益胃消癌汤联合化疗治疗进展期胃癌的增效、减毒及生存期观察

目的探讨益胃消癌汤联合化疗对进展期胃癌患者疗效、减毒作用及生存期的影响。方法选取2014年6月—2016年6月收治的进展期胃癌患者86例,根据随机数字表法分为对照组、治疗组各43例。对照组给予西医OFL[奥沙利铂(OXA)联合氟尿嘧啶(5-FU)及亚叶酸钙(LV)]化疗方案治疗,治疗组在对照组常规化疗基础上加用益胃消癌汤(自拟方)。比较两组中医疗效,观察治疗前后的中医证候评分,并采血检测血红蛋白、血小板计数、白细胞计数、红细胞计数、癌胚抗原水平,分析血常规、癌胚抗原的变化。观察两组毒副作用率,通过电话随访3年,记录两组3年内的生存率、病死率。结果治疗组总有效率83.72%(36/43)高于对照组65.12%(28/43),差异有统计学意义(P<0.05)。两组治疗后中医证候积分显著低于治疗前,且治疗组显著低于对照组(P<0.05)。两组治疗后血红蛋白、血小板计数、白细胞计数、红细胞计数、癌胚抗原均低于治疗前,且治疗组血小板计数、白细胞计数显著高于对照组,癌胚抗原显著低于对照组(P<0.05)。治疗组白细胞下降、血小板下降率分别为30.23%、34.88%,显著低于对照组的53.49%、58.14%(P<0.05)。治疗组3年内有27例(62.79%)生存,16例(37.21%)死亡,对照组有17例(39.53%)生存,26例(60.47%)死亡。治疗组生存率显著高于对照组(P<0.05)。结论进展期胃癌患者在化疗基础上加用益胃消癌汤,能提高疗效,进一步改善中医症状,下调癌胚抗原水平,并降低白细胞、血小板下降率,提高远期生存率。

Synergism,attenuation and survival of Yiwei Xiao'ai Decoction combined with chemotherapy in the treatment of advanced gastric cancer

Objective To investigate the effect of Yiwei Xiao′ai Decoction combined with chemotherapy on the efficacy,attenuation and survival of patients with advanced gastric cancer.Methods A total of 86 patients with advanced gastric cancer admitted to our hospital from June,2014 to June,2016 were included and randomized into the control group and the observation group by using random number table,with 43 patients in each group.The control group was given OFL chemotherapy,while the observation group was given self-formulated Yiwei Xiao'ai Decoction combined with OFL chemotherapy.The curative effect of the two groups was compared.The scores of TCM syndrome before and after treatment were observed.Hemoglobin(HGB),platelet count(PLT),white blood cell count(WBC),red blood cell count(RBC)and carcinoembryonic antigen level(CEA)were detected by blood test,and the changes of blood routine and carcinoembryonic antigen were analyzed.The adverse events of the two groups were observed,and telephone follow-up was carried out for 3 years.The survival rate and mortality rate within 3 years of the two groups were recorded.Results The total effective rate in the observation group(83.72%)was higher than that of the control group(65.12%),and the difference was statistically significant(P<0.05).The TCM syndrome scores in the two groups after treatment were significantly lower than those before treatment,and the observation group had significantly lower scores than the control group(P<0.05).After treatment,HGB,PLT,WBC,RBC and CEA level in the two groups were lower than those before treatment,and PLT and WBC in the observation group were significantly higher than those in the control group,while CEA was significantly lower than that in the control group(P<0.05).The decline rates of WBC and PLT were respectively 30.23%and 34.88%in the observation group,which were significantly lower than those in the control group(respectively 53.49%and 58.14%)(P<0.05).The survival rate was 62.79%(27 cases)in the observation group and 39.53%(17 cases)in the control group;and the mortalityrate was 37.21%(16 cases)in the observation group and 60.47%(26 cases)in the control group.The survival rate in the observation group was significantly higher than in the control group(P<0.05).Conclusion For advanced gastric cancer patients,Yiwei Xiao'ai Decoction combined with chemotherapy can improve the curative effect,further improve the TCM symptoms,down-regulate the level of carcinoembryonic antigen,reduce the rate of leukopenia and platelet decline,and improve the long-term survival rate.