补中益气汤联合FOLFIRI方案化疗对结直肠癌患者免疫功能及炎症反应的影响

doi:10.3969/j.issn.1004-583X.2021.08.011

摘要/Abstract

摘要：

目的探讨补中益气汤联合FOLFIRI方案化疗治疗结直肠癌的效果。方法选择2016年1月至2020年1月在我院诊治的结直肠癌患者80例,按治疗方案的不同分为两组。对照组行FOLFIRI方案化疗,观察组则在前者治疗方案中联合补中益气汤治疗。观察并分析两组治疗前后免疫功能指标、炎症因子水平变化以及血常规、肝肾功能变化情况,治疗后临床疗效、生活质量评分情况。结果观察组总有效率明显高于对照组(P<0.05);治疗后,两组CD3⁺、CD4⁺、CD4⁺/CD8⁺水平较治疗前均有所升高,且观察组升高程度高于对照组(P<0.05);治疗后,两组血浆淀粉样蛋白(SAA)、C反应蛋白(CRP)较治疗前有所升高,且观察组升高程度低于对照组(P<0.05);治疗后,两组血小板计数及白细胞计数较治疗前均有所降低,且观察组下降幅度低于对照组(P<0.05);两组治疗前后肝功能无明显变化(P>0.05)。治疗后,两组血肌酐水平较治疗前有所降低,且观察组明显低于对照组 (P<0.05);治疗后,两组生活质量均有一定改善,且观察组明显高于对照组(P<0.05);治疗后,观察组不良反应发生率低于对照组(P<0.05)。结论 FOLFIRI方案化疗在结直肠癌患者中有良好的治疗效果,配合补中益气汤,能够进一步改善患者免疫功能,降低炎症反应,提高其生活质量,减少不良反应,是一种安全、有效、可行的治疗方案。

关键词: 补中益气汤, FOLFIRI方案, 结直肠肿瘤, 免疫功能, 炎症反应

Abstract:

Objective To analyze the application effect of Buzhong Yiqi Decoction Combined with FOLFIRI chemotherapy in the treatment of colorectal cancer. Methods 80 patients with colorectal cancer in our hospital from January 2016 to January 2020 were selected and divided into two groups according to different treatment schemes. The control group was treated with FOLFIRI chemotherapy, while the observation group was treated with Buzhong Yiqi Decoction. Immune function index, inflammatory factor level, blood routine, liver and kidney function, clinical efficacy and quality of life score between groups before and after treatment were observed and analyzed.Results After treatment, total effective rate was significantly higher in observation group than in control group (P<0.05); significantly higher CD3⁺, CD4⁺, CD4⁺/CD8⁺ level were detected in groups and increase degree in observation group was even higher (P<0.05); significantly higher serum amyloid A(SAA) and C-reactive protein(CRP) in groups and the decline of which in observation group were lower than in control group (P<0.05); significantly lower platelet count and white blood cell count in groups were detected, which were more common to see in observation group (P<0.05); difference is no significant in liver function between groups before and after treatment (P>0.05). significantly decreased serum creatinine level in groups were detected and decreased degree in observation group was even lower (P<0.05); the quality of life and in groups were significantly improved and which in observation group were better (P<0.05); compared with control group, adverse reaction in observation group were lower (P<0.05). Conclusion FOLFIRI chemotherapy has a good therapeutic effect for patients with colorectal cancer; when combined with Buzhong Yiqi Decoction, it can further improve immunity and inflammatory reaction, improve quality of their life, reduce adverse reaction, which is a safe and effective and feasible for treatment.

Key words: buzhong yiqi decoction, FOLFIRI regimen, colorectal neoplasms, immunity, inflammatory reaction

中图分类号:

R735.34

李培培, 曹旸, 王海存, 兑伟华. 补中益气汤联合FOLFIRI方案化疗对结直肠癌患者免疫功能及炎症反应的影响[J]. 临床荟萃, 2021, 36(8): 730-734.

Li Peipei, Cao Yang, Wang Haicun, Dui Weihua. Effect of Buzhong Yiqi Decoction combined with FOLFIRI chemotherapy on immunity and inflammation in patients with colorectal cancer[J]. Clinical Focus, 2021, 36(8): 730-734.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2021.08.011

https://huicui.hebmu.edu.cn/CN/Y2021/V36/I8/730

图/表 7

参考文献 22

[1]	许晓东. FOLFIRI标准化疗方案联合贝伐单抗治疗转移性结直肠癌疗效与不良反应分析[J]. 现代诊断与治疗, 2017, 28(21):3921-3924.
[2]	张康梅, 郑智, 赖敏栋. 扶正消积方联合FOLFIRI化疗方案治疗晚期结直肠癌的效果及安全性[J]. 中国当代医药, 2020, 27(26):48-50.
[3]	李穗华, 胡楚璇, 范翠苗, 等. 贝伐珠单抗联合一线化疗方案治疗晚期转移性结直肠癌的效果[J]. 中国当代医药, 2019, 26(33):136-138, 142.
[4]	王月, 邓玲慧, 陆文斌, 等. 转移性结直肠癌患者应用贝伐株单抗联合FOLFIRI化疗方案治疗的临床价值[J]. 医学理论与实践, 2017, 30(11):1620-1622.
[5]	李明权. 艾迪注射液联合FOLFIRI方案治疗晚期结直肠癌的临床疗效[J]. 临床合理用药杂志, 2018, 11(3):73-74.
[6]	李伍祥, 侯恩存, 郑景辉, 等. 艾迪注射液联合FOLFIRI方案治疗晚期结直肠癌的疗效及安全性Meta分析[J]. 中医临床研究, 2019, 11(14):141-146.
[7]	吴金朋. FOLFIRI方案对晚期结直肠癌近期疗效和毒副反应分析[J]. 临床医药文献电子杂志, 2017, 11(37):149.
[8]	葛小红. XELIRI与FOLFIRI方案治疗晚期结直肠癌疗效及不良反应比较[J]. 临床合理用药杂志, 2019, 12(34):100-102.
[9]	李晓辉, 李丁伟, 初黎明, 等. FOLFOX方案与FOLFIRI方案治疗晚期结直肠癌的效果分析[J]. 中国肛肠病杂志, 2019, 39(12):11-13.
[10]	周学文. 结直肠癌化疗患者采用补中益气汤加减治疗对其便秘症状的改善效果分析[J]. 数理医药学杂志 2019, 32(8):1224-1225.
[11]	刘笑彤, 胡晓天, 周诩栋, 等. 补中益气汤对化疗性大鼠消化道不良反应的防治效果及机制探讨[J]. 中国中医基础医学杂志, 2019, 25(11):1537-1540.
[12]	杨昌卫, 朱政, 陈永强, 等. 补中益气汤改善晚期恶性肿瘤患者癌因性疲乏的临床探讨[J]. 中医临床研究, 2018, 10(7):80-82.
[13]	王翠英. 用补中益气汤联合FOLFOX4方案对晚期直肠癌患者进行治疗的效果[J]. 当代医药论丛, 2017, 15(18):191-192.
[14]	杜秀英. 肠癌术后应用补中益气汤的临床价值分析[J]. 中国医药指南, 2018, 16(6):200-201.
[15]	李小妹, 顾艳, 杨柳. FOLFIRI联合艾迪注射液治疗晚期结直肠癌的疗效及对免疫功能的影响[J]. 癌症进展, 2018, 16(10):69-72.
[16]	闫成秋, 包晗. 补中益气汤在直肠癌术后腹泻患者治疗中的应用价值[J]. 中国保健营养, 2020, 30(30) 30:349.
[17]	朱回福. 补中益气汤对慢性结肠炎患者炎性因子水平的影响[J]. 湖北中医杂志, 2020, 42(11):12-14.
[18]	汪耔璇, 李烜. 补中益气汤联合化疗治疗晚期结直肠癌临床研究[J]. 陕西中医, 2020, 41(10):1414-1417.
[19]	Stintzing S, Oostrum I V, Pescott C P, et al. Cost-effectiveness of FOLFIRI+cetuximab vs FOLFIRI+bevacizumab in the first-line treatment of RAS wild-type metastatic colorectal cancer in Germany: Data from the FIRE-3 (AIO KRK-0306) study[J]. J Med Econ, 2020, 23(5):448-455. doi: 10.1080/13696998.2019.1709848 URL
[20]	Guo W, Zhang X, Wang Y, et al. FOLFIRI versus irinotecan monodrug as second-line treatment in metastatic colorectal cancer patients: An open, multicenter, prospective, randomized controlled phase Ⅲ clinical study[J]. J Clin Oncol, 2020, 38(15 suppl):4038-4038. doi: 10.1200/JCO.2020.38.15_suppl.4038 URL
[21]	Amrane K, Ollivier L, Salaun P Y, et al. Complete metabolic response assessed by FDG PET/CT to FOLFIRI-aflibercept in second-line treatment of metastatic colorectal cancer[J]. Clin Nucl Med, 2019, 44(7):578-579. doi: 10.1097/RLU.0000000000002611 pmid: 31107745
[22]	栗国梁. 补中益气汤对中晚期恶性肿瘤化疗后不良反应改善的临床研究[J]. 山西中医学院学报, 2018, 19(2):32-34.

组别	例数	CD3⁺		CD4⁺		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	40	60.36±3.86	66.86±3.85^*	31.16±2.68	37.56±2.85^*	1.33±0.21	1.52±0.16^*
对照组	40	60.26±3.85	64.53±3.74^*	31.18±2.56	35.74±2.73^*	1.34±0.22	1.38±0.13^*
t值		0.116	2.746	0.034	2.917	0.208	4.295
P值		0.908	0.001	0.973	0.001	0.836	0.001

组别	例数	CD3⁺		CD4⁺		CD4⁺/CD8⁺
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	40	60.36±3.86	66.86±3.85^*	31.16±2.68	37.56±2.85^*	1.33±0.21	1.52±0.16^*
对照组	40	60.26±3.85	64.53±3.74^*	31.18±2.56	35.74±2.73^*	1.34±0.22	1.38±0.13^*
t值		0.116	2.746	0.034	2.917	0.208	4.295
P值		0.908	0.001	0.973	0.001	0.836	0.001

组别	例数	SAA		CRP
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	40	7.48±5.62	14.26±4.35^*	7.39±5.16	8.26±4.68^*
对照组	40	7.39±5.46	18.49±5.13^*	7.41±5.23	11.09±4.81^*
t值		0.073	3.678	0.017	2.667
P值		0.942	0.001	0.986	0.001

组别	例数	SAA		CRP
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	40	7.48±5.62	14.26±4.35^*	7.39±5.16	8.26±4.68^*
对照组	40	7.39±5.46	18.49±5.13^*	7.41±5.23	11.09±4.81^*
t值		0.073	3.678	0.017	2.667
P值		0.942	0.001	0.986	0.001

组别	例数	血小板计(×10⁹/L)		白细胞计数(×10⁹/L)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	40	284.39±65.18	320.26±65.16^*	6.41±1.33	6.08±1.26^*
对照组	40	285.46±66.25	290.58±64.89^*	6.50±1.36	6.86±1.34^*
t值		0.073	2.041	0.299	2.682
P值		0.942	0.045	0.766	0.009