本文關(guān)鍵詞： 大腸癌 復(fù)方斑蝥膠囊 免疫功能 化療　出處：《福建中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：觀察復(fù)方斑蝥膠囊聯(lián)合化療對(duì)大腸癌術(shù)后脾虛血瘀證患者的生活質(zhì)量、免疫功能及化療毒副反應(yīng)方面的影響,以期為中醫(yī)藥在大腸癌術(shù)后輔助化療的治療方面累積一些經(jīng)驗(yàn)。方法：將60例符合入選標(biāo)準(zhǔn)的大腸癌術(shù)后患者隨機(jī)分為治療組和對(duì)照組各30例。對(duì)照組予FOLFOX4方案化療,治療組在給予FOLFOX4方案化療同時(shí)服用復(fù)方斑蝥膠囊,每次3粒,每日2次,兩組均觀察兩個(gè)周期(28天)。各組病人治療前、后予抽血檢查細(xì)胞免疫功能(包括CD3+、CD4+、CD8+、CD4+/CD8+、NK細(xì)胞)以及體液免疫功能(IgA、IgG、IgM)。試驗(yàn)結(jié)束后予評(píng)價(jià)療效,包括免疫學(xué)指標(biāo)、中醫(yī)證候積分、KPS評(píng)分變化及化療藥物的毒副反應(yīng)。結(jié)果：①治療后,兩組CD3+較治療前雖稍有升高,但兩組間無差異(P0.05)。治療后,治療組CD4+、NK細(xì)胞均明顯升高(P0.01),對(duì)照組稍下降,兩組間比較,差異顯著(P0.01)。治療后,治療組CD8+較治療前降低(P0.05),對(duì)照組下降不明顯,兩組相比,差異顯著(P0.01)。治療組治療后CD4+/CD8+明顯升高(P0.01),對(duì)照組升高不明顯,兩組治療后比較,差異顯著(P0.01)。②治療后,兩組IgA變化均不明顯,無差異(P0.05)。治療后,兩組IgG較治療前均明顯升高(P0.01),但兩組間無差異(P0.05)。治療組治療后IgM明顯升高(P0.01),對(duì)照組變化不明顯,治療后兩組相比,有差異(P0.05)。③治療后,治療組KPS評(píng)分明顯升高(P0.01),對(duì)照組稍下降(P0.05),兩組治療后相比,治療組KPS評(píng)分明顯高于對(duì)照組(P0.01)。兩組KPS評(píng)分療效評(píng)價(jià),治療組改善病例數(shù)明顯高于對(duì)照組,有統(tǒng)計(jì)學(xué)差異(P0.05)。④在中醫(yī)證候積分方面,治療組改善率優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。⑤在白細(xì)胞減少及惡心、嘔吐方面,治療組發(fā)生率明顯低于對(duì)照組,兩組比較有差異(P0.05)。結(jié)論：復(fù)方斑蝥膠囊能改善大腸癌術(shù)后化療患者的免疫功能,提高患者的生活質(zhì)量,并能減輕化療藥物所致毒副反應(yīng),有利于提高患者對(duì)術(shù)后輔助化療的依從性,改善大腸癌術(shù)后患者的預(yù)后,具有一定的臨床價(jià)值。
[Abstract]:Objective: to observe the effect of compound cantharidae capsule combined with chemotherapy on the quality of life, immune function and side effects of chemotherapy in patients with spleen deficiency and blood stasis syndrome after operation of colorectal cancer. In order to accumulate some experience for Chinese medicine in the treatment of postoperative adjuvant chemotherapy for colorectal cancer. Methods:. Sixty patients with colorectal cancer were randomly divided into treatment group (n = 30) and control group (n = 30). The control group received FOLFOX4 regimen chemotherapy. The treatment group was treated with FOLFOX4 regimen chemotherapy while taking compound cantharidae capsule, 3 capsules twice a day, the two groups were observed two cycles of 28 days. Before treatment, the patients in each group were treated. The cellular immune function (including CD4 / CD8 / CD8 / NK cells of CD3) and humoral immune function (IgA) were examined. To evaluate the curative effect after the test, including immunological index, KPS score of TCM syndromes and toxicity of chemotherapeutic drugs. CD3 in the two groups was slightly higher than that before treatment, but there was no difference between the two groups (P 0.05). After treatment, the NK cells of CD4 in the treatment group were significantly higher than those in the control group, while those in the control group were slightly decreased. After treatment, the CD8 of the treatment group was lower than that of the pre-treatment group (P 0.05), while that of the control group was not significantly lower than that of the two groups. The difference was significant (P 0.01). The CD4 / CD8 ratio in the treatment group was significantly higher than that in the control group (P 0.01), and there was no significant difference between the two groups after treatment. There was no significant difference in IgA between the two groups after treatment (P 0.01). After treatment, IgG in both groups was significantly higher than that before treatment (P 0.01). However, there was no difference between the two groups (P 0.05). The IgM of the treatment group was significantly higher than that of the control group after treatment, but the change of the control group was not obvious. After treatment, there was a difference between the two groups after treatment. The KPS score of the treatment group was significantly higher than that of the control group (P 0.01), and that of the control group was lower than that of the control group (P 0.05). The KPS score in the treatment group was significantly higher than that in the control group (P 0.01). The curative effect of the two groups was evaluated by KPS score. The number of improved cases in the treatment group was significantly higher than that in the control group. The improvement rate of treatment group was better than that of control group, and the difference was statistically significant in leukopenia, nausea and vomiting. The incidence of the treatment group was significantly lower than that of the control group, there was a difference between the two groups P0.05.Conclusion: compound cantharidae capsule can improve the immune function of patients with colorectal cancer after chemotherapy, improve the quality of life of patients. It can alleviate the side effects caused by chemotherapeutic drugs, improve the compliance of patients with postoperative adjuvant chemotherapy, and improve the prognosis of patients with colorectal cancer after operation, which has certain clinical value.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R735.34

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