目的 探討復(fù)方天仙膠囊聯(lián)合放療治療中晚期食管癌的臨床研究。方法 選取2012年12月—2014年8月沈陽二四二醫(yī)院收治的中晚期食管癌患者64例,將患者隨機(jī)分為治療組(32例)和對照組(32例)。對照組患者采用6MV-X線直線加速器進(jìn)行三維適形放療方法照射,至總劑量為60～70 Gy,6～7周常規(guī)分割治療,5次/周,2 Gy/次。治療組給予復(fù)方天仙膠囊,餐后30 min口服,3粒/次,3次/d,2個月為1個療程。使用2周后同步放療,方法同對照組。放療結(jié)束后3個月對兩組患者臨床療效、放射不良反應(yīng)和生活質(zhì)量改善狀況進(jìn)行評價;在治療前1 d和治療全程結(jié)束后第2天采集血清樣本,測定外周血NK細(xì)胞活性、血清NO水平和血清IL-12水平。結(jié)果 治療后,對照組總有效率為62.5%,治療組總有效率為87.5%,兩組總有效率比較的差異具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。兩組患者治療后放射不良反應(yīng)和Karuafsky評分比較差異均具有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后兩組患者的外周血NK細(xì)胞數(shù)目均較治療前升高,差異有統(tǒng)計(jì)學(xué)意義(P < 0.05),治療組外周血NK細(xì)胞數(shù)目明顯低于對照組,其差異有統(tǒng)計(jì)學(xué)意義(P < 0.05)。治療后,治療組血清NO和IL-12水平明顯優(yōu)于對照組(P < 0.05)。治療后兩組患者的IL-12水平較治療前降低,血清NO水平較治療前升高,差異均有統(tǒng)計(jì)學(xué)意義(P < 0.01、0.05)。結(jié)論 復(fù)方天仙膠囊聯(lián)合放療治療中晚期食管癌具有較好的臨床療效,改善患者生活質(zhì)量。

Objective To explore the effect of Compound Tianxian Capsules combined with radiotherapy in the treatment of advanced esophageal cancer. Methods The patients with advanced esophageal cancer (64 cases) who were cured in Shenyang 242 Hospital from December 2012 to August 2014 were randomly divided into control and treatment groups, and each group had 32 cases. The patients in two groups were accepted treatment with help of 6 MV - X line linear accelerator by three dimensional conformal radiotherapy irradiation method. The total dose was 60 — 70 Gy, and conventional therapy was divided into five times a week during 6 — 7 weeks, 2 Gy/time. The patients in the treatment group were po administered with Compound Tianxian Capsules, 30 min after meals, 3 capsules /time, three times daily. A course included two months. Radiotherapy was adopted in patients in treatment group after two weeks, and other treatment was the same as the control group. After the treatment of radiotherapy for three months, the efficacies, adverse reactions, and quality of life were evaluated. Blood samples were collected 1 d before treatment and second day after treatment to detect peripheral blood NK cell activity and the levels of NO and IL-12. Results After treatment, the efficacies in the control and treatment groups were 62.5% and 87.5%, respectively, and there were differences between two groups (P < 0.05). There were differences of adverse reactions and Karuafsky scores after treatment between two groups (P < 0.05). Peripheral blood NK cell numbers in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). Peripheral blood NK cell numbers in the treatment group were significantly lower than those of the control group, with difference between two groups (P < 0.05). After treatment, the levels of NO and IL-12 in the treatment group were better than those of control group, with significant difference between two groups (P < 0.05). The levels of IL-12 in two groups after treatment were significantly decreased, while the level of NO were decreased, and the difference was statistically significant in the same group (P < 0.05, 0.01). Conclusion Compound Tianxian Capsules combined with radiotherapy has the good clinical effect in the treatment of advanced esophageal cancer, and improve life qualities o patients.