[摘要]目的：评价六味地黄加减方在食管癌放射治疗(以下简称放疗)中的减毒作用并探讨其作用机制。
方法：将60例符合纳入标准的食管癌患者随机分为：治疗组(中药六味地黄加减方配合放疗)和对照组(单纯放疗)。检测患者放疗前后TNF—α(肿瘤坏死因子)和T细胞亚群的变化，观察放疗过程中出现放射性食管炎的程度、骨髓抑制的发生率和程度以及放疗前后的体力状况变化。
结果：放疗前后TNF—a的变化两组间无统计学意义(P>0．05)。治疗组放疗后CD4／CD8比值明显高于对照组(P<0．05)。急性放射性食管炎的发生率治疗组明显低于对照组(P<0．05)。放疗后治疗组体力状况的获益率高于对照组 (P<0．05)。
结论：六味地黄加减方配合放疗能提高食管癌患者的免疫功能，减轻放疗过程中的毒副反应，从而提高食管癌患者的生活质量，但远期疗效尚需进一步观察。
关键词：食管癌：放射治疗；六味地黄加减方
Clinical study of the Combination Liu Wei Dihuang Jiajian Fang and Radiotherapy for cancer of the Esophagus
Affiliated Tumor Ho ital of Xinjiang Medical University
Du Yeqin Li Yuxin Zhang Jingrong Hang Yanchun Pang Rui
[A tract]Purpose: To evaluate the Toxin Reducing-Effect function of Liu Wei Dihuang Jiajian Fang on Radiotherapy for Esophagus Cancer and discu its mechanism. Methods: 60 esophagus cancer patients were randomized into 2 grou : control group (radiotherapy group, 30 cases)and treatment group (combined Bu Shen Yi Huo Tang and Radiotherapy, 30 cases) Routine radiotherapy was a lied to both grou . O erve the changes of TNF- α, T cell subgroup andK score before and after radiotherapy in the two grou . Meanwhile, register the radiation inte ity and their grades when acute radiationesophagitis and arrest of bone marrow occurred. Results: Thedifference of TNF- a before and after radiotherapy between treatmentgroup and control group has no statistic significance (P>0.05). Afterradiotherapy, in treatment group, the peripheral blood CD4/CD8 ratioin T lymphocyte with esophagus cancer was significantly higher thanthat in control group (P<0.05). Acuteradiation esophagitis rate in treatment group is significantly lower thanthat of control group (P<0.05). K score of treatment group after radiotherapy is significantly higher thanthat of control group (P<0.05).Conclusio : Liu Wei Dihuang Jiajian Fang canimprove the esophagus cancer patient\'s life quality because it canimprove immunologic function and reduce side and toxic effect ofradiotherapy. Further investigation about the long-term effect of Bu Shcn Yi huo tang is still nece ary.
Key words: Esophagus Cancer; Radiotherapy; Bu Shen Yi Fluo Fang
报告作者地址：新疆医科大学附属肿瘤医院
电话：0991-7968040 电子邮箱：mongder@163.com
身份 证 号码：650103550208402
食管癌是我国常见的发病率较高的恶性肿瘤之一。而就诊者中70~80%已属中晚期，大部分已失去手术机会，放射治疗是目前主要治疗手段之一。但中晚期食管癌5年生存率多年来未有明显提高，单纯外照射疗效较差，食管癌放射治疗失败的原因主要是局部未控和复发，高达80%。因此，有必要探索新的治疗方法。本课题研究了六味地黄丸方加味而成的六味地黄加减方配合外照射在食管癌治疗中的减毒增效作用，现报告如下。
临床资料
将2003年2月至10月在新疆肿瘤医院放疗二科住院接受放射治疗并且经过病理诊断证实的60例食管癌患者随机分为治疗组(中药六味地黄加减方配合放射治疗）和对照组(单纯放射治疗)。全部病例放射治疗前外周血白细胞均≥4.0×109／L。临床资料见表1，经统计学检验P>0.05,两组具有可比性。
表1 两组食管癌的一般情况
临床资料
治疗组
n=30
对照组
n=30
性别
男/女
20/10
22/8
中位年龄(Y)
62
60
病变长度
<3cm
3~5cm
>5cm
1
10
19
1
7
22
病理类型