Abstract: Objective　To observe the clinical effect of Western medicine chemotherapy combined with Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection in the treatment of advanced gastric cancer. Methods　Seventy patients with advanced gastric cancer admitted to Second People's Hospital of Pingdingshan City from January 2019 to January 2022 were selected as the study objects. The patients were divided into a control group and a study group by lottery, with 35 cases in each group. There were 20 males and 15 females in the control group, and they were (55.17±2.24) years old. There were 23 males and 12 females in the study group, and they were (55.44±2.37) years old. Both groups were treated with the same chemotherapy regimen; on this basis, the study group were treated with Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection. The scores of main and secondary syndromes of traditional Chinese medicine (TCM), the levels of tumor markers, such as carcinoembryonic antigen (CEA), carbohydrate antigen 724 (CA724), CA125, CA199, and alpha fetoprotein (AFP), the levels of immune indicators, such as T lymphocyte subsets (CD) CD3+, CD4+, and CD8+, objective remission rates (ORR), disease control rates (DCR), and incidences of adverse reaction were compared between the two groups. t and χ² tests were applied. Results　After the treatment, the scores of the main (stomachache and deficiency of appetite) and secondary (short of breath and lack of strength and listlessness) syndromes of TCM in the study group were lower than those in the control group [(1.21±0.36) vs. (1.96±0.44), (1.04±0.27) vs. (1.88±0.62), (1.13±0.45) vs. (2.02±0.17), and (1.25±0.33) vs. (2.29±0.41)], with statistical differences (t=7.805, 7.349, 10.946, and 11.690; all P<0.05). The levels of CEA, CA724, CA125, CA199, and AFP in the study group were lower than those in the control group [(3.12±0.45) μg/ml vs. (5.41±0.26) μg/ml, (6.63±0.24) U/ml vs. (8.92±0.71) U/ml, (30.21±1.14) U/ml vs. (32.47±1.36) U/ml, (32.14±1.15)IU/ml vs. (34.24±1.36) IU/ml, and (20.12±2.23) mg/L vs. (23.25±2.76) mg/L], with statistical differences (t=26.068, 18.077, 7.534, 6.976, and 5.219; all P<0.05). The CD3+, CD4+, CD8+, ORR, and DCR in the study group were higher than those in the control group, with statistical differences (t=3.183, 11.144, and 8.822; χ²=7.198 and 9.181; all P<0.05). The incidence of adverse reactions was 14.29% (5/35) in the study group, and was 11.43% (4/35) in the control group, with no statistical difference (χ²=0.365; P>0.05). Conclusions　The combination of traditional Chinese medicine therapies such as Yiqi Fuzheng Jiedu Decoction + Zusanli acupoint injection and Western medicine chemotherapy for patients with advanced gastric cancer can improve their clinical symptoms and signs, reduce the levels of tumor markers, and delay the disease progress. This combination has not significantly enhanced adverse reactions, and its safety is acceptable.

Key words: Advanced gastric cancer, Western medicine chemotherapy, Yiqi Fuzheng Jiedu Decoction, Zusanli acupoint injection, Tumor markers

摘要： 目的　观察西医化疗结合益气扶正解毒汤+足三里穴位注射治疗晚期胃癌的临床效果。方法　选取平顶山市第二人民医院2019年1月至2022年1月院内收治的70例晚期胃癌患者为研究对象，经抽签法将患者分为两组。对照组35例，男20例，女15例，年龄（55.17±2.24）岁；研究组35例，男23例，女12例，年龄（55.44±2.37）岁。两组均予以同种化疗方案治疗，研究组在此基础联合应用益气扶正解毒汤+足三里穴位注射治疗，比较两组的中医主证、次证积分，癌胚抗原（CEA）、糖类抗原724（CA724）、CA125、CA199、甲胎蛋白（AFP）等肿瘤标志物水平，T淋巴细胞亚群（CD）CD3+、CD4+、CD8+等免疫指标，客观缓解率、疾病控制率和不良反应发生率。统计学方法采用t检验和χ²检验。结果　治疗后，研究组的中医主证胃脘疼痛、食少纳差积分，次证气短乏力、精神萎靡积分分别为（1.21±0.36）分、（1.04±0.27）分、（1.13±0.45）分、（1.25±0.33）分，均低于对照组［（1.96±0.44）分、（1.88±0.62）分、（2.02±0.17）分、（2.29±0.41）分］，差异均有统计学意义（t=7.805、7.349、10.946、11.690，均P<0.05）。研究组CEA水平、CA724水平、CA125水平、CA199水平、AFP水平分别为（3.12±0.45）μg/ml、（6.63±0.24）U/ml、（30.21±1.14）U/ml、（32.14±1.15）IU/ml、（20.12±2.23）mg/L，均低于对照组［（5.41±0.26）μg/ml、（8.92±0.71）U/ml、（32.47±1.36）U/ml、（34.24±1.36）IU/ml、（23.25±2.76）mg/L］，差异均有统计学意义（t=26.068、18.077、7.534、6.976、5.219，均P<0.05）；研究组CD3+、CD4+、CD8+、ORR、DCR均高于对照组，差异均有统计学意义（t=3.183、11.144、8.822，χ²=7.198、9.181，均P<0.05）；研究组的不良反应发生率为14.29%（5/35），略高于对照组［11.43%（4/35）］，差异无统计学意义（χ²=0.365，P>0.05）。结论　将益气扶正解毒汤+足三里穴位注射等中医疗法与西医化疗相结合，可促进晚期胃癌患者临床症候、体征改善，对降低各项肿瘤标志物水平、延缓病情进展均有积极意义，此中西结合疗法未明显增强不良反应，安全性尚可。

关键词: 晚期胃癌, 西医化学治疗, 益气扶正解毒汤, 足三里穴位注射, 肿瘤标志物