目的 探讨云芝糖肽胶囊联合TP方案（多西他赛联合奈达铂）治疗中晚期食管癌的临床疗效。方法 选取2016年9月—2020年1月南阳市中心医院收治的103例中晚期食管癌患者为研究对象，将所有患者采用信封法分为对照组（51例）和治疗组（52例）。对照组第1天静脉滴注多西他赛注射液，75 mg/m²加入到0.9%氯化钠溶液100 mL中，同时第1天静脉滴注注射用奈达铂，80 mg/m²加入到0.9%氯化钠溶液100 mL。治疗组在对照组的基础上口服云芝糖肽胶囊，3粒/次，3次/d。21 d为1个周期，两组均治疗4个周期。观察两组的临床疗效，比较两组的T淋巴细胞亚群、免疫球蛋白、血清肿瘤标志物。结果 治疗后，治疗组的疾病控制率、客观缓解率均高于对照组（P<0.05）。治疗后，两组CD3⁺、CD4⁺、CD4⁺/CD8⁺均降低，CD8⁺均升高（P<0.05）；并且治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺低于对照组，CD8⁺高于对照组（P<0.05）。治疗后，两组免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）水平均升高（P<0.05），且治疗组IgA、IgM、IgG水平均高于对照组（P<0.05）。治疗后，两组血清癌胚抗原（CEA）、鳞状细胞癌抗原（SCC-Ag）、糖类抗原199（CA199）水平均较治疗前降低（P<0.05），且治疗组血清CEA、SCC-Ag、CA199水平低于对照组（P<0.05）。结论 云芝糖肽胶囊联合TP方案治疗中晚期食管癌患者可提高治疗效果，减轻免疫抑制，降低血清肿瘤标志物水平。

Objective To investigate the therapeutic effect of Yunzhi Tangtai Capsules combined with TP chemotherapy regimen (docetaxel combined with nedaplatin) in treatment of middle or advanced esophageal cancer. Methods Patients (103 cases) with middle or advanced esophageal cancer in Nanyang Central Hospital from September 2016 to January 2020 were randomly divided into the control group (51 cases) and the treatment group (52 cases). Patients in the control group was given Docetaxel Injection intravenously on the first day, 75 mg/m² was added to 100 mL of 0.9% sodium chloride solution. And Nedaplatin for injection was given intravenously on the first day, and 80 mg/m² was added to 100 mL of 0.9% sodium chloride solution. Patients in the treatment group were po administered with Yunzhi Tangtai Capsules on the basis of the control group, 3 grains/time, three times daily. A course had 21 d, and patients of two groups were treated for 4 courses. After treatment, the clinical efficacies were evaluated, and T lymphocyte subsets, immunoglobulin, and serum tumor markers in two groups were compared. Results After treatment, the disease control rate and objective remission rate of the treatment group were higher than those of the control group (P<0.05). After treatment, the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were decreased, but the CD8⁺ in two groups were increased (P<0.05). And the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the treatment group were lower than those in the control group, but the CD8⁺ in the treatment group were higher than that in the control group (P<0.05). After treatment, the levels of IgA, IgM, and IgG in two groups were increased (P<0.05), and the levels of IgA, IgM, and IgG in the treatment group were higher than that in the control group (P<0.05). After treatment, the levels of CEA, SCC-Ag, and CA199 in two groups were decreased (P<0.05), and the levels of CEA, SCC-Ag, and CA199 in the treatment group were higher than that in the control group (P<0.05). Conclusion Yunzhi Tangtai Capsules combined with TP chemotherapy regimen in the treatment of patients with middle or advanced esophageal cancer can improve the therapeutic effect, reduce immunosuppression, and reduce the level of serum tumor markers.

R975;R979.1

河南省医学科技攻关计划项目（2017T12399）