复方斑蝥胶囊联合化疗对大肠癌术后脾虚血瘀证患者的临床研究

发布时间：2018-01-31 19:33

本文关键词： 大肠癌复方斑蝥胶囊免疫功能化疗　出处：《福建中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：观察复方斑蝥胶囊联合化疗对大肠癌术后脾虚血瘀证患者的生活质量、免疫功能及化疗毒副反应方面的影响,以期为中医药在大肠癌术后辅助化疗的治疗方面累积一些经验。方法：将60例符合入选标准的大肠癌术后患者随机分为治疗组和对照组各30例。对照组予FOLFOX4方案化疗,治疗组在给予FOLFOX4方案化疗同时服用复方斑蝥胶囊,每次3粒,每日2次,两组均观察两个周期(28天)。各组病人治疗前、后予抽血检查细胞免疫功能(包括CD3+、CD4+、CD8+、CD4+/CD8+、NK细胞)以及体液免疫功能(IgA、IgG、IgM)。试验结束后予评价疗效,包括免疫学指标、中医证候积分、KPS评分变化及化疗药物的毒副反应。结果：①治疗后,两组CD3+较治疗前虽稍有升高,但两组间无差异(P0.05)。治疗后,治疗组CD4+、NK细胞均明显升高(P0.01),对照组稍下降,两组间比较,差异显著(P0.01)。治疗后,治疗组CD8+较治疗前降低(P0.05),对照组下降不明显,两组相比,差异显著(P0.01)。治疗组治疗后CD4+/CD8+明显升高(P0.01),对照组升高不明显,两组治疗后比较,差异显著(P0.01)。②治疗后,两组IgA变化均不明显,无差异(P0.05)。治疗后,两组IgG较治疗前均明显升高(P0.01),但两组间无差异(P0.05)。治疗组治疗后IgM明显升高(P0.01),对照组变化不明显,治疗后两组相比,有差异(P0.05)。③治疗后,治疗组KPS评分明显升高(P0.01),对照组稍下降(P0.05),两组治疗后相比,治疗组KPS评分明显高于对照组(P0.01)。两组KPS评分疗效评价,治疗组改善病例数明显高于对照组,有统计学差异(P0.05)。④在中医证候积分方面,治疗组改善率优于对照组,差异有统计学意义(P0.05)。⑤在白细胞减少及恶心、呕吐方面,治疗组发生率明显低于对照组,两组比较有差异(P0.05)。结论：复方斑蝥胶囊能改善大肠癌术后化疗患者的免疫功能,提高患者的生活质量,并能减轻化疗药物所致毒副反应,有利于提高患者对术后辅助化疗的依从性,改善大肠癌术后患者的预后,具有一定的临床价值。
[Abstract]:Objective: to observe the effect of compound cantharidae capsule combined with chemotherapy on the quality of life, immune function and side effects of chemotherapy in patients with spleen deficiency and blood stasis syndrome after operation of colorectal cancer. In order to accumulate some experience for Chinese medicine in the treatment of postoperative adjuvant chemotherapy for colorectal cancer. Methods:. Sixty patients with colorectal cancer were randomly divided into treatment group (n = 30) and control group (n = 30). The control group received FOLFOX4 regimen chemotherapy. The treatment group was treated with FOLFOX4 regimen chemotherapy while taking compound cantharidae capsule, 3 capsules twice a day, the two groups were observed two cycles of 28 days. Before treatment, the patients in each group were treated. The cellular immune function (including CD4 / CD8 / CD8 / NK cells of CD3) and humoral immune function (IgA) were examined. To evaluate the curative effect after the test, including immunological index, KPS score of TCM syndromes and toxicity of chemotherapeutic drugs. CD3 in the two groups was slightly higher than that before treatment, but there was no difference between the two groups (P 0.05). After treatment, the NK cells of CD4 in the treatment group were significantly higher than those in the control group, while those in the control group were slightly decreased. After treatment, the CD8 of the treatment group was lower than that of the pre-treatment group (P 0.05), while that of the control group was not significantly lower than that of the two groups. The difference was significant (P 0.01). The CD4 / CD8 ratio in the treatment group was significantly higher than that in the control group (P 0.01), and there was no significant difference between the two groups after treatment. There was no significant difference in IgA between the two groups after treatment (P 0.01). After treatment, IgG in both groups was significantly higher than that before treatment (P 0.01). However, there was no difference between the two groups (P 0.05). The IgM of the treatment group was significantly higher than that of the control group after treatment, but the change of the control group was not obvious. After treatment, there was a difference between the two groups after treatment. The KPS score of the treatment group was significantly higher than that of the control group (P 0.01), and that of the control group was lower than that of the control group (P 0.05). The KPS score in the treatment group was significantly higher than that in the control group (P 0.01). The curative effect of the two groups was evaluated by KPS score. The number of improved cases in the treatment group was significantly higher than that in the control group. The improvement rate of treatment group was better than that of control group, and the difference was statistically significant in leukopenia, nausea and vomiting. The incidence of the treatment group was significantly lower than that of the control group, there was a difference between the two groups P0.05.Conclusion: compound cantharidae capsule can improve the immune function of patients with colorectal cancer after chemotherapy, improve the quality of life of patients. It can alleviate the side effects caused by chemotherapeutic drugs, improve the compliance of patients with postoperative adjuvant chemotherapy, and improve the prognosis of patients with colorectal cancer after operation, which has certain clinical value.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R735.34

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