复方苦参注射液联合FOLFOX4化疗方案治疗晚期胃癌的作用

目的:观察复方苦参注射液联合FOLFOX4治疗晚期胃癌的临床效果,分析其作用机制.方法:常规培养人胃癌SGC-7901细胞,按组别加入不同浓度的苦参碱,MTT法检查细胞增殖率,流式细胞仪检查细胞凋亡水平.48例中晚期胃癌患者随机分成对照组21例和联合治疗组27例.联合治疗组采用化疗联合复方苦参注射液,对照组给予单纯化疗,比较两组治疗近期效果、不良反应等情况.结果:细胞实验部分,MTT检测结果显示苦参碱以剂量依赖的方式抑制胃癌细胞的增殖,其机制与细胞凋亡水平增加密切相关.临床实验部分,联合治疗组总有效率较对照组增高,但差异无统计学意义(P＞0.05),同时联合治疗组恶心呕吐、白细胞减少、血小板减少的严重程度低于对照组,差异有统计学意义(P＜0.05).结论:复方苦参注射液联合FOLFOX4化疗方案治疗胃癌,不仅有利于降低不良反应,且在总体治疗效率方面有优于单用FOLFOX4方案的趋势,其机制与促进胃癌细胞凋亡有关.

Treatment of Advanced Gastric Cancer with Composed Kushen Injection Combined with FOLFOX4 Adjuvant Chemotherapy

Objective: To observe clinical effects and the mechanism of composed Kushen injection combined with FOLFOX4 adjuvant chemotherapy protocol on advanced gastric cancer.Methods: Gastric cancer SGC-7901 cells were cultured in normal condition or with additional different concentration of matrine.Proliferation levels and apoptosis levels of the cells were tested by MTT and flow cytometry respectively.Forty-eight patients with advanced gastric cancer were randomly divided into two groups: control group(21 cases,FOLFOX4 adjuvant chemotherapy) and combined therapy group(27 cases,FOLFOX4 adjuvant chemotherapy combined with Kushen injection).The effect and toxic reaction of FOLFOX4 alone and FOLFOX4 combined with Kushen injection on the patients with advanced gastric cancer were observed and compared between the two groups.Results: At cell culture level,MTT analysis indicated that matrine could inhibit proliferation level of SGC-7901 cells in a dose-dependent manner,which was mediated by induction of cells apoptosis.In clinical observation,there was no significant change in total effective rate between the two groups(P>0.05).Additionally,there were significant decreasing of severity of nausea,leucopenia and thrombocytopenia between combined therapy group and control group.Conclusion: FOLFOX4 adjuvant chemotherapy combined with Kushen injection protocol induced only milder toxic reaction.The protocol may also improve total effective rate of advanced gastric cancer,and matrine might play a role by inducing the apoptosis of gastric cancer cells.