藿苏养胃方联合XELOX化疗治疗晚期胃癌临床研究OA
Efficacy of Huosu Yangwei formula plus XELOX in advanced gastric cancer
目的:探讨藿苏养胃方联合 XELOX化疗治疗晚期胃癌的临床疗效.方法:选取符合纳入标准的晚期胃癌患者 70 例,随机分组为对照组(XELOX化疗)和试验组(在 XELOX化疗基础上联合藿苏养胃方),干预 2 周期后,比较两组治疗前后客观缓解率(ORR),疾病控制率(DCR),中医症状积分及中医证候疗效,KPS评分及疗效,血清学指标缺氧诱导因子-1α(HIF-1α)、血管内皮生成因子(VEGF)、基质金属蛋白酶-2(MMP-2)、MMP-9 及免疫功能CD4+、CD8+、CD4+/CD8+的变化,以及化疗相关不良反应的发生率.结果:研究最终两组未出现脱落或者缺失病例.治疗后试验组的 ORR为 14.3%,高于对照组的 ORR(8.6%),但差异无统计学意义(P>0.05).试验组DCR(82.9%)较对照组(60.0%)明显提高(P<0.05).中医症状方面,试验组较对照组在倦怠乏力、食欲不振、泄泻肠鸣、餐后饱胀、胃脘胀痛、肌肤甲错等评分更低,且中医证候疗效明显高于对照组(P<0.01).试验组KPS评分较对照组增加(P<0.05),且KPS评分疗效优于对照组(P<0.01).治疗后 HIF-1α、VEGF、MMP2、MMP9 的表达水平试验组较对照组明显下降(P<0.01).试验组较对照组治疗后 CD4+、CD4+/CD8+细胞比例显著上升,CD8+明显下降(P<0.01).治疗后两组均发生了一定的化疗相关不良反应,但试验组在恶心呕吐、肝肾功能减退、便秘、疲乏、口干舌燥、食欲减退、周围神经毒性等方面的发生率显著低于对照组(P<0.05).结论:藿苏养胃方联合XELOX化疗能够提高晚期胃癌的临床有效率,减轻患者的临床症状,并缓解化疗相关的不良反应,从而与化疗药物协同产生减毒增效的作用.
Objective:To investigate the clinical efficacy of Huosu Yangwei formula combined with XELOX chemotherapy in the treatment of advanced gastric cancer.Methods:Seventy patients with advanced gastric cancer meeting the inclusion criteria were selected and randomly divided into a control group(treated with XELOX chemo-therapy)and an experimental group(treated with Huosu Yangwei Formula combined with XELOX chemotherapy on the basis of the control group).After 2 cycles of intervention,the objective response rate(ORR),disease control rate(DCR),TCM symptom scores,TCM syndrome efficacy,Karnofsky Performance Status(KPS)scores and efficacy were compared between the two groups before and after treatment.Changes in serological indicators including hypox-ia-inducible factor-1α(HIF-1α),vascular endothelial growth factor(VEGF),matrix metalloproteinase-2(MMP-2),MMP-9,and immune function markers(CD4+,CD8+,CD4+/CD8+ratio)were also analyzed,as well as the inci-dence of chemotherapy-related adverse reactions.Results:No cases were lost to follow-up or missing in either group by the end of the study.After treatment,the ORR of the experimental group(14.3%)was higher than that of the control group(8.6%),but the difference was not statistically significant(P>0.05).The DCR of the experimental group(82.9%)was significantly higher than that of the control group(60.0%,P<0.05).Regarding TCM symp-toms,the experimental group had lower scores than the control group in fatigue,poor appetite,diarrhea with borbo-rygmus,postprandial fullness,epigastric distension and pain,and rough and dry skin,and the TCM syndrome efficacy was significantly superior to the control group(P<0.01).The KPS score of the experimental group increased com-pared with the control group(P<0.05),and the efficacy of KPS score was better than that of the control group(P<0.01).After treatment,the expression levels of HIF-1α,VEGF,MMP-2,and MMP-9 in the experimental group were significantly lower than those in the control group(P<0.01).Compared with the control group,the experi-mental group showed a significant increase in the proportions of CD4+cells and CD4+/CD8+ratio,and a significant decrease in CD8+cells after treatment(P<0.01).Certain chemotherapy-related adverse reactions occurred in both groups after treatment,but the incidence rates of nausea and vomiting,liver and kidney function impairment,consti-pation,fatigue,dry mouth,decreased appetite,and peripheral neurotoxicity in the experimental group were signifi-cantly lower than those in the control group(P<0.05).Conclusion:Huosu Yangwei Formula combined with XELOX chemotherapy can improve the clinical effective rate of advanced gastric cancer,alleviate patients'clinical symptoms,and reduce chemotherapy-related adverse reactions,thereby achieving a synergistic effect of reducing tox-icity and enhancing efficacy with chemotherapeutic drugs.
HAN Ming;ZHANG Nan;ZHENG Qinwei;FANG Shuangshuang;WANG Hongwei;NI Hongmei;FANG Shengquan
Yueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medi-cine,Shanghai 200437,ChinaYueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medi-cine,Shanghai 200437,ChinaYueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medi-cine,Shanghai 200437,ChinaYueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medi-cine,Shanghai 200437,ChinaYueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medi-cine,Shanghai 200437,ChinaSchool of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,ChinaYueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medi-cine,Shanghai 200437,China
医药卫生
晚期胃癌藿苏养胃方化疗侵袭转移
Advanced Gastric cancerHuosu Yangwei formulaChemotherapyInvasionMetastasis
《陕西中医》 2026 (1)
48-53,6
国家重点研发计划项目(2024YFC3505303)国家自然科学基金青年科学基金资助项目(82505495)上海市进一步加快中医药传承创新发展三年行动计划项目(1-1-2)上海市级医院消化内科临床能力促进与提升专科联盟建设项目(SHDC22021311)上海中医药大学附属岳阳中西医结合医院大学科建设项目(QY71.42.02)上海中医药大学附属岳阳中西医结合医院中医专科建设项目[YW(2025-2026)-03-07]上海中医药大学科技发展项目(24KFL080)
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