[1]程 锐,张 琴,李霈瑶,等.益气健脾养胃煎加减辅助化疗治疗Ⅳ期胃癌及对患者预后生存的影响[J].陕西中医,2025,46(2):215-219.[doi:DOI:10.3969/j.issn.1000-7369.2025.02.014]
　CHENG Rui,ZHANG Qin,LI Peiyao,et al.Effect of Yiqi Jianpi Yangwei decoction in the treatment of stage Ⅳ gastric cancer with adjuvant chemotherapy and its impact on patient prognosis and survival[J].,2025,46(2):215-219.[doi:DOI:10.3969/j.issn.1000-7369.2025.02.014]
点击复制

益气健脾养胃煎加减辅助化疗治疗Ⅳ期胃癌及对患者预后生存的影响
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
46
期数:
2025年2期
页码:
215-219
栏目:
临床研究
出版日期:
2025-02-05

文章信息/Info

Title:
Effect of Yiqi Jianpi Yangwei decoction in the treatment of stage Ⅳ gastric cancer with adjuvant chemotherapy and its impact on patient prognosis and survival
作者:
程 锐; 张 琴; 李霈瑶; 蒲 锐
(南充市中医医院,四川 南充 637000)
Author(s):
CHENG Rui; ZHANG Qin; LI Peiyao; PU Rui
(Nanchong City Hospital of Traditional Chinese Medicine,Nanchong 637000,China)
关键词:
胃癌;  益气健脾养胃煎;  糖类抗原125;  γ干扰素;  白介素;  肿瘤坏死因子α
Keywords:
Gastric cancer;  Yiqi Jianpi Yangwei decoction;  Carbohydrate antigen 125;  Interferon-gamma;  Interleukin;  Tumor necrosis factor-α
分类号:
R 735.2
DOI:
DOI:10.3969/j.issn.1000-7369.2025.02.014
文献标志码:
A
摘要:
目的:探讨益气健脾养胃煎加减辅助化疗治疗Ⅳ期胃癌(脾气虚证)患者的效果及对预后生存的影响。方法:选取104例Ⅳ期胃癌(脾气虚证)患者,按照随机数字表法分为两组,每组各52例。对照组予以常规化疗,观察组在此基础上予以益气健脾养胃煎加减治疗,疗程2个月。观察两组疗效、治疗前后中医症候积分、肿瘤标志物[糖类抗原125(CA125)、糖类抗原199(CA199)/癌胚抗原(CEA)]、免疫炎症指标[γ-干扰素(IFN-γ)、白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)、IFN-γ/IL-4]、肠道微生态指标,随访结束后记录无进展生存率、总生存率。结果:观察组总有效率38.46%,高于对照组的19.23%(P<0.05); 相较于对照组,观察组治疗后中医症候积分更低(P<0.05); 观察组治疗后血清CA125、CA199、CEA低于对照组(P<0.05); 观察组治疗后IFN-γ、IFN-γ/IL-4高于对照组,IL-4、TNF-α低于对照组(P<0.05); 观察组治疗后革兰氏阳性杆菌高于对照组,革兰氏阴性杆菌、革兰氏阳性球菌低于对照组(P<0.05); 观察组无进展生存率、总生存率高于对照组(P<0.05)。结论:益气健脾养胃煎辅助化疗可降低Ⅳ期胃癌(脾气虚证)患者肿瘤标志物水平,调节炎症免疫,改善肠道微生态,对于提高临床疗效、改善预后具有积极作用。
Abstract:
Objective:To investigate the effect of Yiqi Jianpi Yangwei decoction in the treatment of patients with stage Ⅳ gastric cancer(spleen deficiency syndrome)and its impact on prognosis and survival.Methods:A total of 104 patients with stage Ⅳ gastric cancer(spleen deficiency syndrome)were selected,randomly divided into two groups,with 52 cases in each group.The control group received conventional chemotherapy,while the observation group received the modified Yiqi Jianpi Yangwei decoction on top of this,for a period of 2 months.The efficacy,TCM syndromes,tumor markers [Carbohydrate antigen 125(CA125),Carbohydrate antigen 19-9(CA199)/Carcinoembryonic antigen(CEA)],immune inflammatory indicators [interferon-gamma(IFN-γ),interleukin-4(IL-4),tumor necrosis factor-α(TNF-α),IFN-γ/IL-4],and intestinal microecological indicators were observed in both groups before and after treatment.The progression-free survival rate and overall survival rate were recorded after the follow-up.Results:The total effective rate of the observation group was 38.46%,was higher than control group(19.23%,P<0.05).Compare with control group,the score of TCM syndrome in the observation group after treatment was lower(P<0.05).compare with control group,the levels of serum CA125,CA199,and CEA in the observation group were lower(P<0.05).After treatment,compare with control group,the levels of IFN-γ and IFN-γ/IL-4 in the observation group were higher,while the levels of IL-4 and TNF-α were lower(P<0.05).The number of Gram-positive bacilli in the observation group was higher than that in the control group after treatment,while the number of Gram-negative bacilli and Gram-positive cocci was lower than control group(P<0.05).The progression-free survival rate and overall survival rate in the observation group were higher than those in the control group(P<0.05).Conclusion:Yiqi Jianpi Yangwei decoction can assist chemotherapy in reducing the level of tumor markers in patients with stage Ⅳ gastric cancer(spleen deficiency syndrome),regulate inflammation and immunity,improve intestinal microecology,and have a positive effect on strengthening clinical efficacy and improving prognosis.

参考文献/References:

[1] 董红旭,张彦斌,杨帆,等.AFP、CEA、CA125、CA19-9在胃癌腹膜转移诊断及预后评估中的应用[J].保健医学研究与实践,2023,20(12):70-75.
[2] AJANI J A,D'AMICO T A,BENTREM D J,et al.Gastric cancer,version 2.2022,NCCN clinical practice guidelines in oncology[J].J Natl Compr Canc Netw,2022,20(2):167-192.
[3] LIAO L Y,GUI Y Z,LI Q,et al.The signaling pathways and targets of natural products from traditional Chinese medicine treating gastric cancer provide new candidate therapeutic strategies[J].Biochim Biophys Acta Rev Cancer,2023,1878(6):1030-1036.
[4] 苏园园,刘宁宁,赖优莹,等.胃癌中医证型研究进展[J].陕西中医,2023,44(2):262-266.
[5] LI K,MA X Y,LI Z H,et al.A Natural peptide from a traditional chinese medicine has the potential to treat chronic atrophic gastritis by activating gastric stem cells[J].Adv Sci(Weinh),2024,11(20):562-567.
[6] 国家卫生健康委员会医政医管局.胃癌诊疗指南(2022年版)[J].中华消化外科杂志,2022,21(9):1137-1164.
[7] 张高来,闻新丽.基于联合辨证论治胃癌前病变临床思维与经验[J].陕西中医,2024,45(8):1101-1105.
[8] 朱晶,王琦苑,钱蓉,等.消痰散结方联合卡培他滨治疗晚期胃癌临床研究[J].陕西中医,2024,45(2):191-195.
[9] 郭博伟,殷晓霞,张凡.AFP、CEA、CA724、CA125联合胃蛋白酶原检测对早期胃癌的诊断价值[J].河北医药,2024,46(5):709-712.
[10] ZENG Y,JIN R U.Molecular pathogenesis,targeted therapies,and future perspectives for gastric cancer[J].Semin Cancer Biol,2022,86(3):566-582.
[11] 王颖,薛静辉,张姝媗,等.进展期胃癌中医证型的临床研究进展[J].癌症进展,2022,20(17):1747-1748,1752.
[12] 许晶,李冬云,吴洁雅,等.基于数据挖掘及生物信息学探讨中医药治疗晚期胃癌的用药规律和作用机制[J].中医药导报,2023,29(4):132-142.
[13] LU Y T,LIU H Y,YANG K,et al.A comprehensive update:Gastrointestinal microflora,gastric cancer and gastric premalignant condition,and intervention by traditional Chinese medicine[J].J Zhejiang Univ Sci B,2022,15(1):1-18.
[14] 胡玥,吴存恩,邵杰,等.益气健脾解毒方治疗中晚期胃癌疗效及对免疫功能和不良反应的影响[J].现代中西医结合杂志,2022,31(24):3463-3467.
[15] 李峻,顾春林.益气健脾中药并热灌注化疗联合TACE治疗胃癌肝转移的临床应用价值[J].西部中医药,2022,35(2):115-118.
[16] ZHANG Y,LOU Y N,WANG J B,et al.Research status and molecular mechanism of the traditional chinese medicine and antitumor therapy combined strategy based on tumor microenvironment[J].Front Immunol,2021,9(13):1562-1569.
[17] 杨培培,黄雯洁,宋思源,等.基于国家专利的中药复方治疗胃癌的用药规律研究[J].现代中西医结合杂志,2024,33(11):1531-1536.
[18] 魏思媛,刘云,孙琴,等.基于网络药理学研究白术-黄芪药对抗胃癌作用机制[J].现代中药研究与实践,2022,36(1):80-85.
[19] 张云亭,刘羽茜,蒋宗蓥,等.参苓白术散通过IκBα/NF-κB通路调控Lewis肺癌小鼠肿瘤自噬的研究[J].世界科学技术-中医药现代化,2022,24(4):1487-1494.
[20] XU H C,WANG S Q,JIANG Y W,et al.Poria cocos polysaccharide ameliorated antibiotic-associated diarrhea in mice via regulating the homeostasis of the gut microbiota and intestinal mucosal barrier[J].Int J Mol Sci,2023,11(2):1423-1427.
[21] 宋思源,舒鹏.基于网络药理学及体外实验验证研究茯苓-白术药对治疗胃癌的作用机制[J].世界中医药,2022,17(20):2836-2841.
[22] 王彪,谢雨宏,龙衍,等.从扶正固本探讨“三补”治疗去势抵抗性前列腺癌的临证思路[J].中国性科学,2023,32(12):116-119.
[23] HUANG K K,MA H,CHONG R H,et al.Spatiotemporal genomic profiling of intestinal metaplasia reveals clonal dynamics of gastric cancer progression[J].Cancer Cell,2023,11(12):2019-2037.
[24] SHARAFUTDINOV I,TEGTMEYER N,LINZ B,et al.A single-nucleotide polymorphism in Helicobacter pylori promotes gastric cancer development[J].Cell Host Microbe,2023,9(8):1345-1358.
[25] 于涵川,孟杨杨,王恩康,等.补中益气汤经肠道菌群的调控改善脾虚证的作用机制研究[J].中国中药杂志,2024,49(4):1028-1043.

相似文献/References:

[1]裴俊文,孙太振△,蒋立峰.基于对SGC7901细胞Survivin、Bcl2基因的调控 探讨益气化瘀散结方影响胃癌细胞增殖凋亡的作用机制*[J].陕西中医,2019,(4):411.
　PEI Junwen,SUN Taizhen,JIANG Lifeng..Study on the effect of Yiqi Huayu Sanjie decoction on the proliferation and apoptosis of gastric cancer cells based on the regulation of survivin and Bcl2 gene in SGC7901 cells[J].,2019,(2):411.
[2]高聪聪,范 筱,李 宁.益气健脾化积方对胃癌化疗疗效、患者安全性及预后影响的研究*[J].陕西中医,2019,(4):475.
[3]杨国强,闫强△.健脾解毒汤结合射频消融术治疗胃癌肝转移疗效研究[J].陕西中医,2019,(11):1510.
　YANG Guoqiang,YAN Qiang..Therapeutic effect of Jianpi Jiedu decoction combined with radiofrequency ablation on liver metastases from gastric cancer[J].,2019,(2):1510.
[4]马 婷,王品昊,朱 婕,等.行健汤联合穴位贴敷治疗进展期胃癌癌因性疲乏疗效及对患者免疫功能的影响*[J].陕西中医,2020,(10):1410.[doi:DOI:10.3969/j.issn.1000-7369.2020.10.019]
[5]宋成鑫,葛信国△,储 晶.养阴健脾散毒法辅助化疗治疗晚期胃癌临床研究*[J].陕西中医,2020,(11):1543.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.007]
　SONG Chengxin,GE Xinguo,CHU Jing..Advanced gastric cancer treated by the method of nourishing Yin and invigorating spleen and dispersing toxin[J].,2020,(2):1543.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.007]
[6]周 锐,马灏川,陈亚栋,等.针灸辅助治疗胃癌现状及展望[J].陕西中医,2021,(8):1150.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.040]
　ZHOU Rui,MA Haochuan,CHEN Yadong,et al.Review of acupuncture and moxibusition on gastric cancer[J].,2021,(2):1150.[doi:DOI:10.3969/j.issn.1000-7369.2020.08.040]
[7]孟 肖,张新庆,李 璐,等.培元益气汤改善气阴两虚证胃癌相关癌性疲乏及对患者免疫功能的影响[J].陕西中医,2023,(2):174.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.008]
　MENG Xiao,ZHANG Xinqing,LI Lu,et al.Peiyuan Yiqi decoction improves cancer-related fatigue of gastric cancer with deficiency of qi and yin and its effect on immune function[J].,2023,(2):174.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.008]
[8]苏园园,刘宁宁,赖优莹,等.胃癌中医证型研究进展[J].陕西中医,2023,(2):262.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.029]
　SU Yuanyuan,LIU Ningning,LAI Youying,et al.Progress in traditional Chinese medicine syndrome types research of gastric cancer[J].,2023,(2):262.[doi:DOI:10.3969/j.issn.1000-7369.2023.02.029]
[9]李琳婵,鱼麦侠,郝梅梅,等.调中化湿汤对胃癌小鼠炎症损伤干预机制[J].陕西中医,2023,(3):294.[doi:DOI:10.3969/j.issn.1000-7369.2023.03.005]
[10]熊 婷,薛川松,颜 晔.益气养血汤联合参芪扶正注射液治疗胃癌患者肿瘤相关性贫血疗效研究[J].陕西中医,2023,(8):1065.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.015]
　XIONG Ting,XUE Chuansong,YAN Ye.Effect of Yiqi Yangxue decoction combined with Shenqi Fuzheng injection on cancer related anemia in patients with gastric cancer[J].,2023,(2):1065.[doi:DOI:10.3969/j.issn.1000-7369.2023.08.015]

备注/Memo

备注/Memo:
[基金项目]四川省中医药管理局科研专题项目(2020CP0018)
更新日期/Last Update: 2025-02-08