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益脾化瘀汤对胃癌患者化疗期间肿瘤标志物、免疫功能及不良反应的影响:一项回顾性倾向评分匹配研究

Effects of Yipi Huayu decoction on tumor markers, immune function, and adverse reactions during chemotherapy in gastric cancer patients: a retrospective propensity score-matched study.

作者信息

Zhang Mingchang, Cuan Junning, Wang Wenjing, Guo Yan, Zhao Jianfang

机构信息

Department of Traditional Chinese Medicine, Baoji Maternal and Child Health Hospital (Daijiawan Branch) Baoji 721000, Shaanxi, China.

Department of Gastroenterology, Third People's Hospital of Gansu Province Lanzhou 730020, Gansu, China.

出版信息

Am J Transl Res. 2024 Aug 15;16(8):3599-3613. doi: 10.62347/SRHB1100. eCollection 2024.

Abstract

OBJECTIVE

To analyze the effects of Yianpi Huayu Decoction on tumor markers, immune function and adverse reactions during chemotherapy in patients with gastric cancer.

METHOD

The clinical data of 154 patients with progressive gastric cancer who attended Baoji Maternal and Child Health Hospital (Daijiawan Branch) from January 2020 to March 2022 were retrospectively analyzed. The patients were divided into an observation group (61 cases) and a control group (93 cases) according to the treatment method and were matched using propensity score matching (PSM). The control group was given SOX neoadjuvant chemotherapy regimen (oxaliplatin + tiglio), and the observation group was given spleen-strengthening and blood-stasis-reducing tonics as adjuvant treatment on the basis of the treatment given to the control group. Clinical efficacy in the two groups was observed, as well as Carbohydrate Antigen 19-9 (CA19-9), Carbohydrate Antigen 72-4 (CA72-4), and Carcinoembryonic Antigen (CEA) levels, immune function (IgA, IgM, and IgG), Karnofsky Performance Scale (KPS), and occurrence of adverse reactions.

RESULTS

After matching, there was no significant difference in the total clinical efficiency between the two groups (P > 0.05). After matching, there were no differences in CA19-9, CA72-4, and CEA levels between the observation group and the control group before or after treatment (P > 0.05). After matching, the IgA, IgM, and IgG levels in the observation group were significantly better than those in the control group after treatment (P < 0.05). The incidence of leukopenia (P = 0.011) and diarrhea (P = 0.011) during treatment was higher in the control group than in the observation group after matching. The KPS score of the observation group was higher than that of the control group after matching (P < 0.05). After matching, Cox regression analysis found that the treatment regimen (P < 0.001, HR = 2.527), TNM staging (P = 0.001, HR = 0.471), local recurrence (P = 0.001, HR = 2.147), and pretreatment CEA (P = 0.011, HR = 1.131) were independent prognostic factors affecting patients' 2-year survival.

CONCLUSION

While the spleen-enhancing and blood-stasis-removing herbal formula combined with the SOX chemotherapy regimen did not improve therapeutic outcomes in gastric cancer patients, it did enhance immune function, reduce adverse reactions, and improve quality of life.

摘要

目的

分析益脾化瘀汤对胃癌患者化疗期间肿瘤标志物、免疫功能及不良反应的影响。

方法

回顾性分析2020年1月至2022年3月在宝鸡市妇幼保健院(代家湾分院)就诊的154例进展期胃癌患者的临床资料。根据治疗方法将患者分为观察组(61例)和对照组(93例),采用倾向评分匹配法(PSM)进行匹配。对照组给予SOX新辅助化疗方案(奥沙利铂+替吉奥),观察组在对照组治疗基础上加用健脾化瘀滋补剂作为辅助治疗。观察两组的临床疗效、糖类抗原19-9(CA19-9)、糖类抗原72-4(CA72-4)、癌胚抗原(CEA)水平、免疫功能(IgA、IgM和IgG)、卡氏功能状态评分(KPS)及不良反应发生情况。

结果

匹配后,两组总临床有效率差异无统计学意义(P>0.05)。匹配后,观察组与对照组治疗前后CA19-9、CA72-4及CEA水平差异均无统计学意义(P>0.05)。匹配后,观察组治疗后IgA、IgM和IgG水平均显著优于对照组(P<0.05)。匹配后,对照组治疗期间白细胞减少(P=0.011)和腹泻(P=0.011)的发生率高于观察组。观察组匹配后的KPS评分高于对照组(P<0.05)。匹配后,Cox回归分析发现治疗方案(P<0.001,HR=2.527)、TNM分期(P=0.001,HR=0.471)、局部复发(P=0.001,HR=2.147)及治疗前CEA(P=0.011,HR=1.131)是影响患者2年生存的独立预后因素。

结论

健脾化瘀中药方联合SOX化疗方案虽未改善胃癌患者的治疗效果,但可增强免疫功能,减少不良反应,提高生活质量。

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