Clinical Observation Of Yiqi Tongluo Jiedu Decoction Combined With Concurrent Chemoradiotherapy In The Treatment Of Esophageal Cancer With The Type Of Qi Deficiency And Phlegm And Blood Stasis

Objective:Through observing the effects of Yiqi Tongluo Jiedu Decoction combined with concurrent chemoradiotherapy on TCM symptoms,life quality,short-term efficacy,immune function,tumor abnormal protein and adverse reactions of esophageal cancer patients with the type of qi deficiency and phlegm and blood stasis,this study aims at exploring the application value of Yiqi Tongluo Jiedu Decoction in the treatment of esophageal cancer,and the feasibility and superiority of Chinese medicine combined with concurrent chemoradiotherapy,so as to provide a better guidance in clinical application.Methods:60 advanced esophageal cancer patients with the type of qi deficiency and phlegm and blood stasis after definite diagnosis were selected and randomly divided into treatment group and control group with 30 cases in each group.Two groups of patients were treated with concurrent chemoradiotherapy.Three-dimensional conformal intensity modulated radiotherapy was employed in the whole course of radiotherapy.The chemotherapy regimen,"5-fluorouracil+cisplatin"was adopted.Chemotherapy began on the first day of radiotherapy.The treatment group received Yiqi Tongluo Jiedu Decoction at the sametime from the first day of treatment,while the control group just received concurrent concurrent chemoradiotherapy.Both groups were treated for 2 cycles.Results:There were no significant differences in gender,age,pathological type,histological differentiation,clinical stage,lesion region and total score of TCM symptoms between the two groups before treatment(P>0.05).(1)Comparison of the total score of TCM symptoms:After treatment,the total score of TCM symptoms in the two groups decreased significantly compared with that before treatment(P<0.05);the effective rate of the treatment group was 86.67%,and that of the control group was 60.00%.The curative effect of the treatment group was better than that of the control group,and the difference between the two groups was statistically significant(P<0.05).(2)Comparison of KPS score:After treatment,the KPS score of the treatment group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).(3)Comparison of short-term efficacy:After treatment,the total effective rate of the treatment group was 66.67%,and that of the control group was 53.33%.There was no significant difference between the two groups(P>0.05).(4)Comparison of immune function:The levels of CD3~+,CD4~+,CD4~+/CD8~+in the treatment group were significantly higher than those in the control group,and the level of CD8~+was significantly lower than that in the control group(P<0.05).(5)Comparison of TAP:The level of TAP in the treatment group was significantly lower than that in the control group(P<0.01).(6)Comparison of toxicityand side effects:The incidence of radiation esophagitis and digestive tract reaction in the treatment group was significantly lower than that in the control group(P<0.05),but there was no significant difference in the incidence of radiation pneumonia and bone marrow suppression between the two groups(P>0.05).Conclusion:Yiqi Tongluo Jiedu Decoction combined with concurrent chemoradiotherapy can significantly improve TCM symptoms,the quality of life,objective efficacy,alleviate adverse reactions and reduce the incidence of them for patients with esophageal cancer.This kind of method provides a new clinical basis for the application of traditional Chinese medicine combined with concurrent chemoradiotherapy in the comprehensive treatment of esophageal cancer and some suggestions to the future studies.