世界中医药

目的：探讨扶正散瘀法对中晚期食管癌放疗增效的价值与机制。方法：选取2010年7月至2014年2月陕西中医药大学附属医院收治的中晚期食管鳞状细胞癌患者144例，根据随机数字表法分为观察组和对照组，每组72例。对照组给予三维适形放疗，观察组在对照组治疗的基础上给予扶正散瘀法治疗，记录放疗效果、不良反应，随访调查生存率。结果：观察组与对照组的治疗有效率分别为90.3%和72.2%，观察组高于对照组，差异有统计学意义(P<0.05)。观察组放疗期间的放射性食管炎、肺炎、溃疡等发生率分别为47.2%、11.1%和5.6%，对照组为86.1%、30.6%和19.4%，观察组都少于对照组，差异有统计学意义(P<0.05)。治疗后观察组与对照组的NK细胞活性与IL-12含量都明显高于治疗前，差异有统计学意义(P<0.05)，同时治疗后观察组的NK细胞活性与IL-12含量也明显高于对照组，差异有统计学意义(P<0.05)。随访调查显示观察组的1年、2年、3年生存率分别为98.6%、95.8%和94.4%，对照组为88.9%、80.6%和75.0%，观察组明显高于对照组，差异有统计学意义(P<0.05)。结论：扶正散瘀法在中晚期食管癌放疗中应用可激活和平衡细胞因子网络，促进机体的抗瘤免疫效应，从而产生放疗增效与减毒作用，有利于提高患者的生存率，有很好的应用价值。

English Summary:

To investigate the values and mechanism of t Fuzheng Sanyu Therapy in the radiotherapy synergism for the advanced esophageal cancer. Methods:From July 2010 to February 2014, 144 patients with advanced esophageal squamous cell carcinoma in our hospital for treatment were selected as the research object. All the patients were divided into experimental group and control group with 72 cases in each group accorded to random number table method. The control group was received three-dimensional conformal radiotherapy, and the experimental group was given Fuzheng Sanyu therapy treatment based on the control group. The toxicity and effect, the survival rate of followed-up survey were recorded. Results:The effective rates of the experimental group and the control group were 90.3% and 72.2% respectively, and the experimental group was higher than that of the control group (P<0.05). In the experimental group, the incidence rate of radiation esophagitis, pneumonia and ulcer were 47.2%, 11.1% and 19.4% respectively, and 86.1%, 30.6% and 5.6% in the control group. The treatment group were lower than that of the control group (P<0.05). After treatment, the NK activity and IL-12 content in the experimental group and the control group were significantly higher than those before treatment (P<0.05), while the NK activity and IL-12 content in the experimental group after treatment were significantly higher than those in the control group (P<0.05). Followed up survey showed that the 1 year, 2 year and 3 year survival rates of the experimental group were 98.6%, 95.8% and 94.4%, respectively, and 88.9%, 80.6%, 75.0% in the control group. The treatment group were higher than that of the control group (P<0.05). Conclusion:The application of Fuzheng Sanyu Therapy in the advanced esophageal cancer patient can activate and balance the cytokine network, promote anti-tumor immunological effect of the body, result in the synergistic and attenuate effect of radiotherapy, improve the survival rate of patients, with good application values.

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