目的 觀察仙蟾片聯(lián)合曲妥珠單抗和mFOLFOX6方案治療老年表皮生長因子受體-2（HER2）陽性晚期胃癌的臨床療效。方法 選取2011年1月-2014年1月在延安市人民醫(yī)院就診的老年HER2陽性晚期胃癌患者212例，隨機分為對照組和治療組，每組各106例。兩組患者均給予mFOLFOX6方案化療，每個治療周期為21 d。對照組在此基礎(chǔ)上于第1天靜脈滴注注射用曲妥珠單抗8 mg/kg，然后每個周期第1天給予6 mg/kg。治療組在對照組的基礎(chǔ)上口服給予仙蟾片，4片/次，3次/d。兩組患者均治療6個周期。觀察兩組患者近期和遠(yuǎn)期療效，同時比較治療前后兩組患者血清生化指標(biāo)和不良反應(yīng)。結(jié)果 治療后，對照組臨床有效率和控制率分別為60.3%、78.3%，均顯著低于治療組的73.5%、89.6%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者血清纖維母細(xì)胞特異性蛋白-1（FSP-l）、骨髓相關(guān)蛋白-14（MRP-l4）、趨化因子受體-4（CXCR4）和基質(zhì)衍生因子-1（SDF-1）均明顯降低（P<0.05），且治療組上述血清生化指標(biāo)明顯低于對照組（P<0.05）。遠(yuǎn)期療效結(jié)果顯示，對照組有效病例中平均無疾病進展生存時間（PFS）和總生存時間（OS）均分別明顯小于治療組患者，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療期間，治療組的不良反應(yīng)發(fā)生率均明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 仙蟾片聯(lián)合曲妥珠單抗和mFOLFOX6方案治療老年人表皮生長因子受體-2（HER2）陽性晚期胃癌患者臨床療效較好，能夠有效延長生存時間，具有一定的臨床推廣應(yīng)用價值。

Objective To observe the clinical effects of Xianchan Tablets combined with trastuzumab and mFOLFOX6 in treatment of elderly with advanced gastric cancer of HER2 positive. Methods Patients (212 cases) with advanced gastric cancer of HER2 positive in Yan'an People's Hospital from January 2011 to January 2014 were randomly divided into control and treatment groups, and each group had 106 cases. All patients were given mFOLFOX6 chemotherapy, and each treatment cycle was 21 d. Patients in the control group were iv administered with Trastuzumab Injection for the first day of each cycle, and the 1st time was 8 mg/kg, then 6 mg/kg. Patients in the treatment group were po administered with Xianchan Tablets on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 6 cycles. After treatment, the short-term and long-term efficacy was evaluated, the serum biochemical indexes and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and the clinical control rate were 60.3% and 78.3%, which were significantly lower than 73.5% and 89.6% in the treatment group, respectively, and there were differences between two groups (P<0.05).After treatment, the FSP-l, MRP-l4, CXCR4 and SDF-1 in two groups were significantly decreased (P<0.05), and the serum biochemical indexes in the treatment group after treatment was significantly lower than those in the control group (P<0.05). Long-term efficacy result showed that the PFS and OS of valid cases in the control group were lower than those in the treatment group, with significant difference between two groups (P<0.05). During the treatment, the adverse reactions rates in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Xianchan Tablets combined with trastuzumab and mFOLFOX6 in treatment of elderly with advanced gastric cancer of HER2 positive has good effect, and can effectively prolong the survival time, which has a certain clinical application value.