after treatment. Result Before treatment, there were no statistically significant difference between the two groups in the light of TCM syndromes, such as decreased appetite, fatigue, abdominal distention, lethargy, nausea and vomiting, and abnormal defecation(P>0.05). After treatment, the patients in TCM group had lower scores of decreased appetite, fatigue, abdominal distention, lethargy, nausea and vomiting, and abnormal defecation than those in control group(P<0.05). Before treatment, the level of peripheral blood CD3~+, CD4~+ and CD8~+ in the two groups were similar(P>0.05); while the peripheral blood CD3~+and CD4~+ level in TCM group were increased, and CD8~+ level was decreased compared with control group after treatment(P<0.01). Before treatment, the serum VEGF, CEA, CA125, and CA724 level did not differ between the two groups(P>0.05); while those in TCM group were lower than that in control group after treatment(P<0.01). Conclusion The prescription of sparganii rhizoma and curcumae rhizoma are helpful in reducing the TCM syndromes during the course of chemotherapy, meanwhile the prescription may also lower the level of tumor related markers, and improve the immune function of the patients.
引文
[1]左婷婷,郑荣寿,曾红梅,等.中国胃癌流行病学现状[J].中国肿瘤临床,2017,44(1):52-58.
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[4]陈倩琪,潘赛英,赵艳.自拟扶正化瘀汤联合化疗对胃癌患者的辨证临床效果分析[J].世界中医药,2016,11(8):1477-1479.
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[10]王婷婷,李冬,王辉,等.胃癌化疗患者的疾病不确定感、应对方式与生活质量的相关性分析[J].中国临床研究,2016,29(10):1434-1437.
[11]汤汇涓,舒鹏.中医健脾养胃法在胃癌治疗中的应用探讨[J].湖南中医药大学学报,2016,36(4):42-44.
[12]成汇,朱永康.朱永康教授运用中医序贯疗法治疗胃癌手术患者经验介绍[J].现代肿瘤医学,2016,24(13):2145-2147.
[13]Jafarzadeh A,Larussa T,Nemati M,et al.T cell subsets play an important role in the determination of the clinical outcome of Helicobacter pylori infection[J].Microb Pathog,2018,116:227-236.
[14]穆桂芳,穆雪峰,毕海静,等.VEGF和突变型p53在胃癌组织表达及意义[J].中国免疫学杂志,2016,32(1):90-91;96.
[15]Hirahara N,Tajima Y,Fujii Y,et al.Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels:a propensity score matching analysis[J].BMC Cancer,2018,18(1):285.
[16]Wei HE,Zhang LN.Assessment of prognosis and trauma extent in endoscopic resection and traditional open radical resection treatment of early gastric cancer[J].Journal of Hainan Medical University,2016,22(16):75-78.
[2]符涛,季加孚.胃癌诊疗的热点和问题[J].中国肿瘤临床,2016,43(1):2-5.
[3]王志新,邹玺,胡守友.中药抗胃癌的现代药理机制[J].西部中医药,2016,29(4):137-140.
[4]陈倩琪,潘赛英,赵艳.自拟扶正化瘀汤联合化疗对胃癌患者的辨证临床效果分析[J].世界中医药,2016,11(8):1477-1479.
[5]中华人民共和国国家卫生和计划生育委员会.胃癌规范化诊疗指南(试行)[J].中国医学前沿杂志(电子版),2013,5(8):56-63[2018-06-01].http://www.yixueqianyan.cn/CN/abstract/abstract720.shtml.
[6]李忠.临床中医肿瘤学[M].沈阳:辽宁科学技术出版社,2002:185.
[7]巴一,周礼鲲.晚期胃癌的化疗选择[J].中国肿瘤临床,2016,43(1):21-26.
[8]王淳阅,陈莉林.奥沙利铂联合替吉奥辅助化疗对胃癌术后患者的效果分析[J].中国生化药物杂志,2016,36(9):49-51.
[9]万一元,惠红霞,王晓炜,等.卡培他滨或替吉奥联合奥沙利铂方案治疗进展期胃癌的疗效及安全性[J].中华肿瘤杂志,2016,38(1):28-34.
[10]王婷婷,李冬,王辉,等.胃癌化疗患者的疾病不确定感、应对方式与生活质量的相关性分析[J].中国临床研究,2016,29(10):1434-1437.
[11]汤汇涓,舒鹏.中医健脾养胃法在胃癌治疗中的应用探讨[J].湖南中医药大学学报,2016,36(4):42-44.
[12]成汇,朱永康.朱永康教授运用中医序贯疗法治疗胃癌手术患者经验介绍[J].现代肿瘤医学,2016,24(13):2145-2147.
[13]Jafarzadeh A,Larussa T,Nemati M,et al.T cell subsets play an important role in the determination of the clinical outcome of Helicobacter pylori infection[J].Microb Pathog,2018,116:227-236.
[14]穆桂芳,穆雪峰,毕海静,等.VEGF和突变型p53在胃癌组织表达及意义[J].中国免疫学杂志,2016,32(1):90-91;96.
[15]Hirahara N,Tajima Y,Fujii Y,et al.Prognostic nutritional index as a predictor of survival in resectable gastric cancer patients with normal preoperative serum carcinoembryonic antigen levels:a propensity score matching analysis[J].BMC Cancer,2018,18(1):285.
[16]Wei HE,Zhang LN.Assessment of prognosis and trauma extent in endoscopic resection and traditional open radical resection treatment of early gastric cancer[J].Journal of Hainan Medical University,2016,22(16):75-78.