复方苦参注射液对胃癌化疗患者Th1/Th2细胞漂移和骨髓抑制的影响
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摘要
目的研究复方苦参注射液应用于胃癌化疗患者的临床效果。方法回顾性分析112例胃癌化疗患者临床资料,给予复方苦参注射液者纳入观察组(n=45),其他患者纳入对照组(n=67)。比较治疗前及治疗2个周期后,2组中医症状评分、生活质量[生命质量问卷-胃癌特异模块(QLQ-STO22)]、1型/2型辅助性T淋巴细胞(Th1/Th2)分泌功能指标、骨髓抑制指标变化,分析2组存活情况及2个周期内其他毒副反应发生情况。结果治疗2个周期后,2组胃脘疼痛、纳差、嗳气吞酸症状评分、QLQ-STO22评分及血清Th1分泌功能指标均较治疗前显著下降,且观察组明显低于对照组(P <0. 05); 2组血清Th2分泌功能指标水平均较治疗前显著提升,且观察组明显高于对照组(P <0. 05); 2组骨髓抑制指标均较治疗前显著下降,且观察组明显高于对照组(P <0. 05)。观察组中位生存时间明显多于对照组(P <0. 05)。治疗2个周期内,2组严重腹泻、急性肾损伤、肝功能衰竭发生率比较均差异无统计学意义(P> 0. 05)。结论复方苦参注射液能有效增强胃癌患者化疗效果,纠正Th1/Th2细胞漂移,并缓解骨髓抑制作用,对提高其生活质量与延长生存时间有利。
Objective To explore the clinical effects of compound Kushen injection in patients with gastric cancer undergoing chemotherapy. Methods The clinical data of 112 patients with gastric cancer who underwent chemotherapy in our hospital were retrospectively analyzed. The 45 patients in observation group were treated by compound Kushen injection,and the other 67 patients were enrolled as control group. The TCM symptoms scores,quality of life including life quality questionnaire,gastric cancer specific module(QLQ STO22),and type 1/2 helper T lymphocytes(Th1/Th2) secretion function indexes and the changes of myelosuppressive indexes in both groups were observed and compared before treatment and after 2-cycle treatment. The survival status and the incidence rate of the other toxic and adverse reactions were observed and compared between the two groups. Results After 2-cycle treatment,the symptoms scores of stomach pain,poor appetite and belching and acid regurgitation,and the QLQ STO22 scores and serum Th1 secretion function indexes were significantly decreased in both groups,as compared with those before treatment,moreover,which in observation group were significantly lower than those in control group(P < 0. 05). After treatment the serum levels of Th2 secretion function indexes in both groups were significantly higher than those before treatment,moreover,which in observation group were significantly higher than those in control group(P < 0. 05). The myelosuppressive indexes in both groups were significantly lower than those before treatment,which in observation group were significantly higher than those in control group(P < 0. 05). The meso-position survival time in observation group was significantly longer than that in control group(P < 0. 05). Within 2 treatment cycles,there were no significant differences in the incidence rates of severe diarrhea,acute kidney injury and liver failure between the two groups(P > 0. 05). Conclusion Compound Kushen injection can effectively enhance the chemotherapy effects on gastric cancer,which can correct the Th1/Th2 cell drift,and alleviate the myelosuppression,which is beneficial to improve the life quality and prolong survival time of patients.
Objective To explore the clinical effects of compound Kushen injection in patients with gastric cancer undergoing chemotherapy. Methods The clinical data of 112 patients with gastric cancer who underwent chemotherapy in our hospital were retrospectively analyzed. The 45 patients in observation group were treated by compound Kushen injection,and the other 67 patients were enrolled as control group. The TCM symptoms scores,quality of life including life quality questionnaire,gastric cancer specific module(QLQ STO22),and type 1/2 helper T lymphocytes(Th1/Th2) secretion function indexes and the changes of myelosuppressive indexes in both groups were observed and compared before treatment and after 2-cycle treatment. The survival status and the incidence rate of the other toxic and adverse reactions were observed and compared between the two groups. Results After 2-cycle treatment,the symptoms scores of stomach pain,poor appetite and belching and acid regurgitation,and the QLQ STO22 scores and serum Th1 secretion function indexes were significantly decreased in both groups,as compared with those before treatment,moreover,which in observation group were significantly lower than those in control group(P < 0. 05). After treatment the serum levels of Th2 secretion function indexes in both groups were significantly higher than those before treatment,moreover,which in observation group were significantly higher than those in control group(P < 0. 05). The myelosuppressive indexes in both groups were significantly lower than those before treatment,which in observation group were significantly higher than those in control group(P < 0. 05). The meso-position survival time in observation group was significantly longer than that in control group(P < 0. 05). Within 2 treatment cycles,there were no significant differences in the incidence rates of severe diarrhea,acute kidney injury and liver failure between the two groups(P > 0. 05). Conclusion Compound Kushen injection can effectively enhance the chemotherapy effects on gastric cancer,which can correct the Th1/Th2 cell drift,and alleviate the myelosuppression,which is beneficial to improve the life quality and prolong survival time of patients.
引文
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4 刘扬帆.复方苦参注射液联合硫酸吗啡缓释片治疗中重度癌痛的临床研究.中药药理与临床,2015,31:150-152.
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8 刘伟琳,杨舸,芮煜华,等. EORTC QLQ-STO22量表对我国胃癌患者有效性的验证.肿瘤研究与临床,2016,28:595-599.
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10 宋静,顾剑平,楼小萌,等.胃癌前病变从痈论治探析.陕西中医,2013,34:768-768.
11 梁云麒,沈克平,胡兵.中医胃癌病机与治法研究.中华中医药学刊,2014,32:513-515.
12 郭林丰,童姗姗,余江南,等.苦参碱抗肿瘤作用机制研究进展.中国中药杂志,2013,38:3409-3412.
13 冯亚龙,赵英永,丁凡,等.茯苓皮的化学成分及药理研究进展(Ⅰ).中国中药杂志,2013,38:1098-1102.
14 何钦,徐斌,陶飞宝,等.益胃化瘀散对胃癌前病变患者Th1/Th2免疫漂移的影响.中草药,2015,46:1810-1813.
15 贾英杰,于建春,杨佩颖,等.中医药防治化疗致骨髓抑制的临床研究概况.辽宁中医杂志,2014,41:2253-2255.
16 段哲萍,于新江,吕艳玲,等.复方苦参注射液对非小细胞肺癌放疗患者放射性肺损伤及骨髓抑制的防治作用及机制.山东医药,2016,56:81-83.
2 杨铮,陆金根,花永强,等.基于中医理论胃癌生活质量评价量表研制.中国公共卫生,2013,29:960-964.
3 邬伟,张璐,舒琦瑾.胃癌中医证型构成及分布规律的文献分析.中华中医药学刊,2014,32:173-175.
4 刘扬帆.复方苦参注射液联合硫酸吗啡缓释片治疗中重度癌痛的临床研究.中药药理与临床,2015,31:150-152.
5 杨宇飞,林洪生主编.胃癌中西医综合治疗.第1版.北京:人民卫生出版社,2002. 16-17.
6 廖专,孙涛,吴浩,等.中国早期胃癌筛查及内镜诊治共识意见(2014年4月·长沙).中华消化杂志,2014,34:433-448.
7 郑筱萸主编.中药新药临床研究指导原则.第1版.北京:中国医药科技出版社,2002. 151-155.
8 刘伟琳,杨舸,芮煜华,等. EORTC QLQ-STO22量表对我国胃癌患者有效性的验证.肿瘤研究与临床,2016,28:595-599.
9 皋文君,刘砚燕,袁长蓉.国际肿瘤化疗药物不良反应评价系统——通用不良反应术语标准4. 0版.肿瘤,2012,32:142-144.
10 宋静,顾剑平,楼小萌,等.胃癌前病变从痈论治探析.陕西中医,2013,34:768-768.
11 梁云麒,沈克平,胡兵.中医胃癌病机与治法研究.中华中医药学刊,2014,32:513-515.
12 郭林丰,童姗姗,余江南,等.苦参碱抗肿瘤作用机制研究进展.中国中药杂志,2013,38:3409-3412.
13 冯亚龙,赵英永,丁凡,等.茯苓皮的化学成分及药理研究进展(Ⅰ).中国中药杂志,2013,38:1098-1102.
14 何钦,徐斌,陶飞宝,等.益胃化瘀散对胃癌前病变患者Th1/Th2免疫漂移的影响.中草药,2015,46:1810-1813.
15 贾英杰,于建春,杨佩颖,等.中医药防治化疗致骨髓抑制的临床研究概况.辽宁中医杂志,2014,41:2253-2255.
16 段哲萍,于新江,吕艳玲,等.复方苦参注射液对非小细胞肺癌放疗患者放射性肺损伤及骨髓抑制的防治作用及机制.山东医药,2016,56:81-83.