CAJ | 학술논문

目的：探讨替吉奥胶囊联合奥沙利铂化疗对进展期胃癌根治术患者的影响。方法选择2011年1月~2013年8月湖州市中医院收治的86例进展期胃癌患者为研究对象，将其随机分为对照组和观察组，各43例。对照组先给予奥沙利铂化疗，再行腹腔镜胃癌根治术。观察组先给予替吉奥联合奥沙利铂化疗，再行腹腔镜胃癌根治术。观察比较两组患者的临床疗效、不良反应及CD3+T细胞、CD4+T细胞、CD8+T细胞水平。结果观察组总有效率为65.12%，显著高于对照组(41.86%)，差异有统计学意义(P<0.05)。观察组患者白细胞下降发生率(11.63%)、血小板下降发生率(11.63%)、胃肠道反应发生率(16.28%)均显著少于对照组(30.23%、25.58%、34.88%)，差异均有统计学意义(P<0.05)。观察组R0切除率(65.12%)高于对照组(37.21%)，差异有高度统计学意义(P<0.01)。观察组术后复发率(9.30%)低于对照组(41.86%)，病死率(4.65%)低于对照组(23.26%)，差异有统计学意义(P<0.01、P<0.05)。观察组治疗后CD4+T细胞、CD8+T细胞、CD4+/CD8+水平均高于对照组，差异均有统计学意义(P<0.01或P<0.05)。结论术前接受替吉奥胶囊联合奥沙利铂化疗能有效提高进展期胃癌根治术患者的疗效，降低术后复发率、病死率，与正常人比较患者免疫功能明显下降，但化疗后可以提高机体CD4+T细胞、CD4+/CD8+的表达水平。
목적：탐토체길오효낭연합오사리박화료대진전기위암근치술환자적영향。방법선택2011년1월~2013년8월호주시중의원수치적86례진전기위암환자위연구대상，장기수궤분위대조조화관찰조，각43례。대조조선급여오사리박화료，재행복강경위암근치술。관찰조선급여체길오연합오사리박화료，재행복강경위암근치술。관찰비교량조환자적림상료효、불량반응급CD3+T세포、CD4+T세포、CD8+T세포수평。결과관찰조총유효솔위65.12%，현저고우대조조(41.86%)，차이유통계학의의(P<0.05)。관찰조환자백세포하강발생솔(11.63%)、혈소판하강발생솔(11.63%)、위장도반응발생솔(16.28%)균현저소우대조조(30.23%、25.58%、34.88%)，차이균유통계학의의(P<0.05)。관찰조R0절제솔(65.12%)고우대조조(37.21%)，차이유고도통계학의의(P<0.01)。관찰조술후복발솔(9.30%)저우대조조(41.86%)，병사솔(4.65%)저우대조조(23.26%)，차이유통계학의의(P<0.01、P<0.05)。관찰조치료후CD4+T세포、CD8+T세포、CD4+/CD8+수평균고우대조조，차이균유통계학의의(P<0.01혹P<0.05)。결론술전접수체길오효낭연합오사리박화료능유효제고진전기위암근치술환자적료효，강저술후복발솔、병사솔，여정상인비교환자면역공능명현하강，단화료후가이제고궤체CD4+T세포、CD4+/CD8+적표체수평。
Objective To investigate the effect of Tegafur Gimeracil Oteracil Potassium Capsule combined with Oxali-platin chemotherapy for patients with radical gastrectomy for advanced gastric cancer. Methods 86 cases of patients with advanced gastric cancer admitted to Huzhou Hospital of Traditional Chinese Medicine from January 2011 to Au-gust 2013 were chosen as research objects, and they were randomly divided into control group and observation group, with 43 cases in each group. The control group was given Oxaliplatin chemotherapy first, then they were taken laparo-scopic radical gastrectomy; the observation group was given Tegafur Gimeracil Oteracil Potassium Capsule combined with Oxaliplatin chemotherapy first, then they were taken laparoscopic radical gastrectomy. The clinical effect, adverse reactions and levels of CD3+T cell, CD4+T cell, CD8+T cell of the two groups were observed and compared. Results The total efficiency of the observation group was 65.12%, which was higher than that of the control group (41.86%), the dif-ference was statistically significant (P < 0.05). The incidence of leukocyte decrease (11.63%), platelet descend (11.63%), gastrointestinal reactions (16.28%) of the observation group were all less than those of control group (30.23%, 25.58%, 34.88%), the differences were all statistically significant (P<0.05). The R0 resection rate of observation group (65.12%) was higher than that of control group (37.21%), with a highly significant difference (P<0.01). The recurrence rate after operation of observation group (9.30%) was lower than that of control group (41.86%), fatality rate (4.65%) was lower than that of contro group (23.26%), with highly significant differences (P< 0.01, P< 0.05). After treatment, the CD4+T cell, CD8+T cell, CD4+/CD8+of observation group were all higher than those of control group, there were sta-tistically significant differences (P< 0.01 or P< 0.05). Conclusion Tegafur Gimeracil Oteracil Potassium Cap-sule combined with Oxaliplatin chemotherapy before operation can effectively improve the efficacy of patients with rad-ical gastrectomy for advanced gastric cancer, reduce postoperative recurrence rate and fatality rate. Compared with the normal people, the immune function of patients decreases obviously, but after chemotherapy, it can improve the expres-sion levels of CD4+T, CD4+/CD8+.