目的 探讨复方苦参注射液联合FOLFOX4化疗方案治疗胃癌患者的临床疗效及对外周血Th和Tc漂移的影响。方法 2013年7月—2014年1月襄阳市中心医院收治的晚期胃癌患者86例,随机分对照组和治疗组,每组43例。两组患者均采用FOLFOX4方案化疗。治疗组在此基础上每个化疗周期1～10 d静脉滴注复方苦参注射液,20 mL加入250 mL生理盐水,1次/d。2周为1个化疗周期,两组患者均连续治疗2个周期后评价疗效。同时比较两组患者外周血Th、Tc漂移情况。结果 治疗后,对照组和治疗组总有效率分别为55.81%、69.77%,两组比较差异有统计学意义(P < 0.05)。两组患者Th1、Th1/Th2、Tc1、Tc1/Tc2均显著升高,同组治疗前后差异有统计学意义(P < 0.05);且治疗后治疗组Th1、Th2、Th1/Th2、Tc1、Tc1/Tc2高于对照组,两组比较差异有统计学意义(P < 0.05)。治疗后,治疗组IFN-γ、IL-4、IL-10、TNF-α均明显改善,对照组仅IL-4、TNF-α改善,同组治疗前后差异有统计学意义(P < 0.05);且治疗后治疗组IFN-γ、IL-4、IL-10、TNF-α改善程度优于对照组,两组比较差异有统计学意义(P < 0.05)。对照组和治疗组不良反应发生率分别为60.46%、34.88%,两组比较差异具有统计学意义(P < 0.05)。结论 复方苦参注射液联合FOLFOX4化疗方案治疗胃癌具有较好的临床疗效,可明显提高患者的机体免疫功能,值得临床推广应用。

Objective To investigate the effect of Compound Kushen Injection combined with FOLFOX4 chemotherapy in treatment of advanced gastric cancer and peripheral blood Th and Tc drift. Methods The patients with advanced gastric cancer (86 cases) of Xiangyang Central Hospital were randomly divided into control and treatment groups, and each group had 43 cases. The patients in two groups were treated FOLFOX4 chemotherapy. The patients in treatment group were iv administered with Compound Kushen Injection at days 1－10 of each chemotherapy cycle, 20 mL adding 250 mL saline, once daily. A cycle of chemotherapy included 2 weeks, and the efficacy was evaluated after two cycles of treatment. At the same time, peripheral blood Th and Tc drift situation were compared between two groups. Results After treatment, the efficacies in the control and treatment groups were 55.81% and 69.77%, respectively, and there were differences between two groups (P < 0.05). Th1, Th1/Th2, Tc1, and Tc1/Tc2 in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, Th1, Th2, Th1/Th2, Tc1, Tc1/Tc2 in the treatment group were higher than those in the control group, with significant difference between two groups (P < 0.05). IFN-γ, IL-4, IL-10, and TNF-α in treatment group were significantly improved, while IL-4 and TNF-α in the control group improved, and the difference was statistically significant in the same group (P < 0.05). IFN-γ, IL-4, IL-10, and TNF-α in treatment group improved better than those of control group, with significant difference between two groups (P < 0.05). The incidence of adverse reactions in the control and treatment groups were 60.46% and 34.88%, respectively, and there were differences between two groups (P < 0.05). Conclusion Compound Kushen Injection combined with FOLFOX4 chemotherapy has the good clinical effect in treatment of advanced gastric cancer, and can obviously improve the immune function, which is worth clinical promotion.