温阳益气健脾汤剂结合化疗对晚期卵巢癌患者免疫功能及血清HE4、CA125水平的影响
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摘要
目的:探讨自拟温阳益气健脾汤剂结合化疗对晚期卵巢癌患者免疫功能及血清HE4、CA125水平的影响。方法:将我院2014年1月至12月收治的112例晚期卵巢癌患者采用随机数字表法分为观察组和对照组,每组56例。观察其对照组给予紫杉醇联合卡铂(TC)化疗方案,观察组在此基础上联用自拟温阳益气健脾汤剂,观察其对两组临床的有效性、安全性及对患者免疫功能及血清HE4、CA125水平的影响。结果:观察组RR、DCR均显著高于对照组(P<0.05);治疗后两组CD3+、CD4+、CD8+和NK细胞水平较治疗前均显著下降(P<0.05),且观察组显著高于对照组(P<0.05);两组治疗后较治疗前中医证候评分显著下降(P<0.05),KPS评分显著升高(P<0.05),且观察组显著优于对照组(P<0.05);观察组1年、3年生存率均显著高于对照组(P<0.05);观察组HE4和CA125水平显著低于对照组(P<0.05);观察组消化道反应、骨髓抑制发生率均低于对照组(P<0.05)。结论:温阳益气健脾汤剂结合化疗治疗晚期卵巢癌患者能够显著提高免疫功能、降低血清肿瘤标志物水平、减少化疗不良反应临床效果显著,值得临床推广应用。
Objective: To investigate the effects of Wenyang Yiqi Jianpi Decoction combined with chemotherapy on immune function and serum HE4 and CA125 levels in patients with advanced ovarian cancer. Methods: A total of 112 cases of advanced patients with ovarian cancer treated(qi deficiency and blood stasis syndrome) in our hospital from January to December2014 were divided into observation group and control group by random digital table method, with 56 cases in each group. The control group was given paclitaxel combined with carboplatin(TC) chemotherapy regimen, and the observation group was based on the combination of Wenyang Yiqi Jianpi Decoction, to observe the clinical efficacy, safety, immune function and serum HE4 and CA125 levels of the two groups. Results: The RR and DCR in the observation group were significantly higher(P<0.05).After treatment, the levels of CD+3, CD+4, CD+8 and NK cells in the two groups decreased significantly compared with those before treatment, and the observation group was significantly higher than that of the control group(P<0.05). After treatment, the scores of TCM syndromes in the two groups decreased significantly(P<0.05), and KPS increased significantly(P<0.05), and the observation group was significantly better than the control group(P<0.05). The 1 and 3 year survival rates in the observation group were significantly higher(P<0.05). The level of HE4 and CA125 in the observation group was significantly lower(P<0.05).The incidence of gastrointestinal reactions and myelosuppression in the observation group were lower(P<0.05). Conclusion: The combination of Wenyang Yiqi Jianpi Decoction combined with chemotherapy in the treatment of advanced ovarian cancer can significantly improve the immune function, reduce the level of serum tumor markers, and reduce adverse reactions. The clinical effect is remarkable, which is worthy of clinical application.
Objective: To investigate the effects of Wenyang Yiqi Jianpi Decoction combined with chemotherapy on immune function and serum HE4 and CA125 levels in patients with advanced ovarian cancer. Methods: A total of 112 cases of advanced patients with ovarian cancer treated(qi deficiency and blood stasis syndrome) in our hospital from January to December2014 were divided into observation group and control group by random digital table method, with 56 cases in each group. The control group was given paclitaxel combined with carboplatin(TC) chemotherapy regimen, and the observation group was based on the combination of Wenyang Yiqi Jianpi Decoction, to observe the clinical efficacy, safety, immune function and serum HE4 and CA125 levels of the two groups. Results: The RR and DCR in the observation group were significantly higher(P<0.05).After treatment, the levels of CD+3, CD+4, CD+8 and NK cells in the two groups decreased significantly compared with those before treatment, and the observation group was significantly higher than that of the control group(P<0.05). After treatment, the scores of TCM syndromes in the two groups decreased significantly(P<0.05), and KPS increased significantly(P<0.05), and the observation group was significantly better than the control group(P<0.05). The 1 and 3 year survival rates in the observation group were significantly higher(P<0.05). The level of HE4 and CA125 in the observation group was significantly lower(P<0.05).The incidence of gastrointestinal reactions and myelosuppression in the observation group were lower(P<0.05). Conclusion: The combination of Wenyang Yiqi Jianpi Decoction combined with chemotherapy in the treatment of advanced ovarian cancer can significantly improve the immune function, reduce the level of serum tumor markers, and reduce adverse reactions. The clinical effect is remarkable, which is worthy of clinical application.
引文
[1]夏恺,车焕丽,卢雯平.晚期卵巢癌中医证型分布规律研究.新中医,2013,45(4):109-112
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[3]韩凤娟,沈影.试论中医体质与卵巢癌发病的微观因子中介机制.上海中医药杂志,2015,49(12):8-10
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[5]王冬梅,杨格娟,王莹,等.晚期卵巢癌患者中医体质类型与中医证型的相关性研究.现代中西医结合杂志,2016,25(17):1866-1867
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[10]王立岩,张贝贝,赫东芸,等.二甲双胍和紫杉醇对卵巢癌SKOV3细胞体外增殖和凋亡的影响.吉林大学学报(医学版),2017,43(2):255-259
[11]刘伟,丁青.减毒抑癌汤治疗肝肾亏虚型卵巢癌化疗后32例临床观察.湖南中医杂志,2017,33(10):20-22
[12]陈淑卿,华育晖.温阳益气中药辅助腹腔热灌注方案治疗晚期卵巢癌继发腹腔积液疗效观察.中国中医急症,2017,26(8):1487-1489
[13]林雪,殷东风,潘玉真,等.86例原发性卵巢癌中医证候特点分析.中华中医药学刊,2013,31(12):2662-2664
[14]Tao F,Ruan S,Liu W,et al.Fuling Granule,a traditional Chinese medicine compound,suppresses cell proliferation and TGFβ-induced EMT in ovarian cancer.Plos One,2016,11(12):e0168892
[15]Han L,Guo X,Bian H,et al.Guizhi Fuling Wan,a traditional Chinese herbal formula,sensitizes cisplatin-resistant human ovarian cancer cells through inactivation of the PI3K/AKT/mTOR pathway.Evidence-Based Complementray and Alternative Medicine,2016,2(1):1-11
[16]陈璐,周黎,李伊莎.卡铂联合紫杉醇对老年晚期卵巢癌患者的临床疗效及血清HE4、CA125水平的影响.世界临床药物,2017,38(4):252-256
[17]周衍伍,李平.中西医结合治疗晚期卵巢癌的研究现状.中国中医药现代远程教育,2017,15(13):152-154
[18]张涛,徐海亭,惠华,等.洛铂与复方苦参注射液联合腹腔灌注治疗卵巢癌并发恶性腹水的疗效及其对肿瘤坏死因子的影响.中国基层医药,2017,24(15):2281-2284
[19]易良杰,李升伟,何冬梅.加味参苓白术散口服联合白细胞介素-2腹腔灌注治疗卵巢癌相关腹水的临床观察.广州中医药大学学报,2017,34(1):31-34
[2]闫会苓,马丹,卢雯平.益气活血解毒方对晚期卵巢癌患者免疫调节的影响.中国中医药信息杂志,2016,23(1):27-30
[3]韩凤娟,沈影.试论中医体质与卵巢癌发病的微观因子中介机制.上海中医药杂志,2015,49(12):8-10
[4]李悦,张艳,郭滢,等.卵巢癌的中医药研究应用进展.辽宁中医杂志,2016,43(1):194-196
[5]王冬梅,杨格娟,王莹,等.晚期卵巢癌患者中医体质类型与中医证型的相关性研究.现代中西医结合杂志,2016,25(17):1866-1867
[6]中国抗癌协会.新编常见恶性肿瘤诊治规范.北京:中国协和医科大学出版社,1999
[7]CFDA.中药新药临床研究指导原则(试行).北京:中国医药科技出版社,2002:216-224
[8]沈自尹,王文健.中医虚证辨证参考标准.中西医结合杂志,1986,6(10):598
[9]刘先芳,梁敬钰,孙建博.紫杉醇:具有里程碑意义的天然抗癌药物.世界科学技术-中医药现代化,2017,19(6):67-75
[10]王立岩,张贝贝,赫东芸,等.二甲双胍和紫杉醇对卵巢癌SKOV3细胞体外增殖和凋亡的影响.吉林大学学报(医学版),2017,43(2):255-259
[11]刘伟,丁青.减毒抑癌汤治疗肝肾亏虚型卵巢癌化疗后32例临床观察.湖南中医杂志,2017,33(10):20-22
[12]陈淑卿,华育晖.温阳益气中药辅助腹腔热灌注方案治疗晚期卵巢癌继发腹腔积液疗效观察.中国中医急症,2017,26(8):1487-1489
[13]林雪,殷东风,潘玉真,等.86例原发性卵巢癌中医证候特点分析.中华中医药学刊,2013,31(12):2662-2664
[14]Tao F,Ruan S,Liu W,et al.Fuling Granule,a traditional Chinese medicine compound,suppresses cell proliferation and TGFβ-induced EMT in ovarian cancer.Plos One,2016,11(12):e0168892
[15]Han L,Guo X,Bian H,et al.Guizhi Fuling Wan,a traditional Chinese herbal formula,sensitizes cisplatin-resistant human ovarian cancer cells through inactivation of the PI3K/AKT/mTOR pathway.Evidence-Based Complementray and Alternative Medicine,2016,2(1):1-11
[16]陈璐,周黎,李伊莎.卡铂联合紫杉醇对老年晚期卵巢癌患者的临床疗效及血清HE4、CA125水平的影响.世界临床药物,2017,38(4):252-256
[17]周衍伍,李平.中西医结合治疗晚期卵巢癌的研究现状.中国中医药现代远程教育,2017,15(13):152-154
[18]张涛,徐海亭,惠华,等.洛铂与复方苦参注射液联合腹腔灌注治疗卵巢癌并发恶性腹水的疗效及其对肿瘤坏死因子的影响.中国基层医药,2017,24(15):2281-2284
[19]易良杰,李升伟,何冬梅.加味参苓白术散口服联合白细胞介素-2腹腔灌注治疗卵巢癌相关腹水的临床观察.广州中医药大学学报,2017,34(1):31-34