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目的:探讨消瘤汤联合腹腔热灌注化疗对术后结直癌患者免疫功能和血清血管内皮生长因子(VEGF)蛋白表达的影响。方法:104例行手术治疗的进展期结直肠癌患者,按随机数字表分为治疗组和对照组,治疗组54例,采用腹腔热灌注化疗同时口服消瘤汤,对照组50例,单用腹腔热灌注化疗方案进行治疗,观察两组生存质量、免疫功能、化疗药物不良反应、血清血管内皮生长因子水平(VEGF)变化及VEGF蛋白表达情况。结果:治疗组生存质量的改善明显优于对照组(P<0.05);治疗组中性粒细胞减少、腹泻程度、神经毒性等与对照组比较有显著性差异(P<0.05)。治疗组治疗前CD4+/CD8+为(1.32±0.28)%,治疗后提高至(1.58±0.27)%,差异有显著性(P<0.05)。两组术前癌组织已浸透浆膜或术前已有局部淋巴结转移者1年及3年的生存率组间差异有显著意义(P<0.05)。治疗前两组VEGF水平比较差异无统计学意义(P>0.05),治疗后两组VEGF水平均下降(P<0.05),且治疗组下降更为显著(P<0.05);治疗组治疗前后血清VEGF蛋白表达明显下降,两组比较差异差异有统计学意义(P<0.05)。结论:消瘤汤联合腹腔热灌注化疗对结直癌术后患者有一定的防治作用,能改善病人生存期质量,其作用机制之一可能是通过抑制血清中VEGF蛋白表达进而抑制肿瘤血管生成、有效减轻化疗药物不良反应、提高CD4+/CD8+比值、增强巨噬细胞的吞噬功能而发挥作用。
Objective: To investigate the effect of Xiaoluotang combined with intraperitoneal hyperthermic perfusion chemotherapy on immune function and serum vascular endothelial growth factor (VEGF) protein expression in postoperative patients with colorectal cancer. Methods: A total of 104 patients with advanced colorectal cancer undergoing surgery were divided into treatment group and control group according to random number table. The treatment group received 54 cases of intra-abdominal heat infusion chemotherapy and 50 cases of control group, Intraperitoneal hyperthermic perfusion chemotherapy was used to treat the patients. The quality of life, immune function, adverse reactions of chemotherapeutic drugs, the level of serum vascular endothelial growth factor (VEGF) and the expression of VEGF were observed. Results: The improvement of quality of life in the treatment group was significantly better than that in the control group (P <0.05). The neutropenia, diarrhea and neurotoxicity in the treatment group were significantly different from those in the control group (P <0.05). Before treatment, the percentage of CD4 + / CD8 + in the treatment group was (1.32 ± 0.28)% and increased to (1.58 ± 0.27)% after treatment, the difference was significant (P <0.05). There was significant difference between two groups (P <0.05) in the survival rates of one year and three years after the preoperative cancer tissues had been infiltrated with serosal membrane or had preoperative partial lymph node metastasis. There was no significant difference in VEGF levels between the two groups before treatment (P> 0.05), and the levels of VEGF in both groups decreased after treatment (P <0.05), and the treatment group decreased more significantly (P <0.05) VEGF protein expression decreased significantly, the difference between the two groups was statistically significant (P <0.05). Conclusion: The combination of Xiaoliu Decoction and intraperitoneal hyperthermic perfusion chemotherapy has some preventive and therapeutic effects on the postoperative patients with colorectal cancer, which can improve the quality of life of the patients. One of the mechanisms may be that it inhibits tumor angiogenesis by inhibiting VEGF protein expression in serum, Effectively reduce the adverse reactions of chemotherapy drugs, improve the ratio of CD4 + / CD8 + and enhance phagocytosis of macrophages and play a role.