关键词: 胃肿瘤, 药物疗法, 细胞因子类, 丁蔻理中汤

Abstract: Objective To investigate the effects of Dingkoulizhong decoction on cellular immune factors and adverse reactions in patients with advanced gastric cancer treated with chemotherapy. MethodsOne hundred and thirtyeight patients with advanced gastric cancer were enrolled in our hospital from October 2014 to December 2016, and were randomly divided into control group (n=69) and observation group (n=69) by using the random number table. The patients of the control group were treated with FOLFOX4 chemotherapy (oxaliplatin + calcium folinate + fluorouracil), while the patients of the observation group were given by the treatment of Dingkoulizhong decoction on the basis of the control group. The peripheral blood samples of the patients were collected before and after the treatment. The levels of cellular immune factors CD3+, CD4+, CD8+ and CD4+/CD8+ were detected, and the clinical efficacy and adverse reactions of the patients of the two groups were observed. Results After the treatment, the number of complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD) in the observation group were 16, 25, 16 and 12 cases respectively, while the control group were 9, 20, 19 and 21 cases respectively, and there was a statistically significant difference in the distribution of clinical efficacy between the two groups (Z=4.381, P=0.036). Compared with the control group, the clinical benefit rate (CBR) of the observation group was significantly improved (59.42% vs. 42.03%), with a statistically significant difference (χ2=4.175, P=0.041). The cellular immune factors CD3+［(52.67±6.21)% vs. (53.45±6.54)%］, CD4+［(23.56±3.85)% vs. (24.09±2.91)%］, CD8+［(28.16±3.49)% vs. (27.87±3.26)%］ and CD4+/CD8+ (1.13±0.27 vs. 1.19±0.31) of the patients of the observation group showed no statistically significant difference (t=0.718, P=0.474; t=0.912, P=0.363; t=0.504, P=0.615; t=1.212, P=0.227) before and after the treatment, but the cellular immune factor CD3+［(50.36±3.74)% vs. (53.13±6.12)%］, CD4+［(21.26±2.37)% vs. (23.44±3.96)%］ and CD4+/CD8+ (0.96±0.26 vs. 1.15±0.25) of the patients of the control group after the treatment were significantly lower than those before the treatment, and CD8+［(31.64±4.05)% vs. (27.98±3.52)%］ after the treatment was significantly higher than that before the treatment, all with statistically significant differences (t=3.208, P＜0.001; t=3.924, P＜0.001; t=4.289 P＜0.001, t=5.666, P＜0.001). Compared with the control group, the level of CD3+［(53.45±6.54)% vs. (50.36±3.74)%］, CD4+［(24.09±2.91)% vs. (21.26±2.37)%］ and CD4+/CD8+ (1.19±0.31 vs. 0.96±0.26) of the patients of the observation group after the treatment were significantly improved, and CD8+［(27.87±3.26)% vs. (31.64±4.05)%］ was significantly decreased, all with statistically significant differences (t=3.407, P=0.001; t=6.264, P＜0.001; t=4.722, P＜0.001; t=6.023, P＜0.001). Compared with the control group, the total adverse reaction rate of the observation group was significantly decreased (36.23% vs. 55.07%), with a statistically significant difference (χ2=4.936, P=0.026). Conclusion Dingkoulizhong decoction can significantly improve the clinical efficacy in patients with advanced gastric cancer treated with chemotherapy, alleviate the immune function damage caused by chemotherapy, and it can reduce the occurrence of adverse reactions.

Key words: Stomach neoplasms, Drug therapy, Cytokines, Dingkoulizhong decoction