半夏泻心汤辛开苦降法联合mFOLFOX6方案治疗晚期结肠癌
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摘要
目的:研究半夏泻心汤辛开苦降法联合mFOLFOX6方案治疗晚期结肠癌患者的临床效果。方法:选取符合纳入标准的结肠癌患者100例,根据随机原则将患者分为观察组(48例)和对照组(52例)。对照组采用mFOLFOX6方案化疗,观察组患者在化疗的基础上,同时给予半夏泻心汤辛开苦降法治疗。对比两组患者治疗后的临床疗效、症状评分、生活质量评分以及不良反应发生情况。结果:治疗后,两组患者的近期临床疗效及客观缓解率无显著统计学差异(P=0. 575,0. 432);观察组中医证候积分更低(P=0. 022),中医症候总有效率更高(P=0. 013);观察组KPS评分及QLQ-C30评分更高(P=0. 003,0. 012);观察组治疗后部分临床不良事件发生率更低,包括SGOT/SGPT及WBC(P=0. 001,0. 004),而其余统计的不良事件无显著统计学差异(P> 0. 05)。结论:采用半夏泻心汤辛开苦降法结合mFOLFOX6方案治疗晚期结肠癌有一定的临床疗效,能够改善症候评分,提高生活质量,降低部分不良反应发生情况。
Objective: To study the clinical effect of Banxia Xiexin Decoction( herbs acrid in flavor for dispersing and herbs bitter in flavor for descending) combined with mFOLFOX6 chemotherapy in treating advanced colon cancer. Methods: 100 patients with advanced colon cancer were randomly divided into the observation group( n = 48) and the control group( n = 52). The control group was treated with mFOLFOX6 chemotherapy;on which basis,the observation group was also treated with Banxia Xiexin Decoction. The efficacy,TCM syndrome integral,score of life quality and adverse events were compared between the two groups after the treatment. Results: After the treatment,there was no significant difference between the two groups in terms of the clinical efficacy and objective remission rate( P = 0. 575,0. 432). TCM syndrome integral was much lower in the observation group( P = 0. 022),TCM syndrome total efficiency was higher( P = 0. 013). KPS score and QLQ-C30 score were significantly higher in the observation group( P = 0. 003,0. 012). The incidence of some adverse events,including the influences to SGOT/SGPT and WBC,was lower in the observation group( P = 0. 001,0. 004); however,there was no statistically significant difference in other adverse events( P >0. 05). Conclusion: It is effective to treat advanced colon cancer with Banxia Xiexin Decoction combined with mFOLFOX6 chemotherapy.
Objective: To study the clinical effect of Banxia Xiexin Decoction( herbs acrid in flavor for dispersing and herbs bitter in flavor for descending) combined with mFOLFOX6 chemotherapy in treating advanced colon cancer. Methods: 100 patients with advanced colon cancer were randomly divided into the observation group( n = 48) and the control group( n = 52). The control group was treated with mFOLFOX6 chemotherapy;on which basis,the observation group was also treated with Banxia Xiexin Decoction. The efficacy,TCM syndrome integral,score of life quality and adverse events were compared between the two groups after the treatment. Results: After the treatment,there was no significant difference between the two groups in terms of the clinical efficacy and objective remission rate( P = 0. 575,0. 432). TCM syndrome integral was much lower in the observation group( P = 0. 022),TCM syndrome total efficiency was higher( P = 0. 013). KPS score and QLQ-C30 score were significantly higher in the observation group( P = 0. 003,0. 012). The incidence of some adverse events,including the influences to SGOT/SGPT and WBC,was lower in the observation group( P = 0. 001,0. 004); however,there was no statistically significant difference in other adverse events( P >0. 05). Conclusion: It is effective to treat advanced colon cancer with Banxia Xiexin Decoction combined with mFOLFOX6 chemotherapy.
引文
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[11]张海清,韩田.右美托咪定辅助麻醉对结肠癌根治术患者术中血流动力学指标及术后认知功能、辅助T淋巴细胞1和2细胞因子影响[J].临床误诊误治,2018,31(8):39-44.
[12]李丹,汪军,闫飞虎,等.贝伐单抗联合化疗治疗转移性结肠癌患者血清VEGF变化及其与疗效关系[J].现代仪器与医疗,2017,23(3):72-74.
[13]王爱英,龚竹云.多科协作成功救治高龄晚期结肠癌1例[J].中华保健医学杂志,2015,17(4):330.
[14]王静,王鑫,党会芬,等.裴正学教授治疗结肠癌的经验[J].国医论坛,2016,31(6):9-11.
[15]陈熙,马超英,张欢.近年来中药复方及制剂治疗结肠癌的研究进展[J].中华中医药学刊,2015,33(1):67-69.
[2]李凯.辛开苦降法及半夏泻心汤治疗结肠癌的临床和基础研究[D].北京:中国中医科学院,2015:1-10.
[3]中国结直肠癌诊疗规范(2015版)[J].中华普通外科学文献(电子版),2015,9(6):506-523.
[4]梁茂新,高天舒.《中药新药临床研究指导原则》脏腑诸证考察与分析[J].中国中医基础医学杂志,2008,14(5):330-331.
[5]张乃霖.贾民主任医师运用半夏泻心汤合温胆汤治疗上热下寒型痞满经验[J].中医研究,2018(1):51-52.
[6] EISENHAUER E A,THERASSE P,BOGAERTS J,et al. New response evaluation criteria in solid tumours:revised RECIST guideline(version 1. 1)[J]. Eur J Cancer 2009,45:228-247.
[7]张忠涛,蔡军.结肠癌多学科综合治疗协作组诊疗模式专家共识[J].中国实用外科杂志,2017,37(1):44-45.
[8]贝宴屏,张欢乐,陆妙珍.不同辅助化疗方案治疗结肠癌的疗效比较[J].中国现代医生,2017,55(6):82-84+88.
[9]许贺娟.中西医结合治疗对中晚期结肠癌患者生活质量的影响[J].中医临床研究,2017,9(16):89-91.
[10]佟柳,李玉兰,郭星,等.紫杉醇联合复方苦参注射液对结肠癌疗效及对细胞增殖和免疫系统的影响[J].解放军医药杂志,2018,30(11):36-39.
[11]张海清,韩田.右美托咪定辅助麻醉对结肠癌根治术患者术中血流动力学指标及术后认知功能、辅助T淋巴细胞1和2细胞因子影响[J].临床误诊误治,2018,31(8):39-44.
[12]李丹,汪军,闫飞虎,等.贝伐单抗联合化疗治疗转移性结肠癌患者血清VEGF变化及其与疗效关系[J].现代仪器与医疗,2017,23(3):72-74.
[13]王爱英,龚竹云.多科协作成功救治高龄晚期结肠癌1例[J].中华保健医学杂志,2015,17(4):330.
[14]王静,王鑫,党会芬,等.裴正学教授治疗结肠癌的经验[J].国医论坛,2016,31(6):9-11.
[15]陈熙,马超英,张欢.近年来中药复方及制剂治疗结肠癌的研究进展[J].中华中医药学刊,2015,33(1):67-69.