目的 探討鴉膽子油乳注射液聯(lián)合CapeOx方案治療早發(fā)型結(jié)腸癌的臨床療效。方法 選取2017年6月—2021年5月徐州醫(yī)科大學(xué)附屬連云港醫(yī)院收治的96例早發(fā)型結(jié)腸癌患者，按隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各48例。對(duì)照組患者給予CapeOx方案化療，化療第1～14天餐后30 min口服卡培他濱片，1 g/m²，2次/d；第1天靜脈滴注注射用奧沙利鉑，130 mg/m²加入5%葡萄糖注射液250 mL中后給藥，1次/d，每次滴注2 h。治療組在對(duì)照組治療基礎(chǔ)上化療第1～14天靜脈滴注鴉膽子油乳注射液，30 mL/次加入0.9%氯化鈉注射液250 mL中后給藥，1次/d。兩組均以21 d為1個(gè)周期，且均連續(xù)治療2個(gè)周期。觀察兩組的臨床療效，比較治療前后兩組血清腫瘤標(biāo)志物[癌胚抗原（CEA）、糖類(lèi)抗原（CA）199、CA72-4、CA50]和血管內(nèi)皮生長(zhǎng)因子（VEGF）水平、大腸癌患者生命質(zhì)量測(cè)定量表（FACT-C）評(píng)分。統(tǒng)計(jì)兩組不良反應(yīng)情況。結(jié)果 治療后，治療組客觀緩解率（ORR）是47.92%，較對(duì)照組的35.42%有所提高，但差異無(wú)統(tǒng)計(jì)學(xué)意義；治療組疾病控制率（DCR）是87.50%顯著高于對(duì)照組的70.83%（P＜0.05）。治療后，兩組FACT-C中生理狀況評(píng)分、情感狀況評(píng)分、附加關(guān)注領(lǐng)域評(píng)分及量表總評(píng)分均顯著增加（P＜0.05）；且均以治療組患者增加更顯著（P＜0.05）；功能狀況和社會(huì)/家庭狀況領(lǐng)域評(píng)分組內(nèi)治療前后及組間同期比較差異均無(wú)統(tǒng)計(jì)學(xué)意義。治療后，兩組血清CEA、CA199、CA72-4、CA50和VEGF水平均顯著下降（P＜0.05）；均以治療組降低更顯著（P＜0.05）。治療過(guò)程中，治療組白細(xì)胞減少、肝腎損害、血小板減少的發(fā)生率分別為18.75%、10.42%、14.58%，顯著低于對(duì)照組的37.50%、27.08%、33.33%（P＜0.05）。結(jié)論 鴉膽子油乳注射液聯(lián)合CapeOx方案治療早發(fā)型結(jié)腸癌具有一定的增效減毒作用，能有效提高患者近期療效、下調(diào)血清腫瘤標(biāo)志物水平及抑制腫瘤血管生成，并提高化療耐受性，改善患者生命質(zhì)量，值得臨床推廣應(yīng)用。

Objective To explore the clinical efficacy of Yadanzi Oil Emulsion Injection combined with CapeOx regimen in treatment of early-onset colon cancer. Methods A total of 96 patients with early-onset colon cancer admitted to Lianyungang Hospital Affiliated to Xuzhou Medical University from June 2017 to May 2021 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were given CapeOx chemotherapy, and on the 1st to 14th day of chemotherapy, they were po administered with Capecitabine Tablets 30 min after meal, 1 g/m², twice daily. At the same time, they were iv administered with Oxaliplatin for Injection on the first day of chemotherapy, 130 mg/m² was added into 5% Glucose Injection 250 mL, once daily, each time for 2 h. Patients in the treatment group were iv administered with Yadanzi Oil Emulsion Injection on the 1st to 14th day of chemotherapy on the basis of the control group, 30 mL/time was added into 0.9% sodium chloride injection 250 mL, once daily. Both groups were treated for 21 d for 1 cycle, and both groups were treated for 2 consecutive cycles. The clinical efficacy of the two groups was observed, and the serum tumor markers (CEA, CA 199, CA72-4, CA50), vascular endothelial growth factor (VEGF) levels, quality of Life scale (FACT-C) scores of patients with colorectal cancer were compared before and after treatment. The adverse reactions of the two groups were analyzed. Results After treatment, the objective response rate (ORR) of the treatment group was 47.92%, which was higher than that of the control group (35.42%), but the difference was not statistically significant. The disease control rate (DCR) in the treatment group was 87.50% significantly higher than that in the control group (70.83%) (P < 0.05). After treatment, the physiological status score, emotional status score, additional areas of concern score and total scale score of FACT-C in both groups were significantly increased (P < 0.05). The increase was more significant in treatment group (P < 0.05). There were no significant differences in functional status and social/family status before and after treatment. After treatment, serum CEA, CA199, CA72-4, CA50 and VEGF levels in both groups were significantly decreased (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). During the treatment, the incidence of leukopenia, liver and kidney damage and thrombocytopenia in the treatment group were 18.75%, 10.42% and 14.58%, respectively, which were significantly lower than those in the control group (37.50%, 27.08% and 33.33%, P < 0.05). Conclusion Yadanzi Oil Emulsion Injection combined with CapeOx regimen has a certain synergistic and toxic effect in treatment of early-onset colon cancer, and can effectively improve the short-term curative effect of patients, down-regulate the level of serum tumor markers, inhibit tumor angiogenesis, improve chemotherapy tolerance and life quality of patients, which is worthy of clinical application.

R979.1

連云港市第一人民醫(yī)院科研項(xiàng)目（SYSD2022-0163）