中医健脾法配合FOLFOX化疗方案对结肠癌术后癌因性疲乏、Th1/Th2免疫应答平衡和周围神经病变的影响观察
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摘要
目的:探究FOLFOX化疗方案联合中医健脾法对结肠癌术后患者Th1/Th2免疫应答平衡、癌因性疲乏及对其周围神经病变的影响。方法:选取150例结肠癌术后患者,按照数字表法随机分为对照组和观察组,每组各75例,对照组给予常规治疗及FOLFOX化疗方案治疗,观察组给予中医健脾法配合FOLFOX化疗方案治疗,分析两组治疗效果、癌因性疲乏评分、Th1/Th2免疫应答平衡和周围神经病变情况。结果:观察组总有效率(96.00%)明显高于对照组(86.67%)(P<0.05)。观察组患者神经病变发生率(61.34%)明显低于对照组(77.33%)(P<0.05)。观察组患者治疗后的IFN-γ(14.99±1.89)pg/mL、IL-2(52.07±1.39)pg/mL及TNF-α(2.91±0.48)pg/mL、IL-4(8.88±0.92)pg/mL明显优于对照组患者的IFN-γ(11.05±1.62)pg/mL、IL-2(48.33±1.19)pg/mL及TNF-α(4.88±0.52)pg/mL、IL-4(11.73±1.18)pg/mL,差异有统计学意义(P<0.05)。观察组患者经治疗后1个月、3个月及6个月的癌因性疲乏评分(3.48±1.12)分、(4.79±1.34)分、(4.99±1.60)分与对照组患者的(3.96±1.02)分、(5.46±1.55)分、(6.50±1.84)分相比明显较低(P<0.05)。结论:FOLFOX化疗方案与中医健脾法联合对结肠癌术后患者疗效显著,缓解周围神经病变,有效减轻癌因性疲乏,维持Th1/Th2免疫应答平衡。
Objective: To explore the effect of FOLFOX chemotherapy combined with TCM invigorating spleen on Th1/Th2 immune response balance, cancer-induced fatigue and peripheral neuropathy in patients with colon cancer. Methods: Totally 150 patients with colon cancer were randomly divided into the control group and the observation group, 75 cases in each group. The control group was treated with routine treatment and FOLFOX chemotherapy. The observation group was treated with TCM invigorating spleen method and FOLFOX chemotherapy regimen, and the curative effect of the two groups and the cancer cause fatigue score, Th1/Th2 immune response balance and peripheral neuropathy were analyzed. Results: The total effective rate of the observation group(96%) was significantly higher than that of the control group(86.67%)(P<0.05). The incidence of neuropathy in the observation group(61.34%) was significantly lower than that in the control group(77.33%)(P<0.05). IFN-γ(14.99±1.89)pg/mL, IL-2(52.07±1.39)pg/mL, TNF-α(2.91±0.48)pg/mL and IL-4(8.88±0.92)pg/mL in the observation group were significantly better than the control group's IFN-γ(11.05±1.62)pg/mL, IL-2(48.33±1.19)pg/mL, TNF-α(4.88±0.52)pg/mL and IL-4(11.73±1.18)pg/mL, and there was statistical significance(P<0.05). In 1, 3 and 6 months after treatment, the score of cancer-related fatigue[(3.48±1.12),(4.79±1.34) and(4.99±1.60)] in the observation group were significantly lower than those of the control group[(3.96±1.02),(5.46±1.55) and(4.99±1.60)](P<0.05). Conclusion: The combination of FOLFOX chemotherapy and TCM invigorating spleen method has significant effect on postoperative patients with colon cancer, alleviating peripheral neuropathy, reducing cancer induced fatigue effectively, and maintaining the balance of Th1/Th2 immune response.
Objective: To explore the effect of FOLFOX chemotherapy combined with TCM invigorating spleen on Th1/Th2 immune response balance, cancer-induced fatigue and peripheral neuropathy in patients with colon cancer. Methods: Totally 150 patients with colon cancer were randomly divided into the control group and the observation group, 75 cases in each group. The control group was treated with routine treatment and FOLFOX chemotherapy. The observation group was treated with TCM invigorating spleen method and FOLFOX chemotherapy regimen, and the curative effect of the two groups and the cancer cause fatigue score, Th1/Th2 immune response balance and peripheral neuropathy were analyzed. Results: The total effective rate of the observation group(96%) was significantly higher than that of the control group(86.67%)(P<0.05). The incidence of neuropathy in the observation group(61.34%) was significantly lower than that in the control group(77.33%)(P<0.05). IFN-γ(14.99±1.89)pg/mL, IL-2(52.07±1.39)pg/mL, TNF-α(2.91±0.48)pg/mL and IL-4(8.88±0.92)pg/mL in the observation group were significantly better than the control group's IFN-γ(11.05±1.62)pg/mL, IL-2(48.33±1.19)pg/mL, TNF-α(4.88±0.52)pg/mL and IL-4(11.73±1.18)pg/mL, and there was statistical significance(P<0.05). In 1, 3 and 6 months after treatment, the score of cancer-related fatigue[(3.48±1.12),(4.79±1.34) and(4.99±1.60)] in the observation group were significantly lower than those of the control group[(3.96±1.02),(5.46±1.55) and(4.99±1.60)](P<0.05). Conclusion: The combination of FOLFOX chemotherapy and TCM invigorating spleen method has significant effect on postoperative patients with colon cancer, alleviating peripheral neuropathy, reducing cancer induced fatigue effectively, and maintaining the balance of Th1/Th2 immune response.
引文
[1] 何春华,董来荣.FOLFOX6方案对患者结肠癌细胞生物特性影响的研究[J].世界华人消化杂志,2016,24(35):4715-4719.
[2] 王正洪,方亮,蒋明东,等.OLFOX6方案与FOLFIRI方案治疗晚期结直肠癌的疗效和安全性比较及肿瘤转移的临床特点分析[J].实用医院临床杂志,2018,15(1):97-100.
[3] Roncucci L,Mariani F.Prevention of colorectal cancer:How many tools do we have in our basket[J].Eur J Intern Med,2015,26(10):752-756.
[4] 张殿宝,郭艳珍,张宪芬.贞芪扶正颗粒治疗大肠癌术后癌因性疲乏临床研究[J].中医学报,2017,32(4):513-516.
[5] Aocn SHPDA.Cancer-related fatigue[J].Eur J Cancer Care,2015,17(2):87-95.
[6] Arques O,Chicote I,Puig I,et al.Tankyrase Inhibition Blocks Wnt/β-Catenin Pathway and Reverts Resistance to PI3K and AKT Inhibitors in the Treatment of Colorectal Cancer[J].Clin Cancer Res,2016,22(3):644-656.
[7] 卢宏全,黄国定,林影,等.XRCC1基因多态性对结肠癌患者术后FOLFOX4方案化疗疗效的影响[J].实用癌症杂志,2016,31(8):1239-1241,1246.
[8] 季华.FOLFOX4化疗联合自拟中药扶正消积汤治疗中晚期结肠癌疗效观察[J].现代中西医结合杂志,2016,25(21):2363-2365.
[9] Moreno CC,Mittal PK,Sullivan PS,et al.Colorectal Cancer Initial Diagnosis:Screening Colonoscopy Diagnostic Colonoscopy or Emergent Surgery and Tumor Stage and Size at Initial Presentation[J].Clin Colorectal Cancer,2016,15(1):67-73.
[10] Mustian KM,Alfano CM,Heckler C,et al.Comparison of pharmaceutical psychological and exercise treatments for cancer-related fatigue:a meta-analysis[J].JA-MA Oncol,2017,3(7):961-968.
[11] 梁鸿,张辉,田鹏,等.艾迪联合FOLFOX4方案治疗Ⅲ期结肠癌患者术后效果观察[J].中华实用诊断与治疗杂志,2016,30(2):196-198.
[12] 汤妹娥,杨润琴,李丽.舒适护理对结肠癌术后化疗患者康复效果及癌因性疲乏的影响研究[J].河北医学,2016,22(2):314-317.
[13] 王悦,付菊芳,白燕妮,等.症患者对化疗导致周围神经病变症状体验及应对方式的质性研究[J].护理学报,2016,23(22):9-13.
[14] Gerber L H.Cancer-related fatigue:persistent pervasive and problematic[J].Phys Med Rehabil Clin N Am,2017,28(1):65-88.
[15] 李安.艾迪注射液联合FOLFOX4化疗对晚期结肠癌患者肿瘤干细胞特性及抗肿瘤免疫应答的影响[J].海南医学院学报,2017,23(8):1113-1116.
[16] 刘金万,宫玉霞,范治军.PPI联合FOLFOX方案用于Ⅱ、Ⅲ期结肠癌术后辅助化疗的临床研究[J].结直肠肛门外科,2017,23(5):587-591.
[17] 毛竹君,祝利民,卢艳琳,等.中医健脾法配合FOLFOX化疗方案对结肠癌术后患者癌因性疲乏、Th1/Th2免疫应答平衡及周围神经病变的影响[J].现代中西医结合杂志,2017,26(36):4027-4030.
[18] 张建军,张永强,周芳,等.八珍汤加味调节大肠癌术后癌因性疲乏免疫功能[J].中国实验方剂学杂志,2017,23(11):196-201.
[19] 张帆,罗庆锋.结肠癌根治术后FOLFOX或XELOX化疗的Ⅱ、Ⅲ期老年患者无复发生存期和总生存期及其影响因素分析[J].临床和实验医学杂志,2018,17(8):853-856.
[20] 赵凡尘,李雁,骆莹滨,等.益气健脾方对Wistar鼠大肠癌模型中异常腺窝病灶的影响及其相关机制的探讨[J].现代生物医学进展,2017,17(26):5043-5047.
[21] 袁敏,张国铎,李敏,等.督灸辅助治疗大肠癌术后化疗患者癌因性疲乏[J].护理学杂志,2017,32(19):8-10.
[22] 王歌,白龙,王素娟,等.补虚健脾法对大肠癌术后脾虚证疗效及对免疫功能的临床研究[J].世界中西医结合杂志,2018,13(3):399-402.
[23] 苗雯蓉,刘宁宁,朱惠蓉,等.中医药联合化疗治疗晚期大肠癌疗效Meta分析[J].中华中医药学刊,2018,36(5):1119-1124.
[2] 王正洪,方亮,蒋明东,等.OLFOX6方案与FOLFIRI方案治疗晚期结直肠癌的疗效和安全性比较及肿瘤转移的临床特点分析[J].实用医院临床杂志,2018,15(1):97-100.
[3] Roncucci L,Mariani F.Prevention of colorectal cancer:How many tools do we have in our basket[J].Eur J Intern Med,2015,26(10):752-756.
[4] 张殿宝,郭艳珍,张宪芬.贞芪扶正颗粒治疗大肠癌术后癌因性疲乏临床研究[J].中医学报,2017,32(4):513-516.
[5] Aocn SHPDA.Cancer-related fatigue[J].Eur J Cancer Care,2015,17(2):87-95.
[6] Arques O,Chicote I,Puig I,et al.Tankyrase Inhibition Blocks Wnt/β-Catenin Pathway and Reverts Resistance to PI3K and AKT Inhibitors in the Treatment of Colorectal Cancer[J].Clin Cancer Res,2016,22(3):644-656.
[7] 卢宏全,黄国定,林影,等.XRCC1基因多态性对结肠癌患者术后FOLFOX4方案化疗疗效的影响[J].实用癌症杂志,2016,31(8):1239-1241,1246.
[8] 季华.FOLFOX4化疗联合自拟中药扶正消积汤治疗中晚期结肠癌疗效观察[J].现代中西医结合杂志,2016,25(21):2363-2365.
[9] Moreno CC,Mittal PK,Sullivan PS,et al.Colorectal Cancer Initial Diagnosis:Screening Colonoscopy Diagnostic Colonoscopy or Emergent Surgery and Tumor Stage and Size at Initial Presentation[J].Clin Colorectal Cancer,2016,15(1):67-73.
[10] Mustian KM,Alfano CM,Heckler C,et al.Comparison of pharmaceutical psychological and exercise treatments for cancer-related fatigue:a meta-analysis[J].JA-MA Oncol,2017,3(7):961-968.
[11] 梁鸿,张辉,田鹏,等.艾迪联合FOLFOX4方案治疗Ⅲ期结肠癌患者术后效果观察[J].中华实用诊断与治疗杂志,2016,30(2):196-198.
[12] 汤妹娥,杨润琴,李丽.舒适护理对结肠癌术后化疗患者康复效果及癌因性疲乏的影响研究[J].河北医学,2016,22(2):314-317.
[13] 王悦,付菊芳,白燕妮,等.症患者对化疗导致周围神经病变症状体验及应对方式的质性研究[J].护理学报,2016,23(22):9-13.
[14] Gerber L H.Cancer-related fatigue:persistent pervasive and problematic[J].Phys Med Rehabil Clin N Am,2017,28(1):65-88.
[15] 李安.艾迪注射液联合FOLFOX4化疗对晚期结肠癌患者肿瘤干细胞特性及抗肿瘤免疫应答的影响[J].海南医学院学报,2017,23(8):1113-1116.
[16] 刘金万,宫玉霞,范治军.PPI联合FOLFOX方案用于Ⅱ、Ⅲ期结肠癌术后辅助化疗的临床研究[J].结直肠肛门外科,2017,23(5):587-591.
[17] 毛竹君,祝利民,卢艳琳,等.中医健脾法配合FOLFOX化疗方案对结肠癌术后患者癌因性疲乏、Th1/Th2免疫应答平衡及周围神经病变的影响[J].现代中西医结合杂志,2017,26(36):4027-4030.
[18] 张建军,张永强,周芳,等.八珍汤加味调节大肠癌术后癌因性疲乏免疫功能[J].中国实验方剂学杂志,2017,23(11):196-201.
[19] 张帆,罗庆锋.结肠癌根治术后FOLFOX或XELOX化疗的Ⅱ、Ⅲ期老年患者无复发生存期和总生存期及其影响因素分析[J].临床和实验医学杂志,2018,17(8):853-856.
[20] 赵凡尘,李雁,骆莹滨,等.益气健脾方对Wistar鼠大肠癌模型中异常腺窝病灶的影响及其相关机制的探讨[J].现代生物医学进展,2017,17(26):5043-5047.
[21] 袁敏,张国铎,李敏,等.督灸辅助治疗大肠癌术后化疗患者癌因性疲乏[J].护理学杂志,2017,32(19):8-10.
[22] 王歌,白龙,王素娟,等.补虚健脾法对大肠癌术后脾虚证疗效及对免疫功能的临床研究[J].世界中西医结合杂志,2018,13(3):399-402.
[23] 苗雯蓉,刘宁宁,朱惠蓉,等.中医药联合化疗治疗晚期大肠癌疗效Meta分析[J].中华中医药学刊,2018,36(5):1119-1124.