沈迪 郜妙

摘 要 目的：探讨益气化瘀解毒法联合化疗对晚期胃癌和肠癌患者的临床疗效和生活质量的影响。方法：将53例晚期胃癌和12例肠癌患者随机分为对照组（n=33）和观察组（n=32），对照组给以奥沙利铂+卡培他滨联合化疗方案，观察组在对照的基础上根据中医辨证的结果应用益气化瘀解毒法治疗，比较两组疗效。结果：治疗后，观察组中医证候积分、生命质量核心量表评分、肿瘤坏死因子-a水平、肿瘤标志物水平以及不良反应发生率均低于对照组；生活质量评分、白细胞计数高于对照组（P<0.05）。结论：益气化瘀解毒法联合化疗对胃肠道恶性肿瘤患者疗效确切，能改善患者的生活质量。

关键词 益气化瘀解毒法 化疗 晚期胃癌 肠癌 生活质量 免疫功能

中图分类号：R289.5； R735 文献标志码：B 文章编号：1006-1533（2024）03-0028-05

引用本文 沈迪， 郜妙. 益气化瘀解毒法联合化疗治疗晚期胃肠道恶性肿瘤的临床观察[J]. 上海医药， 2024， 45（3）： 28-32.

Clinical observation of the chemotherapy combined with the TCM therapy of replenishing Qi， resolving stasis and detoxification for the treatment of advanced gastrointestinal malignant tumors

SHEN Di， GAO Miao

（Department of Oncology， Yangzhou Jiangdu Hospital of Chinese Medicine， Yangzhou 225299， China）

ABSTRACT Objective： To explore the clinical efficacy and quality of life of the chemotherapy combined with the traditional Chinese medicine （TCM） named replenishing Qi， resolving stasis and detoxification in the treatment of the patients with advanced gastric and intestinal cancers. Methods： Fifty-three patients with advanced gastric cancer and twelve patients with intestinal cancer were randomly divided into a control group （n=33） and an observation group （n=32）. The control group was given an oxaliplatin+capecitabine combination chemotherapy program， and the observation group was treated with the TCM therapy of replenishing Qi， resolving stasis and detoxification according to the results of TCM identification based on the control group. The efficacy was compared between the two groups. Results： After treatment， the TCM evidence points， quality of life core scale scores， levels of tumor necrosis factor-a， levels of tumor markers， and the incidence of adverse reactions were lower， and the scores of quality of life and white blood cell count were higher in the observation group than the control group （all P<0.05）. Conclusion： The TCM therapy of replenishing Qi， resolving stasis and detoxification combined with chemotherapy is effective in patients with gastrointestinal malignant tumors and can improve the quality of life of the patients.

KEY WORDS the TCM therapy of replenishing Qi， resolving stasis and detoxification； chemotherapy； advanced gastric cancer； intestinal cancer； quality of life； immune function

胃腸道恶性肿瘤是临床常见的恶性肿瘤，主要包括胃癌和肠癌。其中胃癌是发病率最高的胃肠道恶性肿瘤，占所有恶性肿瘤的6.8%，5年生存率往往不到30%。肠癌也是一种常见的胃肠道恶性肿瘤，是发病率上升较快的恶性肿瘤，晚期胃癌以及肠癌等胃肠道恶性肿瘤患者由于胃肠功能受到肿瘤的影响，往往伴有营养不良、消瘦、贫血等症状[1-2]。化疗是胃肠道恶性肿瘤治疗常用的方法[3]，通过化疗能延长患者的生存期，但化疗后会出现白细胞计数下降、呕吐、便秘等不良反应，严重降低了患者的生活质量[4]。对于胃肠道恶性肿瘤尤其是胃癌晚期患者，西医常采用奥沙利铂、卡培他滨、紫杉醇、氟尿嘧啶和拓扑异构酶Ⅰ抑制剂等药物进行治疗[5]，这些化疗药物应用时往往需要联合中药使用以提高疗效、防止不良反应的发生。……