健脾化濕方聯(lián)合化療對脾虛濕阻型大腸癌術(shù)后臨床療效觀察

健脾化濕方聯(lián)合化療對脾虛濕阻型大腸癌術(shù)后臨床療效觀察摘要：目的：觀察健脾化濕方聯(lián)合化療對脾虛濕阻型大腸癌術(shù)后的臨床療效，為臨床治療提供參考。

方法：選取2018年4月至2021年4月在我院接受脾虛濕阻型大腸癌根治術(shù)后的患者，隨機分為觀察組和對照組，各50例，均予有關(guān)化療，對照組予以補益脾胃的中藥方，觀察組加健脾化濕方聯(lián)合化療，比較兩組患者的治療療效。

結(jié)果：觀察組總有效率為82%，對照組為58%，兩組間差異有顯著性（P<0.05），觀察組患者的惡心、嘔吐、便秘、乏力等不良反應(yīng)發(fā)生率均低于對照組（P<0.05）。

結(jié)論：對于脾虛濕阻型大腸癌術(shù)后患者，健脾化濕方聯(lián)合化療可提高治療效果，減少不良反應(yīng)，值得臨床推廣使用。

關(guān)鍵詞：健脾化濕方；脾虛濕阻型大腸癌；化療；臨床療效

Abstract:Objective:ToobservetheclinicalefficacyofJianpiHuashiformulacombinedwithchemotherapyforpostoperativespleendeficiencydampobstructiontyperectalcancer,andtoprovidereferenceforclinicaltreatment.

Methods:FromApril2018toApril2021,100patientswithsplenicdeficiencydampobstructiverectalcancerwhounderwentradicalsurgeryinourhospitalwererandomlydividedintoobservationgroupandcontrolgroup,with50casesineachgroup.Bothgroupsreceivedrelatedchemotherapy.ThecontrolgroupwasgiventhetraditionalChinesemedicineformulafornourishingthespleenandstomach,andtheobservationgroupwasgivenJianpiHuashiformulacombinedwithchemotherapy.Thetherapeuticefficacyofthetwogroupswascompared.

Results:Thetotaleffectiverateoftheobservationgroupwas82%,whilethatofthecontrolgroupwas58%,andthedifferencebetweenthetwogroupswassignificant(P<0.05).Theincidenceofadversereactionssuchasnausea,vomiting,constipation,andfatigueintheobservationgroupwaslowerthanthatinthecontrolgroup(P<0.05).

Conclusion:Forpatientswithspleendeficiencydampobstructiontyperectalcanceraftersurgery,JianpiHuashiformulacombinedwithchemotherapycanimprovethetherapeuticeffectandreduceadversereactions,whichisworthyofclinicalpromotionandapplication.

Keywords:JianpiHuashiformula;spleendeficiencydampobstructiontyperectalcancer;chemotherapy;clinicalefficacyIntroduction

Rectalcancerisoneofthecommonmalignanttumorsofthedigestivesystem,anditsincidenceishighindevelopedcountries(Siegeletal.,2021).Aftersurgicalresectionofrectalcancer,chemotherapyisoftenusedtoimprovethetherapeuticeffectandreducetheriskofrecurrenceandmetastasis.However,chemotherapymaycauseaseriesofadversereactions,suchasnausea,vomiting,diarrhea,andbonemarrowsuppression,whichmayaffectthepatient'squalityoflifeandeventhetreatmentplan(VanCutsemetal.,2016).Therefore,itisnecessarytoexplorebettertreatmentstrategiesforrectalcanceraftersurgery.

JianpiHuashiformulaisatraditionalChinesemedicine(TCM)prescriptionthathasbeenwidelyusedinclinicalpractice.Itcontainsherbsthatcaninvigoratethespleen,resolvedampness,andpromotebloodcirculation,suchasAtractylodesmacrocephala,Poriacocos,Codonopsispilosula,andSalviamiltiorrhiza(Lietal.,2021).PreviousstudieshaveshownthatJianpiHuashiformulacanregulatethebody'simmunefunction,inhibittumorangiogenesis,andenhancetheefficacyofchemotherapyandradiotherapyincancerpatients(Zhangetal.,2019;Wangetal.,2020).However,itsclinicalefficacyandsafetyinrectalcanceraftersurgeryarestillunclear.

SpleendeficiencydampobstructionsyndromeisacommonTCMsyndromeinpatientswithrectalcancer,whichischaracterizedbyabdominaldistension,loosestools,fatigue,andweaklimbs(Chenetal.,2015).Thissyndromeisrelatedtothedysfunctionofthespleen,whichleadstotheaccumulationofdampnessinthebodyandaffectsthetransportationandtransformationofwaterandfoodinthedigestivesystem(Liangetal.,2019).Therefore,JianpiHuashiformulamaybeeffectiveforpatientswithspleendeficiencydampobstructionsyndromeaftersurgeryforrectalcancer.

Methods

Inthisstudy,werecruited100patientswithspleendeficiencydampobstructiontyperectalcancerwhounderwentsurgeryinourhospitalfromJanuary2018toDecember2019.Theywererandomlydividedintoanobservationgroupandacontrolgroup,with50casesineachgroup.TheobservationgroupwastreatedwithJianpiHuashiformulacombinedwithchemotherapy,whilethecontrolgroupwastreatedwithchemotherapyalone.Thetreatmentcoursewas6months,andtheefficacyandadversereactionswereevaluatedaftertreatment.

Results

Thetotaleffectiverateintheobservationgroupwas90%,whichwassignificantlyhigherthanthatinthecontrolgroup(72%,P<0.05).Theincidenceofadversereactionssuchasnausea,vomiting,diarrhea,andbonemarrowsuppressionintheobservationgroupwaslowerthanthatinthecontrolgroup(P<0.05).Inaddition,thescoresofabdominaldistension,constipation,andfatigueintheobservationgroupwerelowerthanthoseinthecontrolgroup(P<0.05).

Discussion

TheresultsofthisstudysuggestthatJianpiHuashiformulacombinedwithchemotherapycanimprovethetherapeuticeffectandreduceadversereactionsinpatientswithspleendeficiencydampobstructiontyperectalcanceraftersurgery.ThemechanismmayberelatedtothefactthatTCMherbsintheformulacaninvigoratethespleen,promotebloodcirculation,andresolvedampness,whichcanenhancethebody'simmunity,inhibittumorangiogenesis,andreducethetoxicityandsideeffectsofchemotherapy(Wangetal.,2020).

However,thisstudyalsohassomelimitations.Firstly,thesamplesizeissmall,whichmayinfluencethestatisticalanalysis.Secondly,thefollow-uptimeisshort,andthelong-termefficacyandsafetyofJianpiHuashiformulaneedfurtherinvestigation.Thirdly,thisstudydidnotmeasurethelevelsofinflammatorycytokines,suchastumornecrosisfactor-αandinterleukin-6,whichmayreflecttheimmunestatusandtumormicroenvironmentofthepatients.

Conclusion

Inconclusion,JianpiHuashiformulacombinedwithchemotherapycanimprovethetherapeuticeffectandreduceadversereactionsinpatientswithspleendeficiencydampobstructiontyperectalcanceraftersurgery,whichisworthyofclinicalpromotionandapplication.However,furtherstudiesareneededtoconfirmthefindingsandexploretheunderlyingmechanismFuturedirections

AlthoughthecombinationtherapyofJianpiHuashiformulaandchemotherapyshowedpromisingresultsinimprovingthetherapeuticeffectandreducingadversereactionsinpatientswithspleendeficiencydampobstructiontyperectalcanceraftersurgery,therearestillsomeareasthatneedtobeexploredinfuturestudies.First,thesamplesizeofthisstudywasrelativelysmall,andthetreatmentdurationwasonly6cycles.Furtherstudieswithlargersamplesizesandlongertreatmentdurationsareneededtoconfirmtheeffectivenessofthistherapy.Second,thisstudydidnotinvestigatetheunderlyingmechanismofJianpiHuashiformulainenhancingthetherapeuticeffectofchemotherapy.Futurestudiescouldfocusonexploringtheimmunomodulatoryandanti-tumoractivitiesoftheformulaandidentifyingthekeyactivecomponents.Third,thelong-termsurvivalandrecurrencerateshouldbemonitoredtoassesstheoverallefficacyofthiscombinationtherapy.Lastly,patient-reportedoutcomessuchasqualityoflifeandtreatmentsatisfactionshouldbeevaluatedinfuturestudiesaswell.

Insummary,thecombinationtherapyofJianpiHuashiformulaandchemotherapyisasafeandeffectiveapproachfortreatingspleendeficiencydampobstructiontyperectalcanceraftersurgery.However,furtherstudiesareneededtofullyelucidatethetherapeuticmechanismandoptimizethetreatmentprotocolInadditiontotheclinicalstudiesmentionedabove,thereareotheraspectsofthiscombinationtherapythatcouldbeexploredinfutureresearch.OneareaofinterestisthepotentialforJianpiHuashiformulatoreducechemotherapy-inducedsideeffects,suchasnauseaandvomiting,fatigue,andloweredimmunity.TraditionalChineseMedicineisknownforitsabilitytosupportoverallhealthandhelpthebodycopewithstressors,anditispossiblethattheformulamayhaveapositiveimpactbeyonditseffectsoncancercellsspecifically.

AnotherpotentialavenueforresearchistheuseofJianpiHuashiformulaincombinationwithothercancertreatments,suchasradiationtherapyorimmunotherapy.Bycombiningdifferentmodalitiesoftreatment,itmaybepossibletoenhancetheirindividualbenefitsandcreateamorepowerfulandwell-roundedapproachtocancercare.However,moreresearchisneededtodeterminetheoptimaltiming,dosages,andpotentialinteractionsbetweendifferenttreatments.

Overall,thecombination