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1.承德医学院 附属医院,河北 承德 067002
2.唐山市工人医院,河北 唐山 063000
白璐,硕士,主治医师,从事肿瘤疾病的防治工作, E-mail:xiaojiaoyabailu@sina.com
李青山,硕士生导师,主任医师,从事肿瘤疾病的防治工作, E-mail:libing200865@126.com
收稿日期:2020-12-03,
网络出版日期:2020-12-30,
纸质出版日期:2021-06-05
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白璐,苏锐,权兴苗等.八珍汤加减对胃癌新辅助化疗患者营养状况和免疫功能的影响[J].中国实验方剂学杂志,2021,27(11):117-122.
BAI Lu,SU Rui,QUAN Xing-miao,et al.Effect of Modified Bazhentang on Nutritional Status and Immune Function of Gastric Cancer Patients with Neoadjuvant Chemotherapy[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(11):117-122.
白璐,苏锐,权兴苗等.八珍汤加减对胃癌新辅助化疗患者营养状况和免疫功能的影响[J].中国实验方剂学杂志,2021,27(11):117-122. DOI: 10.13422/j.cnki.syfjx.20210431.
BAI Lu,SU Rui,QUAN Xing-miao,et al.Effect of Modified Bazhentang on Nutritional Status and Immune Function of Gastric Cancer Patients with Neoadjuvant Chemotherapy[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(11):117-122. DOI: 10.13422/j.cnki.syfjx.20210431.
目的
2
观察八珍汤加减对胃癌新辅助化疗(NAC)气血两虚证患者营养状况和免疫功能的影响。
方法
2
将110例患者按随机数字表法分为观察组和对照组各55例。两组患者均按FOLFOX6方案治疗。对照组口服健脾生血片,3片/次,3次/d;观察组内服八珍汤加减,1剂/d;两组疗程均为6周。进行治疗前后主观整体评估量表(PG-SGA),气血两虚证,Piper疲乏修订量表(PFS-R)评分;检测治疗前后血清总蛋白(TB),白蛋白(ALB),前白蛋白(PAB),CD4
+
,CD8
+
,辅助性T淋巴细胞17(Th17),调节性T细胞(Treg)和免疫球蛋白G(IgG),IgM,IgA水平;测量治疗前后体质量指数(BMI),去脂肪体质量指数(FFMI),记录体质量丢失量;进行抗癌药物急性或亚急性毒性反应评估。
结果
2
观察组营养不良程度低于对照组(
Z
=2.401,
P
<
0.01);观察组TB,ALB,PAB水平均高于对照组(
P
<
0.01);观察组CD4
+
,Treg和CD4
+
/CD8
+
均高于对照组(
P
<
0.01),CD8
+
,Th17和Th17/Treg均低于对照组(
P
<
0.01);观察组IgM,IgA水平均高于对照组(
P
<
0.01);观察组PG-SGA评分和体质量丢失均低于对照组(
P
<
0.01);观察组BMI,FFMI均高于对照组(
P
<
0.05),PFS-R和气血两虚证评分均低于对照组(
P
<
0.01);观察组恶心呕吐发生率45.45%(25/55),低于对照组的65.45%(36/55)(
χ
2
=4.452,
P
<
0.05)。
结论
2
八珍汤加减内服辅助用于胃癌NAC患者,可改善营养状况和免疫功能,促进免疫平衡,减轻临床症状和疲劳程度,降低化疗不良反应,值得临床使用。
Objective
2
To observe the effect of modified Bazhentang on the nutritional status and immune function of patients with Qi and blood deficiency syndrome in neoadjuvant chemotherapy (NAC) for gastric cancer.
Method
2
One hundred and ten patients were randomly divided into observation group and control group with 55 cases each. Both groups accepted FOLFOX6 protocol. Patients in control group took Jianpi Shengxue tablets orally, 3 tablets/time, 3 times/day. Patients in observation group received modified Bazhentang, 1 dose/day. The course of treatment was six weeks in both groups. Before and after treatment, scores were graded according to patient generated-subjective global assessment (PG-SGA), Qi and blood deficiency syndrome, and the Revised Piper Fatigue Scale (PFS-R). Levels of serum total protein (TB), albumin (ALB), prealbumin (PAB), CD4
+
, CD8
+
, helper T lymphocyte 17 (Th17), regulatory T cell (Treg), immunoglobulin G (IgG), IgM, and IgA were detected before and after therapy. Body mass index (BMI) and fat free mass index (FFMI) were measured before and after treatment. Weight loss was recorded, and the acute or subacute toxicity of anticancer drugs was evaluated.
Result
2
The degree of malnutrition in the observation group was lower than that in the control group (
Z
=2.401,
P
<
0.01). The levels of TB, ALB and PAB in the observation group were higher than those in the control group (
P
<
0.01). The CD4
+
, Treg and CD4
+
/CD8
+
levels in the observation group were higher than those in the control group (
P
<
0.01). The CD8
+
, Th17 and Th17/Treg levels were lower than those in the control group (
P
<
0.01). Besides, the levels of IgM and IgA in the observation group were higher than those in the control group (
P
<
0.01). The PG-SGA score and weight loss in the observation group were lower than those in the control group (
P
<
0.01). The BMI and FFMI data of the observation group were higher than those of the control group (
P
<
0.05). The scores of PFS-R and Qi-blood deficiency syndrome were lower than those of the control group (
P
<
0.01). The incidence of nausea and vomiting in the observation group was 45.45% (25/55), lower than 65.45% (36/55) in the control group (
χ
2
=4.452,
P
<
0.05).
Conclusion
2
Modified Bazhentang can be used to assist gastric cancer patients with NAC, which can improve nutritional status and immune function, promote immune balance, reduce clinical symptoms and fatigue, and reduce chemotherapy toxicity and side effects, so it is worthy of clinical use.
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