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目的探讨西黄丸联合紫杉醇和铂类新辅助化疗对晚期宫颈癌患者术后疗效的影响。方法选取2014年1月—2017年1月安阳市第三人民医院收治的晚期宫颈癌患者80例为研究对象,采用随机数字表法分为观察组和对照组各40例,均择期行根治性子宫切除术,术后对照组予以紫杉醇+顺铂新辅助化疗方案,3周为1个疗程,治疗2个疗程;观察组在对照组基础上予以西黄丸2次/d,治疗6周。比较两组化疗有效率、生存率及复发率,测定两组化疗前后T淋巴细胞亚群(CD3+、CD4+、CD8+)及免疫球蛋白(Ig A、Ig G、Ig M)水平,应用卡氏评分表(KPS)、数字评分法(NRS)评价生活质量及癌痛度,记录不良反应。结果观察组化疗有效率(87.50%)与对照组(77.50%)比较略高,但差异无统计学意义;观察组化疗后3、6个月生存率、复发率与对照组对比均无统计学差异;化疗后观察组CD3+(72.39±1.47)%、CD4+(37.62±1.17)%、Ig A(11.11±1.34)g/L、Ig G(1.23±0.45)g/L、Ig M(2.60±0.46)g/L较对照组明显增加,差异有统计学意义(P<0.05);观察组CD8+(20.32±1.39)%低于对照组,差异有统计学意义(P<0.05)。治疗后观察组KPS评分(78.49±1.45)分较对照组显著增加,而其NRS评分(1.20±0.11)较对照组明显降低,差异有统计学意义(P<0.05)。观察组不良反应发生率(7.50%)明显低于对照组(25.00%),差异有统计学意义(P<0.05)。结论西黄丸西黄丸联合紫杉醇和铂类新辅助化疗对晚期宫颈癌患者术后疗效较好,可改善其免疫功能、生活质量、疼痛度,减少不良反应,近期不会明显改善生存率及复发率,远期疗效需进一步研究。
Objective To investigate the effect of Xiyhuang Pill combined with paclitaxel and platinum neoadjuvant chemotherapy on postoperative curative effect of patients with advanced cervical cancer. Methods From January 2014 to January 2017, Anyang Third People’s Hospital admitted 80 cases of advanced cervical cancer patients for the study, the use of random number table divided into observation group and control group of 40 patients were elective radical line Hysterectomy, postoperative control group was given paclitaxel + cisplatin neoadjuvant chemotherapy, 3 weeks for a course of treatment for 2 courses; the observation group in the control group on the basis of Xi Huang Wan 2 times / d for 6 weeks. The effective rate, survival rate and recurrence rate of the two groups were compared. The levels of T lymphocyte subsets (CD3 +, CD4 +, CD8 +) and immunoglobulin (Ig A, Ig G, Ig M) were measured before and after chemotherapy. Table (KPS), digital scoring method (NRS) evaluation of quality of life and cancer pain, record adverse reactions. Results The effective rate of chemotherapy (87.50%) in the observation group was slightly higher than that of the control group (77.50%), but the difference was not statistically significant. The survival rate and recurrence rate in the observation group at 3,6 months after chemotherapy were not statistically different from those in the control group (72.39 ± 1.47)%, CD4 (37.62 ± 1.17)%, Ig A (11.11 ± 1.34) g / L, Ig G (1.23 ± 0.45) g / L and Ig M (2.60 ± 0.46 ) g / L increased significantly compared with the control group, the difference was statistically significant (P <0.05); the observation group CD8 (20.32 ± 1.39)% lower than the control group, the difference was statistically significant (P <0.05). After treatment, the score of KPS in the observation group (78.49 ± 1.45) increased significantly compared with the control group, while the NRS score (1.20 ± 0.11) in the observation group was significantly lower than that in the control group (P <0.05). The incidence of adverse reactions in the observation group (7.50%) was significantly lower than that in the control group (25.00%), the difference was statistically significant (P <0.05). Conclusion Xiluwan Xihuang Pill combined with paclitaxel and platinum neoadjuvant chemotherapy has better curative effect on patients with advanced cervical cancer after operation, which can improve its immune function, quality of life, pain and reduce adverse reactions, and will not significantly improve the survival rate in the near future. The recurrence rate, long-term efficacy needs further study.