参芪十一味颗粒联合FOLFOX4方案化疗对晚期结直肠癌患者的近期疗效及其对血清IL-35、IL-37和T淋巴细胞亚群的影响

目的探讨参芪十一味颗粒联合FOLFOX4方案化疗对晚期结直肠癌患者的近期疗效及其对血清白细胞介素-35（IL-35）、IL-37和T淋巴细胞亚群的影响。 方法选择2018年1月至2021年3月上饶市人民医院收治的晚期结直肠癌患者80例，采用随机表字法分为观察组与对照组，各40例，年龄分别为（58.97±8.95）岁和（59.82±9.04）岁。对照组患者采用FOLFOX4化疗方案，观察组患者采用参芪十一味颗粒联合FOLFOX4化疗方案治疗。两组均以21 d为一个周期，治疗2个周期评价。比较两组近期疗效和生存质量改善情况，化疗前后血清IL-35和IL-37、T淋巴细胞亚群变化及毒副反应情况。 结果观察组患者治疗2个周期后的有效率（RR）为80.0%，对照组为60.0%，组间比较差异有统计学意义（P＜0.05）；观察组生活质量的有效率为100.00%，对照组为90.00%，组间比较差异有统计学意义（P＜0.05）；化疗后，观察组血清IL-35水平较化疗前降低，而IL-37、CD₃⁺、CD₄⁺和CD₄⁺/CD₈⁺均较化疗前升高（均P＜0.05）；化疗后，对照组血清IL-35、CD₃⁺、CD₄⁺和CD₄⁺/CD₈⁺水平均较化疗前降低，而IL-37较化疗前升高（均P＜0.05）；化疗后，观察组血清IL-35低于对照组，而IL-37、CD₃⁺、CD₄⁺和CD₄⁺/CD₈⁺均高于对照组，分别为［（48.31±7.49）ng/L vs（59.24±5.89）ng/L，P＜0.001］、［（58.97±2.97）% vs （47.89±3.71）%，P＜0.001］、［（39.54±3.05）% vs （30.91±2.08）%，P＜0.001］、（1.65±0.19 vs 1.02±0.14，P＜0.001）、［（508.15±28.78）μg/L vs （461.23±25.64）μg/L，P＜0.001］。观察组治疗期间胃肠道反应、乏力、肝功能异常、白细胞减少、血小板减少的发生率均低于对照组，差异均有统计学意义（均P＜0.05）。 结论参芪十一味颗粒联合FOLFOX4化疗方案可显著提高晚期结直肠癌患者近期疗效，下调IL-35水平，上调IL-37水平，提高免疫功能并减轻毒副反应。

Shenqishiyiwei granules combined with FOLFOX4 chemotherapy for treatment of patients with advanced colorectal cancer: short-term efficacy and effect on serum IL-35, IL-37, and T lymphocyte subsets

ObjectiveTo investigate the short-term curative effect of Shenqishiyiwei granules combined with FOLFOX4 chemotherapy in patients with advanced colorectal cancer and their effect on serum interleukin-35 (IL-35), interleukin-37 (IL-37), and T lymphocyte subsets. MethodsA total of 80 patients with advanced colorectal cancer admitted to Shangrao People's Hospital from January 2018 to March 2021 were selected and divided into either an observation group or a control group using the random number table method, with 40 cases in each group. The mean age of the two groups was (58.97±8.95) years and (59.82±9.04) years, respectively. The control group was treated with FOLFOX4 chemotherapy alone. The observation group was treated with Shenqishiyiwei granules combined with FOLFOX4 chemotherapy. The two groups were treated for 21 days as a cycle, and the curative effect was calculated after two cycles of treatment. The short-term efficacy and improvement of quality of life were compared between the two groups. The changes of serum IL-35, IL-37, and T lymphocyte subsets and toxic reactions were also compared between the two groups. ResultsThe response rate (RR) of the observation group was 80.0% after two cycles of treatment, and it was 60.0% in the control group (P＜0.05). The improvement rate of quality of life in the observation group was 100.0%, and it was 90.0% in the control group (P＜0.05). After chemotherapy, the level of IL-35 in the observation group was lower than that before chemotherapy, while IL-37, CD3^＋ T cells, CD4^＋ T cells, and CD4^＋/CD8^＋ ratio were higher than those before chemotherapy (P＜0.05). After chemotherapy, the levels of IL-35, CD3^＋ T cells, CD4^＋ T cells, and CD4^＋/CD8^＋ T cell ratio in the control group were lower than those before chemotherapy, while the level of IL-37 was higher than that before chemotherapy (P＜0.05). After chemotherapy, serum IL-35 in the observation group was lower than that in the control group, while IL-37, CD3^＋ T cells, CD4^＋ T cells, and CD4^＋/CD8^＋ T cell ratio were higher than those in the control group (48.31±7.49) ng/L vs (59.24±5.89) ng/L, P＜0.001; (58.97±2.97)% vs (47.89±3.71)%, P＜0.001; (39.54±3.05)% vs (30.91±2.08)%, P＜0.001; (1.65±0.19 vs 1.02±0.14, P＜0.001); and (508.15±28.78) μg/L vs (461.23±25.64) μg/L, P＜0.001, respectively]. The incidences of gastrointestinal reactions, fatigue, abnormal liver function, leucopenia, and thrombocytopenia in the observation group were all significantly lower than those in the control group (P＜0.05). ConclusionShenqishiyiwei granules combined with FOLFOX4 chemotherapy can significantly improve the short-term curative effect in patients with advanced colorectal cancer, down-regulate the level of IL-35, up-regulate the level of IL-37, improve immune function, and reduce toxic and side effects.