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芪参合剂对结直肠癌患者化疗所致骨髓抑制的影响

[Effects of qisheng mixture on chemotherapy induced myelosuppression in patients with colorectal cancer].

作者信息

Chen Jing-Xian, Shen Xiao-Heng

机构信息

Department of Chinese Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Sep;32(9):1161-5.

Abstract

OBJECTIVE

To observe the intervention of Qisheng Mixture (QM) on the chemotherapy induced myelosuppression in patients with colorectal cancer.

METHODS

One hundred and twenty patients with colorectal cancer at Ruijin Hospital, Shanghai Jiaotong University School of Medicine were randomly assigned to the pure chemotherapy group (as the control group) and the QM + chemotherapy group (as the treatment group), 60 in each group. All patients received FOLFOX4 or XELOX regimen for totally 6 cycles. Patients in the treatment group took QM 150 mL at the end of chemotherapy, once in the morning and once in the evening for 7 successive days, totally 6 therapeutic courses. The total and average dosages of using granulocyte colony stimulating factor (G-CSF) were observed in all patients. The changes of white blood cell (WBC) counts were determined before chemotherapy and after the 6th chemotherapy. The hemoglobin (Hb), red blood cell (RBC), and platelet (PLT) counts were observed before chemotherapy, before the 4th chemotheray, and after the 6th chemotherapy. The clinical symptoms integrals (fatigue, liability to catch cold, aphthous stomatitis, pharyngalgia, pale complexion, poor appetite, vomiting, diarrhea, and so on) and the safety indicators (the functions of the liver and kidney, urine routines) were observed. The grading toxic and adverse reactions, KPS scoring, body weight, and the efficacy of the symptoms integrals were compared between the two groups.

RESULTS

During the treatment period the total and average dosages of G-CSF used were larger in the control group than in the treatment group (P<0.01). After treatment the WBC count of the two groups were reduced with statistical difference (P<0.01). The WBC counts were higher in the treatment group than in the control group in the whole therapeutic process except the first chemotherapy (P<0.01, P<0.05). Compared with before treatment in the same group, RBC and PLT were reduced in the two groups before the 4th chemotherapy, RBC, Hb, and PLT were reduced after treatment (P<0.05, P<0.01). Better effects on body weight were obtained in the treatment group than in the control group with statistical difference (P<0.01). Compared with the control group, the clinical symptoms integrals such as fatigue, liability to catch cold, pharyngalgia, pale complexion, poor appetite, vomiting, and diarrhea were reduced (P<0.01). Compared with the control group, the toxic and adverse reactions were reduced in the treatment group before the 4th chemotherapy (P<0.01).

CONCLUSIONS

QM could effectively intervene chemotherapy induced myelosuppression in patients with colorectal cancer. It was a safe Chinese medicine compound with lower toxicity.

摘要

目的

观察芪参合剂(QM)对结直肠癌患者化疗所致骨髓抑制的干预作用。

方法

上海交通大学医学院附属瑞金医院120例结直肠癌患者随机分为单纯化疗组(作为对照组)和QM+化疗组(作为治疗组),每组60例。所有患者均接受FOLFOX4或XELOX方案化疗,共6个周期。治疗组患者在化疗结束时服用QM 150 mL,每日早晚各1次,连续服用7天,共6个疗程。观察所有患者使用粒细胞集落刺激因子(G-CSF)的总量及平均用量。测定化疗前及第6次化疗后白细胞(WBC)计数的变化。观察化疗前、第4次化疗前及第6次化疗后血红蛋白(Hb)、红细胞(RBC)及血小板(PLT)计数。观察临床症状积分(疲劳、易感冒、口腔溃疡、咽痛、面色苍白、食欲减退、呕吐、腹泻等)及安全指标(肝肾功能、尿常规)。比较两组的毒性不良反应分级、KPS评分、体重及症状积分疗效。

结果

治疗期间,对照组使用G-CSF的总量及平均用量均大于治疗组(P<0.01)。治疗后两组WBC计数均降低,差异有统计学意义(P<0.01)。除第1次化疗外,治疗组在整个治疗过程中的WBC计数均高于对照组(P<0.01,P<0.05)。与同组治疗前比较,两组在第4次化疗前RBC和PLT均降低,治疗后RBC、Hb和PLT均降低(P<0.05,P<0.01)。治疗组在体重方面的改善效果优于对照组,差异有统计学意义(P<0.01)。与对照组比较,治疗组疲劳、易感冒、咽痛、面色苍白、食欲减退、呕吐、腹泻等临床症状积分降低(P<0.01)。与对照组比较,治疗组在第4次化疗前毒性不良反应降低(P<0.01)。

结论

QM能有效干预结直肠癌患者化疗所致的骨髓抑制。它是一种毒性较低的安全中药复方。

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