| Objective: Postoperative adjuvant chemotherapy for large intestinal cancer often results in severe gastrointestinal mucositis,and even leads to intolerable patients unable to complete all chemotherapy cycles on schedule and at the proper dose,thus affecting their prognosis.This study aims to observe gastrointestinal mucositis in patients with intestinal cancer after adjuvant chemotherapy,and to evaluate the clinical value of Astragalus granules in the treatment of gastrointestinal mucositis.Methods: Methods: Eighty patients with stage IIB-IIIC large intestinal cancer undergoing postoperative chemotherapy or neoadjuvant chemotherapy in the Department of Large Intestinal Surgery of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine(TCM)and Fudan University Shanghai Cancer Center from October 1,2016 to February 28,2019 were selected.The treatment group was orally administrated with Astragalus granules,a self-made Chinese patent medicine,during adjuvant chemotherapy after surgery,while the control group was given placebo containing 10% Astragalus granules,until the end of last chemotherapy.Digestive tract symptom score,KPS score,FACT-C score,TCM syndrome score and weight change were recorded before each chemotherapy.Chemotherapy completion rate was calculated.Serum citrulline content and serum inflammatory factors were detected.Safety and adverse events were recorded.A database was established using EXCEL.Statistical analysis of the above indicators was carried out by SPSS 23.0,a professional statistical software.Appropriate statistical methods were selected according to data characteristics.Results: Digestive tract symptoms in the treatment group were significantly milder than those in the control group,especially in diarrhea,tenesmus,burning sensation around the anus and fatigue.As for quality of life,the overall quality of life in the treatment group was higher than that in the control group.Physiological condition,emotional state and intestinal cancer subscale score in the treatment group were superior than those in the control group.Outcome indexes were improved significantly in the treatment group.As for quantitative TCM syndrome score,the total effective rate in the treatment group was higher compared with the control group.As for blood indexes,the total lymphocyte count in the treatment group decreased after treatment compared with that before treatment.After chemotherapy,CD8+ decreased in the treatment group while increased in the control group compared with that before chemotherapy.The levels of IL-2 and IL-8 in the treatment group were lower than those in the control group.TNF-α level increased after treatment compared with that before treatment.Serum citrulline increased significantly in the treatment group while decreased in the control group after chemotherapy.During chemotherapy,the incidence of adverse reactions was lower in the treatment group compared with the control group,especially in the improvement of diarrhea.Conclusion: Astragalus granules combined with postoperative adjuvant chemotherapy can alleviate digestive tract reactions during chemotherapy and improve the quality of life,which may be related to the improvement of intestinal mucosal injury and alleviation of inflammatory reaction. |
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