| 摘要: |
| 目的：观察四君子汤加减联合阿帕替尼治疗老年晚期胃癌脾胃气虚证患者的临床效果及不良反应情况。方法：将60例老年晚期胃癌脾胃气虚证患者随机分为治疗组和对照组，每组各30例。对照组口服阿帕替尼治疗，治疗组在对照组的基础上加服四君子汤加减治疗。观察2组的近期疗效、KPS评分，治疗组用药前后CEA、CA199、CA72-4水平变化，2组免疫功能及不良反应情况。结果：治疗组患者客观缓解率和疾病控制率分别为56.67%、93.33%，优于对照组的30.00%、66.67%，2组比较，差异有统计学意义（P<0.05）。2组患者KPS评分治疗前后组内比较及治疗后组间比较，差异均有统计学意义（P<0.05）。治疗组CEA、CA199、CA72-4水平治疗后较治疗前明显下降（P<0.01）。对照组CD4+、CD4+/CD8+水平治疗后较治疗前升高；治疗组CD3+、CD4+、CD4+/CD8+水平较治疗前升高，且治疗组CD3+、CD4+水平升高幅度优于对照组，差异均有统计学意义（P<0.05）。治疗组不良反应如白细胞减少、乏力、蛋白尿、血压升高等发生情况明显低于对照组，差异均有统计学意义（P<0.05）。结论：四君子汤加减联合阿帕替尼治疗老年晚期胃癌脾胃气虚证患者效果较单用阿帕替尼为优，可有效降低CEA、CA199、CA72-4水平，提高患者免疫功能，且不良反应发生率低，值得临床推广。 |
| 关键词: 晚期胃癌 脾胃气虚证 四君子汤 阿帕替尼 |
| DOI： |
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| Clinical effect of modified Sijunzi decoction combined with apatinib in treatment of advanced gastric cancer with deficiency of spleen Qi and stomach Qi in elderly patients：An analysis of 30 cases |
| WANG Fei,DU Xiaoyan,CHEN Siqin |
| (Hunan University of Chinese Medicine，Changsha 410208，Hunan，China;The Affiliated Hospital of Hunan Academy of Chinese Medicine，Changsha 410006，Hunan，China) |
| Abstract: |
| Objective：To investigate the clinical efficacy and adverse effects of modified Sijunzi decoction combined with apatinib in the treatment of advanced gastric cancer with deficiency of spleen Qi and stomach Qi in elderly patients.Methods：A total of 60 elderly patients with advanced gastric cancer with deficiency of spleen Qi and stomach Qi were randomly divided into treatment group and control group，with 30 patients in each group.The patients in the control group were given oral apatinib alone，and those in the treatment group were given modified Sijunzi decoction in addition to the treatment in the control group.The two groups were observed in terms of short-term response，Karnofsky Performance Scale (KPS) score，immune function，adverse events，and levels of carcinoembryonic antigen (CEA)，carbohydrate antigen 199 (CA199)，and carbohydrate antigen 72-4 (CA72-4) before and after treatment.Results：There were significant differences between the treatment group and the control group in objective response rate (56.67% vs 30.00%，P<0.05) and disease control rate (93.33% vs 66.67%，P<0.05).Both groups had a significant change in KPS score after treatment，and there was a significant difference in KPS score between the two groups after treatment (P<0.05).The treatment group had significant reductions in the levels of CEA，CA199，and CA72-4 after treatment (P<0.01).After treatment，the control group had significant increases in CD4+T cells and CD4+/CD8+ratio，and the treatment group had significant increases in CD3+T cells，CD4+T cells，and CD4+/CD8+ratio；the treatment group had significantly greater increases in CD3+and CD4+T cells than the control group (P<0.05).Compared with the control group，the treatment group had significantly lower incidence rates of the adverse events such as leucopenia，weakness，proteinuria，and elevated blood pressure (P<0.05).Conclusion：Modified Sijunzi decoction combined with apatinib has better clinical efficacy than apatinib alone in the treatment of advanced gastric cancer with deficiency of spleen Qi and stomach Qi in elderly patients and can effectively reduce the levels of CEA，CA199，and CA72-4 and improve patients’ immune function，with a lower incidence rate of adverse events.Therefore，it holds promise for clinical application. |
| Key words: advanced gastric cancer deficiency of spleen Qi and stomach Qi Sijunzi decoction apatinib |
