目的 探讨复方天仙胶囊联合放疗治疗中晚期食管癌的临床研究。方法 选取2012年12月—2014年8月沈阳二四二医院收治的中晚期食管癌患者64例,将患者随机分为治疗组(32例)和对照组(32例)。对照组患者采用6MV-X线直线加速器进行三维适形放疗方法照射,至总剂量为60～70 Gy,6～7周常规分割治疗,5次/周,2 Gy/次。治疗组给予复方天仙胶囊,餐后30 min口服,3粒/次,3次/d,2个月为1个疗程。使用2周后同步放疗,方法同对照组。放疗结束后3个月对两组患者临床疗效、放射不良反应和生活质量改善状况进行评价;在治疗前1 d和治疗全程结束后第2天采集血清样本,测定外周血NK细胞活性、血清NO水平和血清IL-12水平。结果 治疗后,对照组总有效率为62.5%,治疗组总有效率为87.5%,两组总有效率比较的差异具有统计学意义(P < 0.05)。两组患者治疗后放射不良反应和Karuafsky评分比较差异均具有统计学意义(P < 0.05)。治疗后两组患者的外周血NK细胞数目均较治疗前升高,差异有统计学意义(P < 0.05),治疗组外周血NK细胞数目明显低于对照组,其差异有统计学意义(P < 0.05)。治疗后,治疗组血清NO和IL-12水平明显优于对照组(P < 0.05)。治疗后两组患者的IL-12水平较治疗前降低,血清NO水平较治疗前升高,差异均有统计学意义(P < 0.01、0.05)。结论 复方天仙胶囊联合放疗治疗中晚期食管癌具有较好的临床疗效,改善患者生活质量。

Objective To explore the effect of Compound Tianxian Capsules combined with radiotherapy in the treatment of advanced esophageal cancer. Methods The patients with advanced esophageal cancer (64 cases) who were cured in Shenyang 242 Hospital from December 2012 to August 2014 were randomly divided into control and treatment groups, and each group had 32 cases. The patients in two groups were accepted treatment with help of 6 MV - X line linear accelerator by three dimensional conformal radiotherapy irradiation method. The total dose was 60 — 70 Gy, and conventional therapy was divided into five times a week during 6 — 7 weeks, 2 Gy/time. The patients in the treatment group were po administered with Compound Tianxian Capsules, 30 min after meals, 3 capsules /time, three times daily. A course included two months. Radiotherapy was adopted in patients in treatment group after two weeks, and other treatment was the same as the control group. After the treatment of radiotherapy for three months, the efficacies, adverse reactions, and quality of life were evaluated. Blood samples were collected 1 d before treatment and second day after treatment to detect peripheral blood NK cell activity and the levels of NO and IL-12. Results After treatment, the efficacies in the control and treatment groups were 62.5% and 87.5%, respectively, and there were differences between two groups (P < 0.05). There were differences of adverse reactions and Karuafsky scores after treatment between two groups (P < 0.05). Peripheral blood NK cell numbers in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). Peripheral blood NK cell numbers in the treatment group were significantly lower than those of the control group, with difference between two groups (P < 0.05). After treatment, the levels of NO and IL-12 in the treatment group were better than those of control group, with significant difference between two groups (P < 0.05). The levels of IL-12 in two groups after treatment were significantly decreased, while the level of NO were decreased, and the difference was statistically significant in the same group (P < 0.05, 0.01). Conclusion Compound Tianxian Capsules combined with radiotherapy has the good clinical effect in the treatment of advanced esophageal cancer, and improve life qualities o patients.