摘要目的 研究十一味参芪片对胃癌放化疗患者的免疫功能及不良反应的影响.方法 选取本院2008年3月至2009年9月放疗科90例胃癌放化疗患者,随机分为十一味参芪片治疗组(治疗组,n=45)和单纯化疗组(对照组,n=45).对照组给予放化疗,治疗组在对照组基础上给予十一味参芪片,21d为1个周期,2个周期后评价患者的生存质量,包括进食量和体质量;观察放化疗不良反应;采用流式细胞仪检测两组患者静脉血Th1、Th2及其比值;ELISA法检测静脉血干扰素γ(IFN-γ)和白细胞介素4(IL-4)的含量;测定白细胞(WBC)、血小板(PLT)、血红蛋白(Hb)水平.维持治疗2年后,进行总体评估,分析患者生存质量、放化疗不良反应、静脉血Th1和Th2及其比值、IFN-γ和IL-4含量、血常规等各个指标.结果 治疗2个周期后,治疗组患者进食量和体质量较对照组明显改善.治疗组各种不良反应发生率低于对照组(均P＜0.05).治疗组患者外周血Th1、Th2及其比值Th1/Th2较对照组患者均有升高[Th1:(6.42±2.10)％比(4.10±2.70)％,Th2:(3.51±1.14)％比(2.81±2.30)％,Th 1/rh2:1.83±0.62比1.46±0.70,均P＜0.05].与对照组相比,治疗组患者血IFN-γ的含量增加,而IL-4含量明显降低[IFN-γ:(66.05±23.13)ng/L比(47.19±10.03)ng/L,IL-4:(34.62±5.34) ng/L比(45.35±6.03)ng/L,均P＜0.05].治疗组患者外周血WBC、Hb以及PLT减少均低于对照组(均P＜0.05).维持治疗2年后,治疗组患者生存质量、不良反应、Th1、Th2、Th 1/Th2、IFN-γ、IL-4及血常规检查结果仍明显优于对照组.结论 十一味参芪片能有效提高胃癌放化疗患者的机体免疫功能,降低不良反应,改善生活质量,是胃癌放化疗治疗中有效的辅助用药.

abstractsObjective To study the effects of Shiyiwei shenqi pills on immunity and side effects in patients with gastric cancer treated with radiochemotherapy.Methods Ninety patients with gastric cancer who were treated with radiochemotherapy between March 2008 and September 2009 in The First People's Hospital of Xuzhou were randomly divided to receive radiochemotherapy alone (control group,n=45) or combination with Shiyiwei shenqi pills group for two 21-day cycles (treatment group,n=45).Assessment of quality of life,food intake and body weight was carried out after 2 treatment cycles,while the side effects were assessed.The levels of Th1 and Th2,and Th1/Th2 ratio in peripheral blood were analyzed by flow cytometry.ELISA was employed to determine the levels of interferon-γ(IFN-γ) and interleukin-4(IL-4).The levels of white blood cells (WBC),platelet (PLT) and hemoglobin (Hb) were also determined.Reassessment of the aforementioned indices was conducted 2 years later following the treatment.Results Shiyiwei shenqi pills significantly improved the food intake and body weight compared with control group (P＜0.05).The incidence of various adverse reactions in treatment group was lower than that in control group.Treatment with Shiyiwei shenqi pills significantly increased the levels of Th 1 [(6.42 ± 2.10) ％ vs (4.10 ± 2.70) ％],Th2 [(3.51±1.14)％ vs (2.81±2.30)％] and Th1/Th2 ratio [1.83±0.62 vs 1.46±0.70] in peripheral blood (all P＜ 0.05).Compared with control group,the treatment group was associated with significantly increased levels of I FN-γ [(66.05 ±23.13) ng/L vs (47.19± 10.03) ng/L,P＜0.05] yet markedly decreased level of IL-4 [(34.62 ± 5.34) ng/L vs (45.35 ±6.03) ng/L,P＜0.05].In addition,the treatment group demonstrated a significantly lower reduction in WBC,Hb and PLT compared with control group (all P＜0.05).The maintenance therapy for 2 years resulted in superior profiles in terms of quality of life,side effects,Th1,Th2,Th1/Th2 ratio,IFN-γ,IL-4 and blood routine test findings in treatment group compared with control group.Conclusion Shiyiwei shenqi pills effectively improves the immunity and quality of life with minor side effects in patients with gastric cancer treated with radiochemotherapy and should be regarded as a worthwhile adjuvant approach for radiochemotherapy.