目的 探寻抗癌平丸与甲磺酸阿帕替尼联合治疗晚期结直肠癌的临床疗效。方法 选取2022年5月—2023年5月广东医科大学附属医院收治的120例晚期结直肠癌患者，经随机数字表法分为对照组和治疗组，各60例。对照组给予甲磺酸阿帕替尼片，0.5 g/次，1次/d。治疗组在对照组基础上联合抗癌平丸，0.5～1 g/次，3次/d，饭后半小时服用，初次服用剂量不可超过0.5 g，之后逐渐增量。两组连续用药12周。对比两组临床疗效、外周血T淋巴细胞亚群（CD3⁺、CD4⁺、CD4⁺/CD8⁺及NK）、癌胚抗原（CEA）、糖类抗原242（CA242）与糖类抗原19-9（CA19-9）、生存时间。结果 治疗后，治疗组客观缓解率（ORR）（53.33%）显著高于对照组（21.67%），差异具有统计学意义（P＜0.05），而两组疾病控制率（DCR）对比（81.67%vs 91.67%），差异不具有统计学意义。治疗12周后，两组患者CD3⁺、CD4⁺、CD4⁺/CD8⁺及NK均较治疗前升高（P＜0.05），且治疗后治疗组CD3⁺、CD4⁺、CD4⁺/CD8⁺及NK均高于对照组（P＜0.05）。治疗12周后，两组患者CEA、CA242、CA19-9均低于治疗前（P＜0.05），且治疗后治疗组CEA、CA242、CA19-9均低于对照组（P＜0.05）。治疗组患者无进展生存时间及总生存时间均长于对照组。结论 在晚期结直肠癌的临床治疗中，采用抗癌平丸联合阿帕替尼可显著增强患者的治疗效果，有效降低肿瘤标志物水平，改善机体免疫功能，同时未明显增加药物相关毒副反应。

Objective To explore the curative effect of Kang’aiping Pills combined with apatinib in treatment of advanced colorectal cancer. Methods A total of 120 patients with advanced colorectal cancer who were admitted to Affiliated Hospital of Guangdong Medical University from May 2022 to May 2023 were selected. They were randomly divided into control group and treatment group, with 60 cases in each group. Patients in control group were given Apatinib Mesylate Tablets at a dose of 0.5 g/time, once daily. Patients in treatment group were treated with the same regimen combined with Kang’aiping Pills, at a dose of 0.5 to 1 g/time, three times daily, taken half an hour after meals. The initial dose should not exceed 0.5 g, and then gradually increase. Both groups were treated continuously for 12 weeks. The clinical efficacy, peripheral blood T lymphocyte subsets (CD3⁺, CD4⁺, CD4⁺/CD8⁺ and NK), carcinoembryonic antigen (CEA), carbohydrate antigen 242 (CA242) and carbohydrate antigen 19-9 (CA19-9), and survival time of the two groups were compared. Results After treatment, the objective response rate (ORR) of treatment group (53.33%) was significantly higher than that of control group (21.67%), and the difference was statistically significant (P < 0.05). However, there was no statistically significant difference in the disease control rate (DCR) between the two groups (81.67% vs 91.67%). After 12 weeks of treatment, the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ and NK in both groups increased compared to before treatment (P < 0.05), and the levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺ and NK in treatment group were higher than those in control group after treatment (P < 0.05). After 12 weeks of treatment, the levels of CEA, CA242, and CA19-9 in both groups were lower than before the treatment (P < 0.05), and the levels of CEA, CA242, and CA19-9 in treatment group were lower than those in control group after treatment (P < 0.05). The progression-free survival time and overall survival time of patients in treatment group were longer than those in control group. Conclusion In the clinical treatment of advanced colorectal cancer, the combination of Kang’aiping Pills and apatinib can significantly enhance the therapeutic effect, effectively reduce the levels of tumor markers, improve the body’s immune function, and at the same time, does not significantly increase the drug-related toxic and side effects.

R979.1

湛江市科技计划项目(2024B01124)