健脾化瘀方改善晚期胃癌血液高凝状态的作用机制研究

Mechanism of Jianpi Huayu Decoction in improving blood hypercoagulability of patients with advanced gastric cancer

  • 摘要:
      目的  观察健脾化瘀方对Ⅲ~Ⅳ期胃癌血液高凝状态患者凝血指标、组织因子(TF)、炎症指标、血小板聚集试验的影响。
      方法  将50例患者随机分为试验组与对照组,每组25例。试验组接受健脾化瘀方联合肿瘤基础治疗,对照组仅接受肿瘤基础治疗,治疗时间(42±2)d。在入组第1天、第(21±2)天、第(42±2)天对受试者进行访视并统计分析结果。
      结果  ① 治疗2个周期后,试验组较对照组D-二聚体(D-D)、纤维蛋白原(FIB)降低,凝血酶时间(TT)延长,差异有统计学意义(P < 0.01)。②与治疗前比较,试验组治疗后组织因子(TF)下降,差异有统计学意义(P < 0.01)。③试验组白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)较对照组下降,差异有统计学意义(P < 0.01)。④ FIB与TF呈显著正相关(r=0.447,P < 0.01),治疗后的改变也呈显著正相关(r=0.434,P < 0.05)。⑤ FIB与IL-1β呈显著正相关(r=0.357,P < 0.05),治疗后的改变也呈显著正相关(r=0.555,P < 0.05)。
      结论  健脾化瘀方可能通过降低TF的表达和炎症因子IL-1β水平来达到改善晚期胃癌患者血液高凝状态的目的。

     

    Abstract:
      Objective  To observe the effect of Jianpi Huayu Decoction on coagulation indexes, tissue factor (TF), inflammation indexes and platelet aggregation test in stages Ⅲ to Ⅳ gastric cancer patients with blood hypercoagulability.
      Methods  Totally 50 patients were randomly divided into experimental group (n=25) and control group (n=25). The experimental group received Jianpi Huayu Decoction combined with basic treatment for tumor, while the control group only received basic treatment for tumor, and both groups were treated for (42±2) days. On the 1st day, the (21±2) day and (42±2) day, the subjects were interviewed and the results were statistically analyzed.
      Results  ① After 2 cycles of treatment, the levels of D-Dimer (D-D) and fibrinogen (FIB) in the experimental group were significantly lower than those in the control group, while the thrombin time (TT) was significantly longer than that in the control group (P < 0.01). ② After treatment, tissue factor (TF) in the experimental group was significantly lower than that in the control group (P < 0.01). ③ Level of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the experimental group were significantly lower than those in the control group (P < 0.01). ④ FIB was positively correlated with TF (r=0.447, P < 0.01), and the changes after treatment also showed a significant positive correlation between two indexes (r=0.434, P < 0.05). ⑤ There was a significant positive correlation between FIB and IL-1β (r=0.357, P < 0.05), and the changes after treatment also showed a significant positive correlation between two indexes (r=0.555, P < 0.05).
      Conclusion  Jianpi Huayu Decoction can improve the blood hypercoagulability in patients with advanced gastric cancer by reducing the expressions of TF and IL-1β.

     

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