| Objectives:This study was designed to observe the short-term efficacy of Jianpi Yangwei decoction,an empirical decoction of Professor Liu Shenlin,on patients with advanced gastric cancer undergoing chemotherapy,as well as its effect in regulating plasma inflammatory cytokines in patients with gastric cancer,and analyze the efficacy and safety of Jianpi Yangwei decoction in the treatment of gastric cancer,and further explore the regulation of the prescription on the tumor immune microenvironment.Methods:a total of 60 cases of stage Ⅳ gastric cancer patients with spleen and stomach weakness syndrome were collected from the Department of oncology and digestive tumor surgery outpatient and ward of Jiangsu Provincial Hospital of traditional Chinese medicine from December 2019 to January 2021.The patients were randomly divided into an experimental group(Jianpi Yangwei decoction combined with chemotherapy)and a control group(chemotherapy alone)with 30 cases in each group.The tumor target lesion size,plasma inflammatory cytokines IL-1β,IL-2,IL-4,IL-6,IL-8,IL-10,TNF-α,EFN-γ levels,TCM symptom score of gastric cancer,Karnofsky score,and common adverse reactions were recorded.Excel was used to record and sort out the data,and SPSS 26.0 software was used for statistical analysis.Results:① Short-term efficacy:after two cycles of treatment,the objective response rate of the experimental group and the control group was 36.67%and 20.00%respectively,and there was no significant difference between the two groups(P=0.152>0.05).②Plasma inflammatory cytokines:before treatment,the levels of some plasma inflammatory cytokines in the two groups were higher than normal,but there was no difference between the two groups,all P>0.05;after treatment,the plasma concentrations of IL-1 β,IL-6,IL-8,and TNF-α in the experimental group significantly decreased(P<0.01);after treatment,the plasma levels of IL-2,IL-6,and IFN-y in the control group decreased(P<0.05),and the levels of IL-1β,IL-8,and TNF-α in the control group decreased significantly(P<0.01);after 2 cycles of treatment,compared with the control group,the concentrations of IL-1,IL-8 and TNF-α in the experimental group decreased more significantly(P<0.05),especially in IL-6(P<0.01),while the concentrations of IFN-γ in the experimental group increased(P<0.05),and there was no difference between the other two groups(P>0.05).③ TCM syndrome score:after treatment,the total effective rates of improving the TCM symptoms of gastric cancer in the two groups were 63.33%and 30.00%respectively,which were significantly higher in the experimental group than in the control group,and the difference between the two groups was statistically significant(P=0.01<0.05).④Quality of life score:after treatment,the improvement rates of Kamofsky functional status score in the two groups were 70.00%and 40.00%,respectively,and the experimental group was significantly higher than the control group,with a significant difference between the two groups(P=0.02<0.05).⑤Toxicity and side effects:the incidence of grade Ⅲ～Ⅳ adverse reactions in the two groups was lower,the incidence of gastrointestinal reactions in the experimental group was 13.33%,and that in the control group was 36.67%,the difference was statistically significant(P=0.037<0.05),but there was no significant difference in the incidence of bone marrow suppression,liver and kidney function injury between the two groups(P>0.05).Conclusion:Although Jianpi Yangwei decoction has no definite advantage in improving the short-term efficacy of chemotherapy in patients with advanced gastric cancer,it can reduce the gastrointestinal side effects of chemotherapy,significantly improve the spleen deficiency syndrome of patients with gastric cancer,and improve their quality of life.At the same time,it can regulate the imbalance of plasma inflammatory cytokines and improve the immunosuppressive microenvironment of gastric cancer to a certain extent. |
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