西黄丸联合紫杉醇和铂类新辅助化疗对晚期宫颈癌患者术后疗效的影响

目的 探讨西黄丸联合紫杉醇和铂类新辅助化疗对晚期宫颈癌患者术后疗效的影响。方法 选取2014年1月-2017年1月安阳市第三人民医院收治的晚期宫颈癌患者80例为研究对象，采用随机数字表法分为观察组和对照组各40例，均择期行根治性子宫切除术，术后对照组予以紫杉醇+顺铂新辅助化疗方案，3周为1个疗程，治疗2个疗程；观察组在对照组基础上予以西黄丸2次/d，治疗6周。比较两组化疗有效率、生存率及复发率，测定两组化疗前后T淋巴细胞亚群（CD3⁺、CD4⁺、CD8⁺）及免疫球蛋白（IgA、IgG、IgM）水平，应用卡氏评分表（KPS）、数字评分法（NRS）评价生活质量及癌痛度，记录不良反应。结果 观察组化疗有效率（87.50%）与对照组（77.50%）比较略高，但差异无统计学意义；观察组化疗后3、6个月生存率、复发率与对照组对比均无统计学差异；化疗后观察组CD3⁺（72.39±1.47）%、CD4⁺（37.62±1.17）%、IgA （11.11±1.34） g/L、IgG （1.23±0.45） g/L、IgM （2.60±0.46） g/L较对照组明显增加，差异有统计学意义（P<0.05）；观察组CD8⁺（20.32±1.39）%低于对照组，差异有统计学意义（P<0.05）。治疗后观察组KPS评分（78.49±1.45）分较对照组显著增加，而其NRS评分（1.20±0.11）较对照组明显降低，差异有统计学意义（P<0.05）。观察组不良反应发生率（7.50%）明显低于对照组（25.00%），差异有统计学意义（P<0.05）。结论 西黄丸西黄丸联合紫杉醇和铂类新辅助化疗对晚期宫颈癌患者术后疗效较好，可改善其免疫功能、生活质量、疼痛度，减少不良反应，近期不会明显改善生存率及复发率，远期疗效需进一步研究。

Effect of Xihuang Pill on curative effect of paclitaxel combined with platinum based neoadjuvant chemotherapy in patients with advanced cervical cancer after operation

Objective To investigate the effect of Xihuang Pill on the curative effect of paclitaxel combined with platinum based neoadjuvant chemotherapy in patients with advanced cervical cancer after operation. Methods 80 cases of patients with advanced cervical cancer treated in our hospitalfrom January 2014 to January 2017 were enrolled in the study. By random number table method, the patients were divided into the observation group and the control group with 40 cases in each group, and all patients were treated with radical hysterectomy. After operation, the control group were treated with paclitaxel and platinum (cisplatin) based neoadjuvant chemotherapy, while the observation group were treated with Xihuang Pill and platinum based neoadjuvant chemotherapy. The effective rate of chemotherapy, survival rate and recurrence rate were compared between the two groups. The levels of T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺) and immunoglobulin (IgA, IgG, IgM) in two groups were determined before and after chemotherapy. The quality of life and cancer pain degree were evaluated with the Karnofsky Performance Scale (KPS) and the numeric rating scale (NRS), and adverse reactions were recorded. Results The effective rate of chemotherapy was slightly higher in the observation group than the control group (87.50% vs 77.50%). Three months and six months after chemotherapy, the survival rate and recurrence rate showed no significant difference between the two groups. After chemotherapy, percentages of CD3⁺ and CD4⁺, levels of IgA, IgG and IgM were significantly higher in the observation group than the control group (P<0.05), and the percentage of CD8⁺ was lower than the control group (P<0.05). After treatment, KPS score of the observation group was significantly higher than the control group, and NRS score was significantly lower than the control group (P<0.05). The incidence of adverse reactions was significantly lower in the observation group than the control group (7.50% vs 25.00%) (P<0.05). Conclusion Xihuang Pill combined with cisplatin based neoadjuvant chemotherapy is effective in the treatment of advanced cervical cancer after operation. The regimen can improve the immune function and quality of life, relieve pain degree and reduce adverse reactions. It will not increase the short-term survival rate and recurrence rate, and long-term efficacy needs further study.