摘要目的:探讨复方苦参注射液联合替吉奥与奥沙利铂治疗复发转移性食管癌的效果及对患者生活质量的影响。方法:选取2017年8月至2020年8月新泰市第三人民医院内一科收治的92例复发转移性食管癌患者，男47例，女45例，年龄(59.84±5.87)岁，年龄范围为45~72岁，采用随机数表法将患者随机分为传统治疗组与联合治疗组，每组46例。传统治疗组给予替吉奥联合奥沙利铂，联合治疗组患者在传统治疗组基础上给予复方苦参注射液，两组患者均连续治疗28 d。观察比较两组患者临床治疗效果、生存质量、免疫功能及不良反应发生情况。结果:联合治疗组患者的客观缓解率(ORR)、疾病控制率(DCR)为65.2%(30/46)、82.6%(38/46)，显著高于传统治疗组[43.5%(20/46)、58.7%(27/46)]，差异有统计学意义( P<0.05)；两组患者治疗前生命质量核心量表(QLQ-C30 )评分比较，差异无统计学意义( P>0.05)，两组患者治疗后QLQ-C30评分均高于治疗前，且联合治疗组QLQ-C30评分高于传统治疗组，差异有统计学意义( P<0.05)；两组患者治疗前血液簇分化抗原3 +(CD3 +)、血液簇分化抗原4 +(CD4 +)、血液簇分化抗原8 +(CD8 +)、CD4 +/CD8 +水平比较，差异无统计学意义( P>0.05)。两组患者治疗后CD3 +[(51.75±8.14)%、(57.69±8.67)%]、CD4 +[(33.56±4.59)%、(37.74±5.15)%]、CD4 +/CD8 +[(1.39±0.19)、(1.78±0.24)]水平显著高于治疗前[(42.69±7.05)%、(42.78±7.09)%，(27.72±3.65)%、(27.69±3.69)%，(1.05±0.14)、(1.07±0.12)]，CD8 +水平[(27.89±3.79)%、(24.38±3.32)%]显著低于治疗前[(31.69±4.25)%、(31.64±4.27)%]，且联合治疗组CD3 +、CD4 +、CD4 +/CD8 +水平显著高于传统治疗组，CD8 +水平显著低于传统治疗组，差异有统计学意义( P<0.05)；联合治疗组患者血红蛋白减少、中性粒细胞减少、血小板减少、恶心呕吐及脱发等不良反应的发生显著少于传统治疗组，差异有统计学意义( P<0.05)。 结论:采用复方苦参注射液联合替吉奥与奥沙利铂治疗复发转移性食管癌，具有较好的临床治疗效果，安全性较高，值得在临床上推广应用。

abstractsObjective:To investigate the effect of compound Sophoginseng injection combined with tegio and oxaliplatin in the treatment of recurrent and metastatic esophageal cancer and its effect on the quality of life of patients.Methods:A total of 92 patients with recurrent and metastatic esophageal cancer treated in the first department of Xintai Third People′s Hospital from August 2017 to August 2020 were selected, 47 males and 45 females, aged(59.84±5.87)years old, ranging from 45 to 72 years old.The patients were randomly divided into traditional treatment group and combined treatment group by random number table method, with 46 patients in each group.The traditional treatment group was treated with tegio combined with oxaliplatin, and the combined treatment group was treated with compound Sophora flavescentum injection in addition to the traditional treatment group.Both groups were treated for consecutive 28 days.Clinical treatment effect, quality of life, immune function and adverse reactions were observed and compared between the two groups.Results:The objective response rate(ORR)and disease control rate(DCR)of combined therapy group[65.2%(30/46), 82.6%(38/46)]were significantly higher than those of traditional therapy group[43.5%(20/46), 58.7%(27/46)], and the differences were statistically significant( P<0.05). There was no significant difference in quality of life questionnare-core 30(QLQ-C30)score before treatment between 2 groups, the difference was not statistically significant( P>0.05), but the QLQ-C30 score after treatment was higher in 2 groups than before treatment, and the QLQ-C30 score in the combined treatment group was higher than that in the traditional treatment group, the difference was statistically significant( P<0.05). There were no significant differences in THE levels of cluster of differentiation 3 + (CD3 + ), cluster of differentiation 4 + (CD4 + ), cluster of differentiation 8 + (CD8 + ) and CD4 + /CD8 + between 2 groups before treatment, the differences were not statistically significant( P>0.05). The levels of CD3 + [(51.75±8.14)%, (57.69±8.67)%], CD4 + [(33.56±4.59)%, (37.74±5.15)%], CD4 + /CD8 + [(1.39±0.19), (1.78±0.24)]after treatment were significantly higher than those before treatment[(42.69±7.05)%, (42.78±7.09)%, (27.72±3.65)%, (27.69±3.69)%, (1.05±0.14), (1.07±0.12)], CD8 + levels[(27.89 ±3.79)%, (24.38±3.32)%]were significantly lower than those before treatment[(31.69±4.25)%, (31.64±4.27)%], and the levels of CD3 + , CD4 + , CD4 + /CD8 + in the combined treatment group were significantly higher than those in the traditional treatment group, CD8 + level was significantly lower than that of traditional treatment group, the differences were statistically significant( P<0.05). The incidence of adverse reactions such as hemoglobinia, neutropenia, thrombocytopenia, nausea, vomiting and alopecia in the combined treatment group was significantly less than that in the conventional treatment group, the differences were statistically significant( P<0.05). Conclusion:Compound Sophora flavescens injection combined with ticgio and oxaliplatin in the treatment of recurrent and metastatic esophageal cancer has good clinical efficacy and high safety, which is worthy of clinical application.