化疗联合中药胰岩消方加减治疗胰腺癌腹膜转移的临床观察
Clinical observation on chemotherapy combined with modified Yiyanxiao Formula in treating patients of pancreatic cancer with peritoneal metastasis
- 上海中医药大学学报 2023年37卷第1期 页码：17-22
- 作者机构：
1.上海中医药大学附属岳阳中西医结合医院（上海 200437）
2.上海中医药大学（上海 201203）
- 作者简介：
李富龙，女，在读博士生，副主任医师，主要从事中西医结合防治消化系统疾病的临床与基础研究
方盛泉，主任医师，博士生导师；E-mail： fsq20032003@163.com
- 基金信息：上海市自然科学基金资助项目(20ZR1459300);上海申康医院发展中心临床研究培育项目(SHDC12018X30);上海中医药大学附属岳阳中西医结合医院科研项目(2019YY201)
DOI：10.16306/j.1008-861x.2023.01.003
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李富龙,秦艺文,王宏伟等.化疗联合中药胰岩消方加减治疗胰腺癌腹膜转移的临床观察[J].上海中医药大学学报,2023,37(01):17-22.
LI Fulong,QIN Yiwen,WANG Hongwei,et al.Clinical observation on chemotherapy combined with modified Yiyanxiao Formula in treating patients of pancreatic cancer with peritoneal metastasis[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2023,37(01):17-22.
李富龙,秦艺文,王宏伟等.化疗联合中药胰岩消方加减治疗胰腺癌腹膜转移的临床观察[J].上海中医药大学学报,2023,37(01):17-22. DOI： 10.16306/j.1008-861x.2023.01.003.
LI Fulong,QIN Yiwen,WANG Hongwei,et al.Clinical observation on chemotherapy combined with modified Yiyanxiao Formula in treating patients of pancreatic cancer with peritoneal metastasis[J].Academic Journal of Shanghai University of Traditional Chinese Medicine,2023,37(01):17-22. DOI： 10.16306/j.1008-861x.2023.01.003.
摘要
目的,2,观察化疗联合胰岩消方加减治疗胰腺癌腹膜转移患者的临床疗效。,方法,2,纳入68例胰腺癌腹膜转移患者，随机分为对照组和治疗组，每组各34例。两组患者均予吉西他滨静脉滴注结合顺铂腹腔灌注化疗， 21 d为1个疗程，共治疗2个疗程。在此基础上，治疗组患者予以胰岩消方加减口服。治疗前后检测并比较两组患者的肿瘤标志物［包括糖类抗原199（CA199）、癌胚抗原（CEA）、糖类抗原125（CA125）］及炎性细胞因子［包括白介素-1β（IL-1β）、肿瘤坏死因子-α（TNF-α）、IL-6］水平；评价两组患者的临床疗效；比较两组患者的中医症状总积分和不良反应发生率。,结果,2,①治疗后，治疗组和对照组的疾病控制率分别为64.7%、44.1%，治疗组的疾病控制率高于对照组（,P,<,0.05）；治疗组和对照组的疾病缓解率分别为8.8%、5.9%，两组比较差异无统计学意义（,P,>,0.05）。②治疗后，两组患者的中医症状总积分较治疗前均降低（,P,<,0.05），且治疗组患者的积分低于对照组（,P,<,0.05）。③治疗后，两组患者的CA199、CEA水平较治疗前均明显降低（,P,<,0.05），且治疗组患者的CA199水平低于对照组（,P,<,0.05）。④治疗后，两组患者的IL-1β、IL-6水平较治疗前均降低（,P,<,0.05），治疗组患者的TNF-α水平较治疗前亦降低（,P,<,0.05），且治疗组患者的IL-1β、IL-6水平低于对照组（,P,<,0.05）。⑤治疗过程中，治疗组的不良反应发生率为44.1%，对照组为76.5%，治疗组的不良反应发生率明显低于对照组（,P,<,0.05）。,结论,2,化疗联合中药胰岩消方加减治疗胰腺癌腹膜转移患者，可有效抑制肿瘤标志物及炎性细胞因子表达，改善患者的临床症状，提高疾病控制率，降低化疗不良反应发生率。
Abstract
Objective： To observe the clinical efficacy of chemotherapy combined with modified Yiyanxiao Formula in the treatment of pancreatic cancer with peritoneal metastasis.,Methods,2,Sixty-eight patients of pancreatic cancer with peritoneal metastasis were enrolled and randomly divided into the control group and treatment group， 34 cases in each group. The patients in both groups were treated with gemcitabine intravenous drip combined with cisplatin intraperitoneal perfusion chemotherapy. Twenty-one was a course of treatment and a total of two courses of treatment was performed. Based on above， the patients in the treatment group were treated with modified Yiyanxiao Formula orally. Before and after treatment， the levels of the tumor markers including carbohydrate antigen 199 （CA199）， carcinoembryonic antigen （CEA） and carbohydrate antigen 125 （CA125）， and the inflammatory cytokines including interleukin-1β（IL-1β）， tumor necrosis factor-α （TNF-α） and IL-6 in the two groups were detected and compared. The clinical efficacy of the two groups was evaluated. The total scores of traditional Chinese medical symptoms and the incidence of adverse reactions were compared between the two groups.,Results,2,①After treatment， the disease control rates of the treatment group and the control group were 64.7% and 44.1% respectively， and the disease control rate of the treatment group was higher than that of the control group （,P,<,0.05）. The disease remission rates of the treatment group and the control group were 8.8% and 5.9% respectively， with no statistically significant difference between the two groups （,P,>,0.05）. ②After treatment， the total scores of traditional Chinese medical symptoms in both groups were decreased compared with those before treatment （,P,<,0.05）， and the score of the patient in the treatment group was lower than that in the control group （,P,<,0.05）. ③After treatment， the levels of CA199 and CEA in the two groups were significantly decreased compared with those before treatment （,P,<,0.05）， and the level of CA199 in the treatment group was lower than that in the control group （,P,<,0.05）. ④After treatment， the levels of IL-1β and IL-6 in the two groups were decreased compared with those before treatment （,P,<,0.05）， the level of TNF-α in the treatment group was also decreased compared with that before treatment （,P,<,0.05）， and the levels of IL-1β and IL-6 in the treatment group were lower than those in the control group （,P,<,0.05）. ⑤During the treatment， the incidence of adverse reactions was 44.1% in the treatment group and was 76.5% in the control group. The incidence of adverse reactions in the treatment group was significantly lower than that in the control group （,P,<,0.05）.,Conclusion,2,Chemotherapy combined with modified Yiyanxiao Formula can effectively inhibit the expressions of tumor markers and inflammatory cytokines in the treatment of patients of pancreatic cancer with peritoneal metastasis， improve the clinical symptoms of the patients， increase the disease control rate， and decrease the incidence of adverse reactions of chemotherapy.
关键词
胰腺癌腹膜转移腹腔灌注化疗胰岩消方中西医结合
Keywords
pancreatic cancerperitoneal metastasisintraperitoneal perfusion chemotherapyYiyanxiao Formulaintegrated traditional Chinese and western medicine
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