目的 探討云芝糖肽膠囊聯(lián)合TP方案（多西他賽聯(lián)合奈達(dá)鉑）治療中晚期食管癌的臨床療效。方法 選取2016年9月—2020年1月南陽(yáng)市中心醫(yī)院收治的103例中晚期食管癌患者為研究對(duì)象，將所有患者采用信封法分為對(duì)照組（51例）和治療組（52例）。對(duì)照組第1天靜脈滴注多西他賽注射液，75 mg/m²加入到0.9%氯化鈉溶液100 mL中，同時(shí)第1天靜脈滴注注射用奈達(dá)鉑，80 mg/m²加入到0.9%氯化鈉溶液100 mL。治療組在對(duì)照組的基礎(chǔ)上口服云芝糖肽膠囊，3粒/次，3次/d。21 d為1個(gè)周期，兩組均治療4個(gè)周期。觀察兩組的臨床療效，比較兩組的T淋巴細(xì)胞亞群、免疫球蛋白、血清腫瘤標(biāo)志物。結(jié)果 治療后，治療組的疾病控制率、客觀緩解率均高于對(duì)照組（P<0.05）。治療后，兩組CD3⁺、CD4⁺、CD4⁺/CD8⁺均降低，CD8⁺均升高（P<0.05）；并且治療組CD3⁺、CD4⁺、CD4⁺/CD8⁺低于對(duì)照組，CD8⁺高于對(duì)照組（P<0.05）。治療后，兩組免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）水平均升高（P<0.05），且治療組IgA、IgM、IgG水平均高于對(duì)照組（P<0.05）。治療后，兩組血清癌胚抗原（CEA）、鱗狀細(xì)胞癌抗原（SCC-Ag）、糖類抗原199（CA199）水平均較治療前降低（P<0.05），且治療組血清CEA、SCC-Ag、CA199水平低于對(duì)照組（P<0.05）。結(jié)論 云芝糖肽膠囊聯(lián)合TP方案治療中晚期食管癌患者可提高治療效果，減輕免疫抑制，降低血清腫瘤標(biāo)志物水平。

Objective To investigate the therapeutic effect of Yunzhi Tangtai Capsules combined with TP chemotherapy regimen (docetaxel combined with nedaplatin) in treatment of middle or advanced esophageal cancer. Methods Patients (103 cases) with middle or advanced esophageal cancer in Nanyang Central Hospital from September 2016 to January 2020 were randomly divided into the control group (51 cases) and the treatment group (52 cases). Patients in the control group was given Docetaxel Injection intravenously on the first day, 75 mg/m² was added to 100 mL of 0.9% sodium chloride solution. And Nedaplatin for injection was given intravenously on the first day, and 80 mg/m² was added to 100 mL of 0.9% sodium chloride solution. Patients in the treatment group were po administered with Yunzhi Tangtai Capsules on the basis of the control group, 3 grains/time, three times daily. A course had 21 d, and patients of two groups were treated for 4 courses. After treatment, the clinical efficacies were evaluated, and T lymphocyte subsets, immunoglobulin, and serum tumor markers in two groups were compared. Results After treatment, the disease control rate and objective remission rate of the treatment group were higher than those of the control group (P<0.05). After treatment, the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in two groups were decreased, but the CD8⁺ in two groups were increased (P<0.05). And the CD3⁺, CD4⁺, and CD4⁺/CD8⁺ in the treatment group were lower than those in the control group, but the CD8⁺ in the treatment group were higher than that in the control group (P<0.05). After treatment, the levels of IgA, IgM, and IgG in two groups were increased (P<0.05), and the levels of IgA, IgM, and IgG in the treatment group were higher than that in the control group (P<0.05). After treatment, the levels of CEA, SCC-Ag, and CA199 in two groups were decreased (P<0.05), and the levels of CEA, SCC-Ag, and CA199 in the treatment group were higher than that in the control group (P<0.05). Conclusion Yunzhi Tangtai Capsules combined with TP chemotherapy regimen in the treatment of patients with middle or advanced esophageal cancer can improve the therapeutic effect, reduce immunosuppression, and reduce the level of serum tumor markers.

R975;R979.1

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（2017T12399）