健脾清肠方结合化疗治疗大肠癌术后临床观察

目的观察健脾清肠方联合化疗治疗大肠癌术后的临床疗效及其对免疫细胞因子表达的影响。方法将60例大肠癌术后脾虚湿热证患者随机分为治疗组和对照组,各30例;两组均以5-Fu+CF+奥沙利铂化疗方案为基础治疗,治疗组在化疗间期加用中药健脾清肠方;比较两组治疗前后脾虚湿热证证候、生活质量(KPS评分)、化疗毒副反应和细胞因子IL-2、IL-10的变化情况。结果治疗组治疗后脾虚湿热证候总积分较治疗前明显降低(P<0.01),与对照组比较差异有统计学意义(P<0.01)。治疗组总有效率为80.00%,对照组为23.33%(P<0.01)。治疗组治疗后KPS评分较治疗前有显著升高(P<0.01),与对照组比较差异有统计学意义(P<0.01)。两组治疗前后在外周血白细胞、粒细胞,肝功能、肾功能及周围神经(感觉障碍)方面以及化疗毒副反应比较无统计学差异(P>0.05)。对照组治疗后IL-2水平较治疗前显著降低(P<0.01),治疗组治疗后IL-2水平较治疗前显著增加(P<0.01),组间比较差异有统计学意义(P<0.01)。两组治疗前后IL-10水平比较差异无统计学意义(P>0.05)。结论健脾清肠结合化疗能明显改善大肠癌术后患者脾虚湿热证证候,提高生活质量,改善KPS体力状态,增强细胞免疫。

Clinical observation of "Jianpi Qingchang Decoction" on postoperation of colorectal cancer of spleen deficiency and damp heat pattern

Objective To observe the effect of "Jianpi Qingchang Decoction" on clinical efficacy and expression of immunocyte in postoperation of colorectal cancer of spleen deficiency and damp heat pattern.Methods Sixty cases with colorectal cancer after operation were randomized into treatment group(n=30) and control group(n=30).Both of the groups were treated by chemotherapy of Oxaliplatin+5-Fu/CF for 2 chemotherapeutic cycles,between the 2 chemotherapeutic cycles,the cases in treatment group were treated with "Jianpi Qingchang Decoction".The symptom score,QOL,adverse effect and changes of IL-2 and IL-10 were compared before and after treatment between the two groups.Results The total symptom score after treatment was lower than that before treatment in treatment group(P<0.01),there was significant difference in symptom score between the two groups(P<0.01).The total effective rate was 80.00% in treatment group and 23.33% in control group.The KPS score after treatment was higher than before treatment in treatment group(P<0.01),with significant difference between the two groups(P<0.01).There were no significant differences in cases with adverse effect on PWBC,granulocyte,liver function and kidney function between the two groups(P>0.05).After treatment,the IL-2 was decreased in control group(P<0.01),and expression of IL-2 was increased in treatment group(P<0.01),with significant difference between the two groups(P<0.01).No significant difference was found in IL-10 before and after treatment between the two groups(P>0.05).Conclusion Combined "Jianpi Qingchang Decoction" with chemotherapy after colorectal cancer operation can relieve the spleen deficiency and damp heat symptom,and can improve the quality of life,physical state and cellular immune function.