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目的:观察黄芪多糖联合化疗对胃癌恶性腹水的临床效果,探讨黄芪多糖抗肿瘤机制。方法:将98例进展期胃癌合并恶性腹水患者随机分为联合组及对照组。两组患者均采用腹水抽吸+腹腔化疗药物注射方案。联合组在化疗方案基础上加用黄芪多糖治疗。21 d为1个疗程。1个疗程结束后评价治疗效果。结果:联合组治疗有效率为73.5%,对照组治疗有效率为49.0%,联合组有效率高于对照组(P<0.05);两组患者治疗前在CD3+、CD4+、CD8+、CD4+/CD8+上差异无统计学意义(P>0.05);治疗后,联合组在CD3+、CD4+及CD4+/CD8+上均明显高于对照组(P<0.01);两组患者化疗前腹水中TNF-α、IL-6及IL-10差异无统计学意义(P>0.05);化疗后联合组腹水中TNF-α、IL-6及IL-10均低于对照组(P<0.05)。结论:黄芪多糖可提高化疗对于胃癌合并恶性腹水的治疗效果,其抗肿瘤机制可能与增强细胞免疫CD4+、抑制炎性因子分泌有关。
Objective: To observe the clinical effects of astragalus polysaccharide combined with chemotherapy on malignant ascites of gastric cancer, and explore the antitumor mechanism of Astragalus polysaccharide. Methods: 98 cases of advanced gastric cancer with malignant ascites were randomly divided into combined group and control group. Two groups of patients were treated with ascites suction + intraperitoneal chemotherapy drug injection program. The combined group on the basis of chemotherapy with astragalus polysaccharide treatment. 21 d for a course of treatment. After a course of treatment to evaluate the effect of treatment. Results: The effective rate was 73.5% in the combination group and 49.0% in the control group, and the effective rate in the combined group was higher than that in the control group (P <0.05). Before treatment, the two groups were on CD3 +, CD4 +, CD8 + and CD4 + / CD8 + The difference was not statistically significant (P> 0.05). After treatment, the levels of CD3 +, CD4 + and CD4 + / CD8 + in the combined group were significantly higher than those in the control group (P <0.01) (P> 0.05). The levels of TNF-α, IL-6 and IL-10 in ascites of the combination group were lower than those of the control group after chemotherapy (P <0.05). Conclusion: Astragalus polysaccharide can improve the curative effect of chemotherapy on malignant ascites due to gastric cancer. The anti-tumor mechanism may be related to the enhancement of cellular immune CD4 + and the inhibition of the secretion of inflammatory cytokines.