目的 探讨复方苦参注射液联合多西他赛和奈达铂治疗中晚期宫颈癌的临床疗效。方法 选取2012年6月-2015年6月辽宁省肿瘤医院妇科收治的中晚期宫颈癌患者92例,根据治疗方案的差别分为对照组和治疗组,每组各46例。对照组静脉滴注多西他赛注射液,70 mg/m²,每周1次;同时在每个化疗周期的第一天静脉滴注注射用奈达铂,70 mg/m²。治疗组在对照组治疗基础上静脉滴注复方苦参注射液,20 mL加入250 mL生理盐水,1次/d,连用14 d。两组21 d为1个化疗疗程,两组均连续治疗2个疗程。观察两组的临床疗效和生活质量改善情况,同时比较两组患者治疗前后CD³⁺、CD⁴⁺、CD⁴⁺/CD⁸⁺、NK细胞的变化情况。结果 治疗后,治疗组和对照组治疗有效率分别为65.22%、43.48%;临床获益率分别为89.13%、78.26%,两组有效率、临床获益率比较差异有统计学意义(P<0.05)。对照组和治疗组生活质量改善率分别为65.22%、84.78%,两组比较差异有统计学意义(P<0.05)。治疗后,治疗组CD³⁺、CD⁴⁺、CD⁴⁺/CD⁸⁺、NK细胞较治疗前均有显著增高,同组治疗前后差异有统计学意义(P<0.05);治疗后,治疗组这些观察指标显著高于对照组,两组比较差异具有统计学意义(P<0.05)。对照组治疗前后这些观察指标没有显著变化。治疗组白细胞下降、血小板下降、骨髓抑制、胃肠道反应、肝肾功能异常的发生例数均显著低于对照组,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多西他赛和奈达铂治疗中晚期宫颈癌具有较好的临床疗效,可改善患者的生活质量,增加患者的细胞免疫功能,且不良反应较少,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Compound Kushen Injection combined with docetaxel and nedaplatin in treatment of medium-term and advanced cervical cancer. Methods Patients (92 cases) with medium-term and advanced cervical cancer in Department of Gynaecology of Liaoning Cancer Hospital from June 2012 to June 2015 were enrolled in this study. According to the different treatment plan, patients were divided into treatment (46 cases) and control (46 cases) groups. The patients in the control group were iv administered with Docetaxel Injection, 70 mg/m², once weekly. And they were iv administered with Nedaplatin for injection on the first day of each chemotherapy course, 70 mg/m². The patients in the treatment group were iv administered with Compound Kushen Injection, 20 mL added into 0.9% normal saline 250 mL, once daily, 14 d in one course. One course of treatment included 4 weeks, and two groups were treated for two courses. The clinical efficacy and improvement of life quality in two groups were evaluated, and the changes of CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺, and NK in two groups were compared. Results After treatment, the total effective rate of control group was 43.48%, and the clinical benefit rate was 78.26%, while the total effective rate of treatment group was 65.22%, and the clinical benefit rate was 89.13%, and there were differences between two groups (P < 0.05). The improvement rate of life quality in the control and treatment groups were 65.22% and 84.78%, respectively, and there were differences between two groups (P < 0.05). After treatment, CD³⁺, CD⁴⁺, CD⁴⁺/CD⁸⁺, and NK cells in treatment group were increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The observation indexes in the control group did not change significantly before and after treatment. The cases of white blood cells decline, platelet decline, bone marrow suppression, gastrointestinal reaction, liver and kidney dysfunction in the treatment group were significantly lower than those in the control group, and there were differences between two groups (P < 0.05). Conclusion Compound Kushen Injection combined with docetaxel and nedaplatin has the good clinical effect in treatment of medium-term and advanced cervical cancer, and can improve the quality of life, also can increase cell immune function with less adverse reaction, which has a certain clinical application value.