目的 觀察采用芪珍膠囊聯(lián)合甲磺酸阿帕替尼片治療二線及以上治療失敗晚期胃癌的臨床療效。方法 選取2021年8月—2023年5月在陜西省核工業(yè)二一五醫(yī)院收治的96例二線及以上治療失敗晚期胃癌患者，按照隨機(jī)數(shù)字表法將患者分為對(duì)照組（48例）和治療組（48例）。對(duì)照組早餐后0.5 h口服甲磺酸阿帕替尼片，0.5 g/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服芪珍膠囊，5粒/次，3次/d。4周為1個(gè)療程，兩組治療6個(gè)療程后進(jìn)行評(píng)價(jià)。。對(duì)比兩組臨床療效、腫瘤標(biāo)志物、細(xì)胞免疫功能指標(biāo)。患者出院后開始隨訪1年，觀察兩組的無(wú)進(jìn)展生存時(shí)間（PFS）、總生存時(shí)間（OS）。結(jié)果 治療組的客觀緩解率（ORR）、疾病控制率（DCR）高于對(duì)照組（P＜0.05）。治療后，兩組血清癌胚抗原（CEA）、糖類抗原199（CA199）、糖類抗原125（CA125）水平下降（P＜0.05），治療組血清CEA、CA199、CA125水平低于對(duì)照組（P＜0.05）。治療后，兩組CD8⁺下降，CD3⁺、CD4⁺、CD4⁺/CD8⁺升高（P＜0.05），治療組患者CD8⁺低于對(duì)照組，CD3⁺、CD4⁺、CD4⁺/CD8⁺高于對(duì)照組（P＜0.05）。治療組的無(wú)進(jìn)展生存時(shí)間（PFS）、總生存時(shí)間（OS）分別為6.5、10.0個(gè)月，均高于對(duì)照組的PFS和OS（4.3、5.7個(gè)月，P＜0.05）。結(jié)論 二線及以上治療失敗晚期胃癌采用芪珍膠囊聯(lián)合甲磺酸阿帕替尼片治療后，可控制疾病進(jìn)展，降低腫瘤標(biāo)志物水平，提高患者的免疫功能，延長(zhǎng)患者的生存期。

Objective To observe the clinical efficacy of Qizhen Capsules combine with Apatinib Mesylate Tablets in treatment of second-line and above treatment failure advanced gastric cancer. Methods 96 Patients with advanced gastric cancer who failed in second-line and above treatment in No.215 Hospital of Shaanxi Nuclear Industry from August 2021 to May 2023 were divided into control group (48 cases) and study group (48 cases) by random number table method. Patients in the control group took orally Apatinib Mesylate Tablets half an hour after breakfast, 0.5 g/time, once daily. Patients in the treatment group were po administered with Qizhen Capsules on the basis of the control group, 5 capsules/time, 3 times daily. Four weeks was one course of treatment, and two groups of patients were evaluated after six courses of treatment. The clinical efficacy, tumor markers, and cellular immune function indicators were compared between two groups. The patients were followed up for 1 year after discharge, and the tumor progression-free survival time (PFS) and overall survival time (OS) in two groups were observed. Results The ORR and DCR of the treatment group were higher than those of the control group (P < 0.05). After treatment, the serum levels of CEA, CA199, and CA125 decreased in both groups (P < 0.05), and the serum levels of tumor markers in the treatment group were lower than those in the control group (P < 0.05). After treatment, CD8⁺ decreased in both groups, while CD3⁺, CD4⁺, and CD4⁺/CD8⁺ increased (P < 0.05). CD8⁺ in the treatment group was lower than that in the control group, while CD3⁺, CD4⁺, and CD4⁺/CD8⁺ were higher than those in the control group (P < 0.05). PFS and OS of the treatment group were 6.5 and 10.0 months, respectively, which were higher than the PFS and OS of the control group of 4.3 and 5.7 months (P < 0.05). Conclusion The combination of Qizhen Capsules and Apatinib Mesylate Tablets in treatment of advanced gastric cancer with second-line or higher treatment failure can control disease progression, reduce tumor marker levels, improve patient immune function, and prolong patient survival.

R979.1

陜西省科技計(jì)劃項(xiàng)目(2021JQ-539)