膈气散配合同步放化疗治疗中晚期食管癌58例

目的:探讨膈气散配合同步放化疗对中晚期食管癌患者生活质量和体机免疫的调节作用。方法:将115例中晚期食管癌同步放化疗患者随机按入院前后顺序分为对照组57和观察组58例。对照组采用三维适形放疗+同步化疗。观察组在对照组治疗的基础上采用膈气散加减治疗。两组疗程均为12周。采用CT或核磁共振成像(MRI)对可测量病灶进行检测;评价治疗前后主要症状、体征;采用食管癌专用量表(QLQ-OES18)评价治疗前后患者生活质量;检测治疗前后外周血T淋巴细胞亚群CD3+,CD4+和CD4+/CD8+和自然杀伤细胞(NK)水平;进行安全性监测。结果:观察组实体瘤疗效有效率为70.69%,对照组为56.14%,观察组高于对照组,但差异无统计学意义;治疗后观察组QLQ-OES18量表中吞咽困难、进食困难、进食疼痛、口水、吞咽梗阻、口干、食欲等维度评分低于对照组(P0.01);治疗后对照组CD3+,CD4+和NK细胞水平均比治疗前下降(P0.05,P0.01));观察组CD3+,CD4+,CD4+/CD8+变化无统计学意义,NK比治疗前升高(P0.05),治疗后观察组CD3+,CD4+和NK水平高于对照组(P0.01);治疗后观察组急性放射性肺损伤(P0.05)和恶心呕吐(P0.01)发生程度低于对照组。结论:膈气散能改善了中晚期食管癌同步放化疗患者的临床症状、体征,减轻了放化疗的毒副反应,提高了机体的免疫功能和生活质量,近期疗效显著。

Effect of Modified Geqi Powder Combined Concurrent Chemoradiotherapy in Treating 58 Patients with Middle and Terminal Esophageal Cancer

Objective: To discuss the effect of modified Geqi powder combined concurrent chemoradiotherapy on quality of life and immunoregulation in treating patients with middle and terminal esophageal cancer. Method: One hundred and fifteen patients with middle and terminal esophageal cancer were randomly divided into the control group (57 cases) and the observation group (58 cases) by a random number table. Patients in the control group received three dimensional conformal radiation therapy and synchronous chemotherapy. Based on the treatment of the control group, patients in the observation group added modified Geqi powder. All patients in two groups received 12 weeks of treatment. The detectable lesion was detected by CT or MRI. Before and after treatment, symptoms and signs were recorded. Patients' life of quality was evaluated by esophageal cancer specific scale (QLQ-OES18). Levels of CD3⁺, CD4⁺ and CD4⁺/CD8⁺ of T cell subpopulations and natural killer cell (NK) were detected. Safety was monitored during the treatment. Result: The efficient of solid tumor in the observation group was 70.69%, which was higher than that of 56.14% in the control group, while there was no statistically significant difference between two groups. After treatment, scores of dysphagia, difficulty in feeding, pain, drool, swallowing obstruction, dry mouth and appetite were lower, levels of CD3⁺, CD4⁺ and NK were higher in the observation group than those in the control group (P<0.01). The occurrence degree of acute radiation injury (P<0.05) and nausea and vomit (P<0.01) were lower than those in the control group (P<0.01). Conclusion: Modified Geqi powder could ameliorate clinical symptoms and signs, relieve toxic and side effect of radiotherapy and chemotherapy, and improve bodies' immune function and quality of life, and it has an obvious short-term effect.