益气解毒消癌方联合化疗治疗晚期转移性结直肠癌脾虚瘀毒证的临床观察

目的:观察晚期转移性结直肠癌(AMCC)脾虚瘀毒证患者应用益气解毒消癌方联合化疗治疗的临床疗效及不良反应。方法:筛选2013年1月至2015年6月宜兴市中医医院收治的AMCC脾虚瘀毒证患者62例,分层随机分为两组,对照组采用四君子汤联合伊立替康-亚叶酸钙-氟尿嘧啶(FOLFIRI)方案化疗,观察组采用益气解毒消癌方煎剂口服联合FOLFIRI化疗治疗,分别随访两组临床疗效、无进展生存期、中位总生存时间、肿瘤标志物、生活质量、不良反应,并比较两组患者的疗效差别。结果:治疗后,观察组疾病控制率(80.65%)高于对照组(54.84%)(P0.05);观察组中位无进展生存期、中位总生存时间分别为11.51,25.54个月,均高于对照组的8.77,20.75个月(P0.01)。在对两组患者中30例肝转移患者随访中,观察组15例患者疾病控制率分别为82.25%,高于对照组15例患者的46.77%(P0.05)。治疗后,观察组肿瘤标志物CEA,CA199水平低于对照组(P0.05,P0.01)。观察组生活质量改善水平明显优于对照组(P0.05),不良反应发生率低于对照组(P0.05),其他指标组间比较差异无统计学差异。结论:AMCC脾虚瘀毒证患者应用益气解毒消癌方联合化疗治疗可其增加肝转移患者的疾病控制率,延长生存期,减轻化疗带来的不良反应、降低血液肿瘤标志物、提高生活质量。

Clinical Observation on Yiqi Jiedu Xiaoai Decoction and Chemotherapy for Treatment of Advanced Metastatic Colorectal Cancer with Stagnated-toxin Spleen Deficiency Syndrome

Objective: To observe the clinical efficacy and adverse reactions of Yiqi Jiedu Xiaoai decoction and chemotherapy for advanced metastatic colorectal cancer (AMCC) with stagnated-toxin spleen deficiency syndrome. Method: A total of 62 patients with AMCC stagnated-toxin spleen deficiency syndrome in our department from January 2013 to June 2015 were selected and randomly divided into two groups. Patients in control group were treated with Sijunzi Tang combined with Irinotecan-folinic acid calcium salt hydrate-5-fluorouracil(FOLFIRI)chemotherapy, while the patients in observation group were treated with Yiqi Jiedu Xiaoai decoction combined with FOLFIRI chemotherapy. The clinical efficacy, progression-free survival, median overall survival time, tumor markers, quality of life and adverse reactions were followed up in both groups, and the difference in efficacy between two groups was compared. Result: After treatment, the disease control rate was 80.65% in observation group, higher than 54.84% in control group (P<0.05). After treatment, the median progression-free survival in observation group was 11.51 months, significantly longer than 8.77 months in control group (P<0.01), and the median overall survival in observation group (25.54 months) was also significantly longer than that in control group (20.75 months) (P<0.01). In the follow-up of 30 patients with liver metastases, the control rate was 82.25% for 15 patients in observation group, significantly higher than 46.77% in control group (P<0.05). After treatment, the levels of CEA and CA199 in observation group were significantly lower than those in control group (P<0.05,P<0.01). In addition, the improvement of quality of life in observation group was significantly better than that in control group (P<0.05), and the incidence of adverse reactions in was significantly lower than that of control group (P<0.05). There was no statistically significant difference in other indicators between two groups. Conclusion: The combination of Yiqi Jiedu Xiaoai decoction combined with FOLFIRI chemotherapy can increase the disease control rate in AMCC patients with liver metastases, prolong the survival period, reduce the adverse reactions caused by chemotherapy, reduce the blood tumor markers and improve the quality of life for patients with advanced metastatic colorectal cancer with stagnated-toxin spleen deficiency.