| Purpose To observe the clinical efficacy and safety of Changji prescription combined with XELOX regimen + bevacizumab in the treatment of advanced colorectal cancer,so as to provide more theoretical and clinical research basis for TCM prescription in the treatment of advanced colorectal cancer.Method A total of 60 patients with advanced(stageⅣ)colorectal cancer who met the inclusion criteria were collected and randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was treated with Changji prescription combined with XELOX chemotherapy combined with bevacizumab targeted therapy,while the control group was treated with XELOX chemotherapy combined with bevacizumab targeted therapy.Tumor size,neutrophil lymphocyte ratio(NLR),quality of life score(KPS),TCM syndrome efficacy score,tumor markers CEA and CA19-9,and serum D-dimer changes were recorded before and after 2 cycles of treatment,respectively.Myelosuppression,digestive tract reaction,hypertension,albuminuria,and peripherals were also recorded Neurotoxicity,liver and kidney function impairment and other toxic reactions.Statistical software SPSS25.0 was used for statistical analysis of the above data.Results 1.After 2 cycles of treatment,ORR53.33% and DCR93.33% of the treatment group were higher than ORR43.33% and DCR86.67% of the control group.The therapeutic effect of the treatment group was slightly higher than that of the control group,but there was no statistical difference between the groups(P>0.05).2.Neutrophil-lymphocyte ratio(NLR)was changed,and the level of NLR in both the treatment group and the control group was decreased after treatment,with statistical significance(P<0.05).After treatment,the level of NLR in the treatment group was significantly lower than that in the control group,with statistical significance(P<0.05).3.Comparison of physical status showed that KPS score of the treatment group was significantly higher after treatment than before treatment,and the difference was statistically significant(P<0.01);after treatment,the treatment group was significantly better than the control group,and the difference was statistically significant(P<0.01).4.The scores of TCM syndromes in the treatment group decreased significantly compared with the control group,and the difference was statistically significant(P<0.01).5.Comparison of serum tumor markers showed that CEA and CA199 levels in the treatment group and the control group were decreased after treatment,and there was statistical significance in CEA and CA199 levels between the two groups before and after treatment(P<0.05),but there was no significant difference between the two groups after treatment(P>0.05).6.The serum D-dimer level in the treatment group decreased significantly after treatment,and the difference before and after treatment was statistically significant(P<0.05),while no significant difference was found in the control group(P>0.05),but the D-dimer level in the treatment group was lower than that in the control group after treatment,and the index difference between the two groups was statistically significant(P<0.05).7.The incidence of neutropenia,nausea,vomiting and diarrhea,and alanine aminotransferase level in the treatment group were lower than those in the control group,the difference was statistically significant(P<0.05).For the occurrence and severity of hypertension and albuminuria,the treatment group was significantly lower than the control group,and the difference was statistically significant(P<0.05).There were no significant differences in the levels of hemoglobin,platelet and creatinine between the two groups(P>0.05).8.Comparison of peripheral neurotoxicity: The incidence of peripheral neurotoxicity in treatment group was significantly lower than that in control group,and the difference was statistically significant(P<0.05).Conclusion Changji formula combined with XELOX scheme and bevacizumab in the treatment of advanced colorectal cancer(spleen deficiency phlegm-dampness syndrome)can improve clinical objective efficacy,KPS score,TCM syndrome efficacy,reduce NLR level,relieve blood hypercoagulability,and the efficacy is better than that of chemotherapy plus bevacizumab group.It can also significantly reduce the related toxicity caused by chemotherapy and targeted therapy,such as bone marrow suppression,gastrointestinal adverse reactions,peripheral neurotoxic reactions,hypertension,albuminuria,etc,significantly improve the quality of life of patients,and provide clinical treatment ideas for the treatment of advanced colorectal cancer by integrated Chinese and western medicine,worthy of promotion and application. |
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