清热消滞抗癌方联合放疗对食管癌患者4-羟基壬烯醛、糖类抗原199的影响

目的:探究清热消滞抗癌方联合放疗对食管癌(EC)痰气交阻证患者外周血4-羟基壬烯醛(4-HNE)、糖类抗原199(CA199)的影响。方法:选取105例EC痰气交阻证患者为研究对象,采用随机信封法分为研究组(n=52)、对照组(n=53)。对照组采用单纯放疗,研究组在对照组的基础上联合清热消滞抗癌方加减治疗,两组患者均治疗7周。比较两组患者治疗后中医临床疗效。比较两组治疗前和治疗后中医证候积分、氧化应激指标[4-HNE、丙二醛(MDA)]、血清肿瘤标志物[CA199、鳞状上皮细胞癌抗原(SCC)、人细胞角蛋白21-1片段(CYFRA21-1)],以及两组患者治疗期间的不良反应发生情况。结果:治疗后,研究组总有效率94.2%,明显高于对照组患者的81.1%,差异有统计学意义(P<0.05)。治疗后,两组患者中医证候积分、血清CA199、SCC、CYFRA21-1水平均较治疗前降低,且研究组低于对照组,差异有统计学意义(均P<0.05)。治疗后,两组患者4-HNE、MDA均较治疗前升高,且对照组高于研究组,差异有统计学意义(均P<0.05)。治疗期间,研究组发生放射性肺炎、放射性食管炎者均低于对照组,差异有统计学意义(均P<0.05)。结论:清热消滞抗癌方联合放疗可改善EC患者临床症状,降低血清肿瘤标志物水平,减轻因放疗造成的氧化应激反应,且不良反应少。

Effects of Qingre Xiaozhi Kang'ai decoction combined with radiotherapy on levels of 4-HNE and CA199 in patients with esophageal cancer

Objective:To explore effects of Qingre Xiaozhi Kang'ai decoction combined with radiotherapy on 4-hydroxynonenal(4-HNE)and carbohydrate antigen 199(CA199)in peripheral blood of patients with esophageal carcinoma(EC)of Tanqi Jiaozu syndrome.Methods:105 patients with EC of Tanqi Jiaozu syndrome were selected as study subjects,and they divided into study group(n=52)and control group(n=53)by the random envelope method.The control group were treated with radiotherapy alone,while the study group were combined with Qingre Xiaozhi Kangai decoction on the basis of the control group.Both groups were treated for 7 weeks.The clinical TCM efficacy was compared between the two groups after 7 weeks of treatment.TCM symptom score,oxidative stress [4-HNE,malondialdehyde(MDA)] and serum tumor markers [CA199,squamous cell carcinoma antigen(SCC),human cytokeratin 21-1 fragment(CYFRA21-1)] were recorded before treatment and after 7 weeks of treatment.The occurrence of adverse reactions of radiotherapy during treatment in the two groups were recorded.Results:After 7 weeks of treatment,the total effective rate 94.2% in the study group was significantly higher than that in the control group 81.1%,difference statistically significant(P<0.05).The score of TCM symptom and levels of serum CA199,SCC and CYFRA21-1 in the two groups after treatment were reduced compared with those before treatment,and they were lower in the study group than those in the control group,difference statistically significant(all P<0.05).The levels of 4-HNE and MDA in both groups were enhanced after treatment compared to before treatment,they were lower in the study group than those in the control group,difference statistically significant(all P<0.05).During treatment,the severity of radiation pneumonitis and radiation esophagitis were significantly milder in the study group than those in the control group(P<0.05).Conclusion:Qingre Xiaozhi Kang'ai decoction combined with radiotherapy can improve clinical symptoms of patients with EC,reduce the levels of serum tumor markers,and relieve oxidative stress response caused by radiotherapy,with mild adverse reactions.