[1]韩明,张楠,郑沁薇,等.藿苏养胃方联合XELOX化疗治疗晚期胃癌临床研究[J].陕西中医,2026,(1):48-53.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.008]
　HAN Ming,ZHANG Nan,ZHENG Qinwei,et al.Efficacy of Huosu Yangwei formula plus XELOX in advanced gastric cancer[J].,2026,(1):48-53.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.008]
点击复制

藿苏养胃方联合XELOX化疗治疗晚期胃癌临床研究

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年1期
页码:
48-53
栏目:
临床研究
出版日期:
2026-01-05

文章信息/Info

Title:
Efficacy of Huosu Yangwei formula plus XELOX in advanced gastric cancer
作者:
韩明1; 张楠1; 郑沁薇1; 方霜霜1; 王宏伟1; 倪红梅2; 方盛泉1
（1.上海中医药大学附属岳阳中西医结合医院消化内科，上海 200437；2.上海中医药大学中医学院，上海 201203）
Author(s):
HAN Ming1; ZHANG Nan1; ZHENG Qinwei1; FANG Shuangshuang1; WANG Hongwei1; NI Hongmei2; FANG Shengquan1
（1.Yueyang Hospital of Integrative Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China; 2.School of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China）
关键词:
晚期胃癌; 藿苏养胃方; 化疗; 侵袭; 转移
Keywords:
Advanced Gastric cancer; Huosu Yangwei formula; Chemotherapy; Invasion; Metastasis
分类号:
R 737.31
DOI:
DOI:10.3969/j.issn.1000-7369.2026.01.008
文献标志码:
A
摘要:
目的：探讨藿苏养胃方联合XELOX化疗治疗晚期胃癌的临床疗效。方法：选取符合纳入标准的晚期胃癌患者70例，随机分组为对照组（XELOX化疗）和试验组（在XELOX化疗基础上联合藿苏养胃方），干预2周期后，比较两组治疗前后客观缓解率(ORR），疾病控制率（DCR），中医症状积分及中医证候疗效，KPS评分及疗效，血清学指标缺氧诱导因子-1α(HIF-1α)、血管内皮生成因子（VEGF）、基质金属蛋白酶-2(MMP-2)、MMP-9及免疫功能CD4+、CD8+、CD4+/CD8+的变化，以及化疗相关不良反应的发生率。结果：研究最终两组未出现脱落或者缺失病例。治疗后试验组的ORR为14.3%，高于对照组的ORR（8.6%），但差异无统计学意义（P＞0.05）。试验组DCR（82.9%）较对照组（60.0%）明显提高（P＜0.05）。中医症状方面，试验组较对照组在倦怠乏力、食欲不振、泄泻肠鸣、餐后饱胀、胃脘胀痛、肌肤甲错等评分更低，且中医证候疗效明显高于对照组（P＜0.01）。试验组KPS评分较对照组增加（P＜0.05），且KPS评分疗效优于对照组（P＜0.01）。治疗后HIF-1α、VEGF、MMP2、MMP9的表达水平试验组较对照组明显下降（P＜0.01）。试验组较对照组治疗后CD4+、CD4+/CD8+细胞比例显著上升，CD8+明显下降（P＜0.01）。治疗后两组均发生了一定的化疗相关不良反应，但试验组在恶心呕吐、肝肾功能减退、便秘、疲乏、口干舌燥、食欲减退、周围神经毒性等方面的发生率显著低于对照组（P＜0.05）。结论：藿苏养胃方联合XELOX化疗能够提高晚期胃癌的临床有效率，减轻患者的临床症状，并缓解化疗相关的不良反应，从而与化疗药物协同产生减毒增效的作用。
Abstract:
Objective:To investigate the clinical efficacy of Huosu Yangwei formula combined with XELOX chemotherapy in the treatment of advanced gastric cancer.Methods:Seventy patients with advanced gastric cancer meeting the inclusion criteria were selected and randomly divided into a control group (treated with XELOX chemotherapy) and an experimental group (treated with Huosu Yangwei Formula combined with XELOX chemotherapy on the basis of the control group).After 2 cycles of intervention,the objective response rate (ORR),disease control rate (DCR),TCM symptom scores,TCM syndrome efficacy,Karnofsky Performance Status (KPS) scores and efficacy were compared between the two groups before and after treatment.Changes in serological indicators including hypoxia-inducible factor-1α (HIF-1α),vascular endothelial growth factor (VEGF),matrix metalloproteinase-2 (MMP-2),MMP-9,and immune function markers (CD4+,CD8+,CD4+/CD8+ ratio) were also analyzed,as well as the incidence of chemotherapy-related adverse reactions.Results:No cases were lost to follow-up or missing in either group by the end of the study.After treatment,the ORR of the experimental group (14.3%) was higher than that of the control group (8.6%),but the difference was not statistically significant (P>0.05).The DCR of the experimental group (82.9%) was significantly higher than that of the control group (60.0%,P<0.05).Regarding TCM symptoms,the experimental group had lower scores than the control group in fatigue,poor appetite,diarrhea with borborygmus,postprandial fullness,epigastric distension and pain,and rough and dry skin,and the TCM syndrome efficacy was significantly superior to the control group (P<0.01).The KPS score of the experimental group increased compared with the control group (P<0.05),and the efficacy of KPS score was better than that of the control group (P<0.01).After treatment,the expression levels of HIF-1α,VEGF,MMP-2,and MMP-9 in the experimental group were significantly lower than those in the control group (P<0.01).Compared with the control group,the experimental group showed a significant increase in the proportions of CD4+ cells and CD4+/CD8+ ratio,and a significant decrease in CD8+ cells after treatment (P<0.01).Certain chemotherapy-related adverse reactions occurred in both groups after treatment,but the incidence rates of nausea and vomiting,liver and kidney function impairment,constipation,fatigue,dry mouth,decreased appetite,and peripheral neurotoxicity in the experimental group were significantly lower than those in the control group (P<0.05).Conclusion:Huosu Yangwei Formula combined with XELOX chemotherapy can improve the clinical effective rate of advanced gastric cancer,alleviate patients' clinical symptoms,and reduce chemotherapy-related adverse reactions,thereby achieving a synergistic effect of reducing toxicity and enhancing efficacy with chemotherapeutic drugs.

参考文献/References:

[1]BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2024,74(3):229-263.
[2]SUNDAR R,NAKAYAMA I,MARKAR S R,et al.Gastric cancer[J].Lancet,2025,405(10494):2087-2102.
[3]QI J,LI M,WANG L,et al.National and subnational trends in cancer burden in China,2005-20:An analysis of national mortality surveillance data[J].Lancet Public Health,2023,8(12):943-955.
[4]解亦斌,田艳涛.我国晚期胃癌临床特点及诊治策略[J].中华医学杂志,2018,98(24):1897-1898.
[5]FITZMAURICE C,ALLEN C,BARBER R M,et al.Global,regional,and national cancer incidence,mortality,years of life lost,years lived with disability,and disability-adjusted life-years for 32 cancer groups,1990 to 2015:A systematic analysis for the global burden of disease study[J].JAMA Oncol,2017,3(4):524-548.
[6]LI C,TIAN Y,ZHENG Y,et al.Pathologic response of phase III study:Perioperative camrelizumab plus rivoceranib and chemotherapy versus chemotherapy for locally advanced gastric cancer (dragon Ⅳ/cap 05)[J].J Clin Oncol,2025,43(4):464-474.
[7]ZHANG X,WANG J,WANG G,et al.First-line sugemalimab plus chemotherapy for advanced gastric cancer:The GEMSTONE-303 randomized clinical trial[J].JAMA,2025,333(15):1305-1314.
[8]LUO D,LIU Y,LU Z,et al.Targeted therapy and immunotherapy for gastric cancer:Rational strategies,novel advancements,challenges,and future perspectives[J].Mol Med,2025,31(1):52.
[9]吴霖光缙,王婷,宋和平,等.四君子汤加减联合化疗对脾虚型晚期胃癌患者预后影响的双向队列研究[J].中医杂志,2022,63(4):341-348.
[10]陈媛媛,潘棋,任玲,等.益气养阴解毒方联合低剂量替吉奥治疗高龄晚期胃癌(气阴亏虚型)的临床观察[J].辽宁中医杂志,2025,52(2):111-114.
[11]ZHANG M,DING Y,HU S,et al.Transcriptomics and systems network-based molecular mechanism of herbal formula Huosu-Yangwei inhibited gastric cancer in vivo[J].J Ethnopharmacol,2023,316:116674.
[12]FANG S Q,LIU Y H,ZHAO K P,et al.Transcriptional profiling and network pharmacology analysis identify the potential biomarkers from Chinese herbal formula Huosu Yangwei Formula treated gastric cancer in vivo[J].Chin J Nat Med,2021,19(12):944-953.
[13]赵堃鹏,张惠惺,张彩云,等.藿苏养胃口服液治疗胃癌的作用机制研究[J].上海中医药大学学报,2021,35(1):112-120.
[14]李富龙,秦艺文,王宏伟,等.藿苏养胃口服液联合SOX化疗方案干预晚期胃癌的临床研究[J].上海中医药大学学报,2023,37(1):23-30.
[15]朱俊燃,方盛泉,陈启龙,等.藿苏养胃口服液联合SOX方案治疗晚期胃癌的临床观察[J].上海中医药杂志,2021,55(4):50-54.
[16]中华人民共和国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.
[17]GREENE F L,EDGE S,SCHILSKY R L,et al.Ajcc cancer staging manual 8th edition[M].Springer,2018：203-218.
[18]胃癌中西医结合诊疗指南标准化项目组.胃癌中西医结合诊疗指南（2023年）[J].中国中西医结合杂志,2024,44(3):261-272.
[19]林洪生.恶性肿瘤中医诊疗指南[M].北京:人民卫生出版社,2014：200-204.
[20]PARK Y H,KIM B,RYOO B,et al.A phase Ⅱ study of capecitabine plus 3-weekly oxaliplatin as first-line therapy for patients with advanced gastric cancer[J].Br J Cancer,2006,94(7):959-963.
[21]KU G,SHEN L,DAYYANI F,et al.A first-in-human study of givastomig,a cldn18.2 and 4-1bb bispecific antibody,as monotherapy in patients with CLDN18.2-positive advanced or metastatic solid tumors[J].Clin Cancer Res,2025,31(23):4944-4952.
[22]EISENHAUER E A,THERASSE P,BOGAERTS J,et al.New response evaluation criteria in solid tumours:Revised RECIST guideline(version 1.1)[J].Eur J Cancer,2009,45(2):228-247.
[23]国家食品药品监督管理总局.中药新药临床研究指导原则 [M].北京:中国医药科技出版社,2002:402.
[24]KARIMI P,ISLAMI F,ANANDASABAPATHY S,et al.Gastric cancer:Rescriptive epidemiology,risk factors,screening,and prevention[J].Cancer Epidem Biomar,2014,23(5):700-713.
[25]LI W,NG J M,WONG C C,et al.Molecular alterations of cancer cell and tumour microenvironment in metastatic gastric cancer[J].Oncogene,2018,37(36):4903-4920.
[26]ZHONG J,CHEN Y,WANG L J.Emerging molecular basis of hematogenous metastasis in gastric cancer[J].World J Gastroenterol,2016,22(8):2434-2440.
[27]WU C Y,WU M S,CHEN Y J,et al.Clinicopathological significance of MMP-2 and TIMP-2 genotypes in gastric cancer[J].Eur J Cancer,2007,43(4):799-808.
[28]MU G,ZHU Y,DONG Z,et al.Calmodulin 2 Facilitates angiogenesis and metastasis of gastric cancer via STAT3/HIF-1α/VEGF-a mediated macrophage polarization[J].Front Oncol,2021,11:727306.
[29]魏亚宁,李小芳,谭莉莉,等.晚期胃癌中缺氧诱导因子-1α、血管内皮生长因子的表达与替吉奥联合多西紫杉醇化疗疗效的关系[J].安徽医药,2015,19(8):1602-1603.
[30]强永虎,吴坚,孙闻佳,等.益气化瘀解毒方联合新辅助化疗治疗进展期胃癌的临床研究[J].中华中医药杂志,2025,40(1):441-446.
[31]李秋蓉,杨培培,黄雯洁,等.基于胃癌“脾虚瘀毒”理论探讨CD8+T细胞耗竭中医病机的科学内涵[J].中国医药导报,2024,21(31):136-139.
[32]彭丽丽,王慧纬,任燕燕,等.升阳益胃汤对老年晚期胃癌患者化疗不良反应和免疫功能的影响[J].现代中西医结合杂志,2025,34(7):925-928.
[33]JANJIGIAN Y Y,SHITARA K,MOEHLER M,et al.First-line nivolumab plus chemotherapy versus chemotherapy alone for advanced gastric,gastro-oesophageal junction,and oesophageal adenocarcinoma (CheckMate 649):A randomised,open-label,phase 3 trial[J].Lancet,2021,398(10294):27-40.

相似文献/References:

[1]李 雯 ,杜雅冰△,冯 堃,等.养正消积胶囊联合心理干预治疗胃癌晚期疗效及对患者生活质量、情绪的影响*[J].陕西中医,2019,(6):722.
　LI Wen,DU Yabing,FENG Wei,et al.Study on effects quality of life and emotion of Yangzheng Xiaoji capsule combined with psychological intervention on advanced gastric cancer[J].,2019,(1):722.
[2]蒋 峰,柳小芳,高艺文,等.解毒散结方联合化疗治疗晚期胃癌疗效及对患者血管内皮生长因子和受体的影响[J].陕西中医,2021,(5):582.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.009]
　JIANG Feng,LIU Xiaofang,GAO Yiwen,et al.Effect of Jiedu Sanjie recipe combined with chemotherapy on patients with advanced gastric cancer and the effect of serum VEGF and VEGFR-1[J].,2021,(1):582.[doi:DOI:10.3969/j.issn.1000-7369.2020.05.009]
[3]刘包欣子,张 烨,张晶焱,等.健运清化方联合XELOX方案治疗晚期胃癌脾气虚弱证临床研究[J].陕西中医,2023,(10):1377.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.009]
　LIU Baoxinzi,ZHANG Ye,ZHANG Jingyan,et al.Jianyun Qinghua formula and XELOX regimen for the treatment of spleen weakness syndrome in advanced gastric cancer[J].,2023,(1):1377.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.009]

备注/Memo

备注/Memo:
国家重点研发计划项目（2024YFC3505303）；国家自然科学基金青年科学基金资助项目（82505495）；上海市进一步加快中医药传承创新发展三年行动计划项目（1-1-2）；上海市级医院消化内科临床能力促进与提升专科联盟建设项目(SHDC22021311)；上海中医药大学附属岳阳中西医结合医院大学科建设项目（QY71.42.02）；上海中医药大学附属岳阳中西医结合医院中医专科建设项目[YW（2025-2026）-03-07]；上海中医药大学科技发展项目（24KFL080）
更新日期/Last Update: 2026-01-08