十全大补汤加减对鼻咽癌放化疗后气血两虚证患者的疗效及免疫功能影响

Effect of Modified Shiquan Dabu Decoction on Clinical Efficacy and Immune Function in Patients with Qi and Blood Deficiency Syndrome Following Chemoradiotherapy for Nasopharyngeal Carcinoma

摘要: (1) 目的：评估十全大补汤加减对鼻咽癌放化疗后气血两虚证患者的临床疗效及免疫功能影响。(2) 方法：纳入140例气血两虚型鼻咽癌放化疗后患者，随机分为对照组(n = 69，常规对症支持治疗)与实验组(n = 71，常规治疗 + 十全大补汤加减)，疗程6周。比较两组中医证候积分、KPS评分、T淋巴细胞亚群及不良反应发生率。(3) 结果：治疗后实验组证候积分显著低于对照组(P < 0.05)；KPS评分、CD3⁺、CD4⁺及CD4⁺/CD8⁺均高于对照组(P < 0.05)；CD8⁺水平低于对照组(P < 0.05)。实验组任意不良反应总发生率(53.52%)低于对照组(79.71%)，其中恶心呕吐、口腔黏膜炎(P < 0.05)及白细胞减少、血小板减少(P < 0.05)差异显著；血红蛋白下降、肝肾功能异常组间无显著差异(P > 0.05)。(4) 结论：十全大补汤加减有助于改善气血两虚型鼻咽癌放化疗后患者的证候积分与体力状态，促进免疫功能恢复，减轻部分放化疗不良反应。

Abstract: (1) Objective: To evaluate the clinical efficacy of modified Shiquan Dabu Decoction and its effect on immune function in patients with qi and blood deficiency syndrome following chemoradiotherapy for nasopharyngeal carcinoma. (2) Methods: A total of 140 nasopharyngeal carcinoma patients with qi and blood deficiency syndrome after chemoradiotherapy were enrolled and randomly assigned to a control group (n = 69, receiving conventional symptomatic supportive care) and an experimental group (n = 71, receiving conventional care plus modified Shiquan Dabu Decoction), with a treatment duration of 6 weeks. The two groups were compared with respect to TCM syndrome scores, KPS scores, T lymphocyte subsets, and the incidence of adverse reactions. (3) Results: After treatment, the TCM syndrome score in the experimental group was significantly lower than that in the control group (P < 0.05). KPS scores, CD3⁺ levels, CD4⁺ levels, and the CD4⁺/CD8⁺ ratio were all higher in the experimental group than in the control group (all P < 0.05), whereas the CD8⁺ level was lower (P < 0.05). The overall incidence of adverse reactions in the experimental group (53.52%) was lower than that in the control group (79.71%), with significant differences observed for nausea and vomiting, oral mucositis (P < 0.05), as well as leukopenia and thrombocytopenia (P < 0.05). No significant between-group differences were found for hemoglobin decline, hepatic dysfunction, or renal dysfunction (P > 0.05). (4) Conclusion: Modified Shiquan Dabu Decoction helps improve TCM syndrome scores and performance status, promotes immune reconstitution, and alleviates selected chemoradiotherapy-related adverse reactions in nasopharyngeal carcinoma patients with qi-blood deficiency syndrome after chemoradiotherapy.