健脾养胃方联合化疗对胃癌患者T细胞亚群、凝血标志物的影响

Effect of Spleen-Strengthening Stomach-Nourishing Decoction combined with chemotherapy on T cell subgroups and coagulation markers in patients with gastric cancer

摘要:

目的 探讨健脾养胃方联合化疗对胃癌患者T细胞亚群、凝血标志物的影响。方法 选取2019年7月—2021年12月在河北省中医院就诊的168例胃癌患者。按照随机数字表法分为对照组和研究组，每组84例。对照组采用化疗，研究组采用健脾养胃方+化疗，两组均治疗4个周期。观察两组的临床疗效、毒副反应，比较两组治疗前、后的T细胞亚群（CD4⁺、CD8⁺、CD4⁺/CD8⁺）、凝血标志物［凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FIB）］及营养状况（血红蛋白、前白蛋白、总蛋白）的变化。结果 研究组治疗总有效率高于对照组（P <0.05）；研究组胃肠道反应、肾毒性发生率均低于对照组（P <0.05）；研究组CD4⁺、CD8⁺治疗前后差值均小于对照组，CD4⁺/CD8⁺治疗前后差值大于对照组（P <0.05）；研究组PT、APTT、FIB治疗前后差值均大于对照组（P <0.05）；研究组血红蛋白、前白蛋白、总蛋白治疗前后差值均小于对照组（P <0.05）。结论 健脾养胃方联合化疗在胃癌患者中疗效显著，有助于维持患者机体免疫力及营养状况，改善凝血功能，减少毒副反应。

Abstract:

Objective To explore the effects of Spleen-Strengthening and Stomach-Raising Decoction combined with chemotherapy on T cell subsets and coagulation markers in patients with gastric cancer.Methods A total of 168 patients with gastric cancer from July 2019 to December 2021 in Hebei Provincial Hospital of Traditional Chinese Medicine were divided into a control group (84 cases) and a research group (84 cases) according to the random number table method. The patients in the control group received chemotherapy, while those in the research group received Jianpi Yangwei Decoction + chemotherapy, with four cycles of chemotherapy in both groups. The clinical effects and adverse reactions were observed. T cell subsets (CD4⁺, CD8⁺, CD4⁺/CD8⁺) and coagulation markers [prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB) ] and nutritional status (hemoglobin, prealbumin, and total protein) in the two groups were compared before and after treatment.Results The study group showed a higher total effective rate compared to the control group (P < 0.05). Gastrointestinal reactions and renal toxicity rates were lower in the study group than in the control group (P < 0.05). The study group exhibited smaller differences in CD4⁺ and CD8⁺ levels before and after treatment compared to the control group, while the CD4⁺/CD8⁺ ratio showed a larger difference in the study group (P < 0.05). PT (prothrombin time), APTT (activated partial thromboplastin time), and FIB (fibrinogen) exhibited larger differences before and after treatment in the study group than in the control group (P < 0.05). Hemoglobin, prealbumin, and total protein showed smaller differences before and after treatment in the study group compared to the control group (P < 0.05).Conclusion Spleen-Strengthening and Stomach-Nourishing Decoction combined with chemotherapy has significant curative effect in patients with gastric cancer, which helps to maintain the body immunity and nutritional status of patients, improve coagulation function, and reduce toxic and side effects.