作者：郭玉玉，郁沙莎，徐晓婉，翟笑枫

单位：中国人民解放军海军军医大学第一附属医院中医肿瘤科，上海 200083

Authors: Guo Yuyu, Yu Shasha, Xu Xiaowan, Zhai Xiaofeng

Unit:  Department of Traditional Chinese Medicine Oncology, First Affiliated Hospital of Second Military Medical University of the People's Liberation Army, Shanghai 200083, China

摘要：

目的  探讨通关藤口服液联合多西他赛（docetaxel, DXT）-奈达铂（nedaplatin, NDP）方案治疗中晚期食管癌的临床疗效。方法  选取2020年2月至2023年3月中国人民解放军海军军医大学第一附属医院收治的中晚期食管癌患者64例，采用随机数字表法将患者分为化疗组（n=32）和综合组（n=32），化疗组进行DXT-NDP方案化疗，综合组在化疗组治疗方案的基础上给予通关藤口服液，两组均连续治疗2个周期。比较两组临床疗效、中医证候积分、细胞免疫功能、生活质量及毒副反应发生情况。结果  综合组的客观缓解率较化疗组高（P＜0.05）。治疗后，两组主症、次症及总分的中医证候积分下降，综合组更低（P＜0.05）。治疗前、后，两组CD8+ T细胞计数差异无统计学意义（P＞0.05）；与治疗前相比，治疗后两组CD4+ T细胞、CD4+/CD8+、CD3-CD16+CD56+及CD3+CD16+CD56+自然杀伤细胞水平升高，治疗后综合组的CD4+ T细胞、CD4+/CD8+、CD3-CD16+CD56+及CD3+CD16+CD56+自然杀伤细胞水平高于同时间点的化疗组（P＜0.05）。治疗后，两组Karnofsky功能状态评分和生活质量评估表评分较治疗前升高，治疗后综合组Karnofsky功能状态评分和生活质量评估表评分高于同时间点的化疗组（P＜0.05）。与化疗组相比，综合组Ⅰ+Ⅱ级胃肠道反应和肝肾功能损伤及骨髓抑制的发生率、肝肾功能损伤和胃肠道反应的总发生率均较低（P＜0.05）。结论  将通关藤口服液联合DXT-NDP 方案运用到中晚期食管癌治疗中可显著提高疗效，缓解临床症状，提高机体免疫功能，进而提升患者生活质量，并能减少毒副反应的发生。

关键词： 食管癌；化疗；通关藤口服液；临床疗效

Abstract：

Objective   To investigate the clinical effect of Tongguanteng oral liquid combined with docetaxel (DXT) and nedaplatin (NDP) regimen in the treatment of middle and advanced esophageal cancer. Method  64 patients with middle and advanced esophageal cancer admitted to the First Affiliated Hospital of Second Military Medical University of the People's Liberation Army during February 2020 to March 2023 were selected. They were divided into chemotherapy group (n=32) and comprehensive group (n=32) using the random number table method. The chemotherapy group was treated with DXT-NDP regimen, and the comprehensive group was treated with Tongguanteng oral liquid combined with DXT -NDP regimen. Both groups received treatment for 2 consecutive cycles. The clinical efficacy, Traditional Chinese medicine (TCM) syndrome score, cellular immune function, quality of life and toxic side effects were compared between the 2 groups. Result  The objective remission rate of the comprehensive group was higher than that of the chemotherapy group (P<0.05). After treatment, the scores of TCM syndrome of main disease, secondary disease and total score decreased in 2 groups, while the sores of comprehensive group were lower (P<0.05). There was no statistical difference in CD8+ T cells level between the 2 groups before and after treatment (P>0.05). Compared with before treatment, the levels of CD4+ T cells, CD4+/CD8+, CD3-CD16+CD56+ and CD3+ CD16+CD56+ natural killer cells were increased in 2 groups after treatment, and the levels of comprehensive group were higher than those of chemotherapy group at the same time point after treatment(P<0.05). After treatment, the scores of Karnofsky performance scale and quality of life questionnaire-C30 in 2 groups were higher than those before treatment, while the sores of comprehensive group were higher than those of chemotherapy group at the same time point after treatment (P<0.05). Compared with chemotherapy group, the incidence of grade Ⅰ+Ⅱgastrointestinal reaction, liver and kidney function injury, myelosuppression, and the total incidence of liver and kidney function injury and gastrointestinal reaction were lower in comprehensive group (P<0.05). Conclusion  The application of Tongguanteng oral liquid combined with DXT-NDP regimen in the treatment of middle and advanced esophageal cancer can significantly improve the curative effect, alleviate clinical symptoms, improve the immune function of the body, thus improve the quality of life of patients, and reduce the occurrence of toxic side effects.

Key Words:  Esophageal cancer; Chemotherapy; Tongguanteng oral liquid; Clinical effect

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