摘要
目的观察中医健脾法配合FOLFOX化疗方案对结肠癌术后患者癌因性疲乏、Th1/Th2免疫应答平衡及周围神经病变的影响。方法将84例行结肠癌根治术的患者随机分为对照组和观察组,每组42例。对照组术后给予FOLFOX方案化疗和西药保肝、止吐、升白等对症支持治疗,观察组在对照组基础上给予中医健脾方药内服。分别于治疗前及治疗3个周期、6个周期后,采用简明疲乏量表(BFI)评价2组癌因性疲乏情况,检测2组外周血Th1细胞因子IL-2、IFN-γ水平和Th2细胞因子IL-4、IL-10水平,根据奥沙利铂Levi专用感觉神经分级标准判定周围神经病变级别。结果治疗3个周期、6个周期后,观察组BFI评分均显著低于对照组(P均<0.05)。对照组治疗3个周期后IFN-γ水平明显高于治疗前(P<0.05);治疗6个周期后IL-2和IFN-γ水平明显高于治疗前(P均<0.05),IL-4和TNF-α平明显低于治疗前(P均<0.05)。观察组治疗3个周期和6个周期后IL-2和IFN-γ水平明显高于治疗前及同时间点对照组(P均<0.05),IL-4和TNF-α水平明显低于治疗前及同时间点对照组(P均<0.05),周围神经病变的发生率明显低于对照组(P<0.05)。结论中医健脾法可以有效减轻结肠癌患者术后接受FOLFOX化疗方案引起的癌因性疲乏和周围神经病变,可能与其维持机体Th1/Th2免疫应答平衡有关。
Objective It is to observe the influence of traditional Chinese medicine invigorating spleen combined with FOLFOX chemotherapy on cancer related fatigue,Th1/Th2immune response balance and peripheral neuropathy in patients with colon cancer after operation.Methods84patients who underwent radical resection of colon cancer were randomly divided into control group and observation group,there were42cases in each group.The control group was given FOLFOX chemotherapy and symptomatic and supportive treatmentwith Western medicine for hepatoprotective,antiemetic,leukogenic,the observation group was given oral administration of traditional Chinese medicine invigorating spleen decoction on the basis of the control group.Before treatment and after treatment for3cycles and6cycles,the cancer related fatigue in the two groups were assessed by brief fatigue scale(BFI)respectively;the levels of Th1cytokines IL2,IFNγ,and the levels of Th2cytokines IL4,IL10,and the sensory conduction velocity(SCV)in two groups were detected;the grade of peripheral neuropathy was judged according to the standard of sensory nerve grading of oxaliplatin Levi.Results After treatment for3cycles and6cycles,the BFI scores of the observation group were significantly lower than those of the control group(all P<0.05).The IFNγlevel in the control group after3cycles of treatment was significantly higher than that before treatment(P<0.05);after6cycles of treatment,the levels of IL2and IFNγwere significantly higher than those before treatment(all P<0.05),the levels of IL4and TNFαwere significantly lower than before treatment(all P<0.05).After treatment for3cycles and6cycles,the levels of IL2and IFNγin the observation group were significantly higher than those before the treatment and at the same time point as the control group(all P<0.05),and the levels of IL4and TNFαwere significantly lower than those before treatment and at the same time point as control group(all P<0.05),the incidence of peripheral neuropathy was significantly lower than that of the co
作者
毛竹君
祝利民
卢艳琳
沈克平
MAO Zhujun;ZHU Limin;LU Yanlin;SHEN Keping(The Affiliated Hospital of Longhua Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200011, China)
出处
《现代中西医结合杂志》
CAS
2017年第36期4024-4027,4036,共5页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
结肠癌
化疗
癌因性疲乏
T辅助细胞
周围神经病变
colon cancer
chemotherapy
cancer related fatigue
T helper cells
peripheral neuropathy
