Citation: | SHEN Yi, JING Ying. Efficacy of Aiyu Capsule combined with FOLFOX4 chemotherapy in treatment of median or advanced rectum cancer and its impacts on cellular immunity and survival[J]. Journal of Clinical Medicine in Practice, 2024, 28(23): 58-64. DOI: 10.7619/jcmp.20242114 |
To observe the clinical efficacy of Aiyu Capsule in combination with FOLFOX4 chemotherapy for patients with median or advanced rectum cancer, and to investigate its impacts on cellular immune function and survival.
A total of 347 patients with adenocarcinoma-type median or advanced rectum cancer were enrolled in this study from March 2018 to June 2019 were selected as study objects. Patients were divided into control group (173 patients) or observation group (174 patients) using an odd-even number system, and both groups were followed up for 36 months. The control group received FOLFOX4 chemotherapy, while the observation group additionally took Aiyu Capsule orally. Both groups underwent four consecutive treatment cycles.Clinical efficacy and traditional Chinese medicine (TCM) syndrome scores were evaluated after 2 and 4 cycles. Tumor markers, cellular immune function, adverse reaction rates, and cumulative survival rates were compared between the two groups before and after treatment.
After 2 and 4 cycles of treatment, the complete response rate and disease control rate were significantly higher in the observation group compared to the control group (P<0.05). After 2 cycles of treatment, disease control rate in the observation group was significantly higher than that in the control group (P<0.05). Both primary and secondary symptom scores, as well as total scores, decreased in both groups post-treatment, with lower scores in the observation group (P<0.05). Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels decreased in both groups after 2 cycles, with significant reduction in the observation group (P<0.05). After 4 courses of treatment, CEA and CA19-9 levels in two groups were lower than before treatment and 2 courses of treatment, and the observation group was lower than the control group (P<0.05). After two treatment cycles, the levels of CD3+, CD4+ T cells, and the CD4+ to CD8+ ratio(CD4+/CD8+) in the observation group were significantly elevated compared to pre-treatment, whereas the CD8+ T cell levels decreased significantly (P<0.05). After four treatment cycles, the control group demonstrated elevation in CD4+ T cell levels and the CD4+/CD8+ compared to the levels after two cycles (P<0.05). After four treatment cycles, the observation group had significant increase in CD3+, CD4+ T cell levels, and the CD4+/CD8+, whereas a significant reduction in CD8+ T cells compared to pretreatment (P<0.05). The incidence of dermatitis and liver function impairment was lower in the observation group (P<0.05). The Kaplan-Meier survival curve demonstrated a higher cumulative survival rate in the observation group (P=0.011).
The combination of Aiyu Capsule and FOLFOX4 chemotherapy promotes immune function recovery, alleviates chemotherapy-related adverse reactions, extends survival outcomes, and enhances clinical efficacy in patients with median or advanced rectum cancer.
[1] |
D'SOUZA N, DE NEREE TOT BABBERICH M P M, D'HOORE A, et al. Definition of the rectum: an international, expert-based Delphi consensus[J]. Ann Surg, 2019, 270(6): 955-959. doi: 10.1097/SLA.0000000000003251
|
[2] |
冯小雪, 燕忠生. 结直肠癌中医证型与客观指标的相关性研究概况[J]. 江苏中医药, 2020, 52(8): 82-86.
|
[3] |
郭天安, 谢丽, 赵江, 等. 中国结直肠癌1988—2009年发病率和死亡率趋势分析[J]. 中华胃肠外科杂志, 2018, 21(1): 33-40 doi: 10.3760/cma.j.issn.1671-0274.2018.01.007
|
[4] |
CHEN L J, NGUYEN T N M, LAETSCH D C, et al. Association of Comedication Quality With Chemotherapy-Related Adverse Drug Reactions and Survival in Older Colorectal Cancer Patients[J]. J Gerontol A Biol Sci Med Sci, 2022, 77(5): 1009-1019. doi: 10.1093/gerona/glab198
|
[5] |
徐胜昔, 张利群, 郭翔取, 等. 艾愈胶囊辅助治疗乳腺癌的有效性、安全性及经济性研究[J]. 中国医院用药评价与分析, 2014, 14(9): 780-782, 783.
|
[6] |
卢秀花, 杜瑞超, 杨波. 艾愈胶囊用于老年晚期非小细胞肺癌化疗患者的临床观察[J]. 中药药理与临床, 2016, 32(4): 123-125.
|
[7] |
邓建辉, 童小燕, 刘秋江. 艾愈胶囊配合针刺治疗胃癌化疗后白细胞减少症临床观察[J]. 中国医学创新, 2015, 12(32): 103-105. doi: 10.3969/j.issn.1674-4985.2015.32.031
|
[8] |
中华人民共和国卫生和计划生育委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2017年版)[J]. 中国医学前沿杂志: 电子版, 2018, 10(3): 1-21.
|
[9] |
中华中医药学会. 中医肛肠科常见病诊疗指南[M]. 北京: 中国中医药出版社, 2012: 65-69.
|
[10] |
URBUTE A, SAND F L, BELMONTE F, et al. Trends in rectal cancer incidence, relative survival, and mortality in Denmark during 1978—2018[J]. Eur J Cancer Prev, 2021, 31(5): 451-458.
|
[11] |
朱伟明, 陈玉超. 陈玉超辨治中晚期大肠癌的中医辨证及方药规律总结[J]. 中医药导报, 2018, 24(4): 36-38.
|
[12] |
周义志, 张忠伟, 向立斌, 刘岩, 王硕, 曹美楠. 结直肠癌组织中Rictor蛋白的表达及其与临床病理特征、预后的关系[J]. 实用临床医药杂志, 2022, 26(15): 80-83, 88. doi: 10.7619/jcmp.20220770
|
[13] |
刘景华, 王海玲, 赵阳, 等. circPRKCI和miR-545在结直肠癌中的表达及相关性研究[J]. 中华全科医学, 2024, 22(3): 376-379.
|
[14] |
史学伟, 封凯, 黄燕东, 等. 免疫检查点抑制剂在结直肠癌中的应用现状及进展[J]. 中国临床医生杂志, 2023, 51(7): 781-784. doi: 10.3969/j.issn.2095-8552.2023.07.007
|
[15] |
DIJKSTRA E A, HOSPERS G A P, KRANENBARG E M, et al. Quality of life and late toxicity after short-course radiotherapy followed by chemotherapy or chemoradiotherapy for locally advanced rectal cancer-The RAPIDO trial[J]. Radiother Oncol, 2022, 171: 69-76. doi: 10.1016/j.radonc.2022.04.013
|
[16] |
向林果, 谭憬一, 姚远, 等. 结直肠癌组织中MMR蛋白表达、MSI、RAS和BRAF基因突变与临床病理特征的关系[J]. 检验医学与临床, 2024, 21(1): 1-7.
|
[17] |
BAHADOER R R, DIJKSTRA E A, VAN ETTEN B, et al. Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial[J]. Lancet Oncol, 2021, 22(1): 29-42. doi: 10.1016/S1470-2045(20)30555-6
|
[18] |
季漪, 吴勉华. 山慈菇化学成分及其抗肿瘤作用机制研究进展[J]. 中华中医药学刊, 2018, 36(3): 596-598.
|
[19] |
杨守研, 刘瑛琦. 苦参的化学成分、药理作用及临床应用研究进展[J]. 中国药物滥用防治杂志, 2024, 30(1): 80-83.
|
[20] |
赫军, 马秉智, 田雪峰, 等. 白英化学成分和抗肿瘤药理作用的研究进展[J]. 中国药房, 2014, 25(39): 3713-3718. doi: 10.6039/j.issn.1001-0408.2014.39.24
|
[21] |
李静, 何牟, 李玲, 等. 白术挥发油化学成分及药理作用研究进展[J]. 中成药, 2024, 46(3): 881-889.
|
[22] |
LIU J, YU L, MO N L, et al. Supercritical fluid extract of Angelica sinensis and Zingiber officinale roscoe ameliorates TNBS-induced colitis in rats[J]. Int J Mol Sci, 2019, 20(15): 3816. doi: 10.3390/ijms20153816
|
[23] |
ZHOU R R, HE D, XIE J, et al. The synergistic effects of polysaccharides and ginsenosides from American ginseng (Panax quinquefolius L. ) ameliorating cyclophosphamide-induced intestinal immune disorders and gut barrier dysfunctions based on microbiome-metabolomics analysis[J]. Front Immunol, 2021, 12: 665901. doi: 10.3389/fimmu.2021.665901
|
[24] |
章玲玲, 胡本辉, 刘雅雯, 等. 艾愈胶囊联合放化疗对中晚期宫颈癌患者的临床疗效与造血系统的影响[J]. 现代医学与健康研究电子杂志, 2023, 7(12): 16-18.
|
[25] |
SEFRIOUI D, BEAUSSIRE L, GILLIBERT A, et al. CEA, CA19-9, circulating DNA and circulating tumour cell kinetics in patients treated for metastatic colorectal cancer (mCRC)[J]. Br J Cancer, 2021, 125: 725-733. doi: 10.1038/s41416-021-01431-9
|
[26] |
PAUL M S, OHASHI P S. The roles of CD8+ T cell subsets in antitumor immunity[J]. Trends Cell Biol, 2020, 30(9): 695-704. doi: 10.1016/j.tcb.2020.06.003
|
[27] |
王洋, 唐娟, 孙鹏, 等. 山慈菇提取物对人结直肠癌SW480细胞增殖和凋亡的影响[J]. 中国中医基础医学杂志, 2021, 27(11): 1754-1758, 1842.
|
[28] |
曹建, 魏润杰, 邓茹芸, 等. 苦参碱及氧化苦参碱抑制肿瘤作用机制研究进展及展望[J]. 中草药, 2019, 50(3): 753-760.
|
[29] |
梁彪, 高家治, 徐朝辉, 等. 基于网络药理学的淫羊藿增强免疫功能作用机制研究[J]. 世界中医药, 2021, 16(23): 3467-3471, 3477. doi: 10.3969/j.issn.1673-7202.2021.23.011
|
[30] |
陈彦旭, 杨华, 徐慧琳, 等. 苦参多糖的提取分离、理化性质及免疫调节活性研究[J]. 国际药学研究杂志, 2018, 45(8): 611-618.
|
[31] |
杨锦涛, 程希, 陈红伟, 等. 白术多糖免疫调节作用机制的研究进展[J]. 中国兽药杂志, 2018, 52(6): 80-85.
|
[32] |
DROTT J, FOMICHOV V, STARKHAMMAR H, et al. Oxaliplatin-Induced Neurotoxic Side Effects and Their Impact on Daily Activities: A Longitudinal Study Among Patients With Colorectal Cancer[J]. Cancer Nurs, 2019, 42(6): E40-E48. doi: 10.1097/NCC.0000000000000674
|
[33] |
沈红, 雷舒. 基于加速康复外科理念的护理干预在晚期直肠癌减瘤术联合腹腔灌注化疗患者中的应用效果[J]. 实用临床医药杂志, 2024, 28(7): 110-114. doi: 10.7619/jcmp.20232986
|
[34] |
ZHANG E, YIN S, ZHAO S, et al. Protective effects of glycycoumarin on liver diseases[J]. Phytother Res, 2020, 34(6): 1191-1197. doi: 10.1002/ptr.6598
|
[35] |
王雪娇, 刘力, 徐赟, 等. 当归止痒合剂治疗血虚风燥型老年性皮肤瘙痒症的效果[J]. 中国医药导报, 2019, 16(32): 115-118, 126.
|
[36] |
陈淼, 郭成云. 艾愈胶囊联合化疗治疗直肠癌的应用效果观察[J]. 实用中西医结合临床, 2023, 23(22): 17-20.
|