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Article(id=1322928206654865899, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.10.015, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340263284, onlineDateStr=2026-10-30, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340263284, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340263284, creator=13701087609, updateTime=1793340263284, updator=13701087609, issue=Issue{id=1322926740955341011, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='10', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339913834, creator='13701087609', updateTime=1793340753123, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930261259846420, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930261259846421, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=71, endPage=75, ext={EN=ArticleExt(id=1322928206898135532, articleId=1322928206654865899, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Multilevel Effect of Shenqi Decoction（参芪汤）Combined with Chemotherapy on Immune Protein Factor and Autophagy Protein in Treatment of Colorectal Cancer, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the multilevel effects of Shenqi Decoction（参芪汤）combined with chemotherapy on immune protein factor and autophagy protein in the treatment of colorectal cancer.

Methods

A total of 92 patients with colorectal cancer admitted to the hospital from January 2021 to December 2023 were divided into two groups by random number table method.Forty-six patients in the control group were treated with chemotherapy，and the other 46 patients in the observation group were treated with Shenqi Decoction combined with chemotherapy.The difference of efficacy，tumor markers，angiogenesis factor levels，immune function and autophagy related proteins LC3 and Beclin 1 were compared between the two groups.

Results

The objective remission rate and disease control rate in the observation group were 41.30%（19/46）and 93.48%（43/46），respectively，which were higher than 26.09%（12/46）and 76.09%（35/46）in the control group（P<0.05）.After treatment，the levels of tumor markers［cancer antigen 125，carbohydrate antigen 125（CA125）and cancer antigen 19-9（CA19-9）］，vascular endothelial growth factor（VEGF），hypoxia-inducible factor 1-alpha（HIF-1α）and transforming growth factorβ1（TGF-β1）in the observation group were lower than those in the control group（P<0.05）.After treatment，the positive rates of autophagy related proteins LC3 and Beclin 1 were lower than those of the control group，and the levels of immunoglobulin A（IgA），immunoglobulin G（IgG）and immunoglobulin M（IgM）were higher than those of the control group（P<0.05）.

Conclusion

Shenqi Decoction combined with chemotherapy can effectively improve the therapeutic effect of colorectal cancer patients，reduce the levels of serum tumor markers，regulate the immune ability，inhibit the growth of tumor cells and angiogenesis，reduce the expressions of autophagy related proteins LC3 and Beclin 1，and plays a positive role in improving the prognosis of patients.

, authors=Kaiping WANG1, Ruitong WANG2, Guangyan WEI3, Lixin ZHANG1, authorsList=Kaiping WANG, Ruitong WANG, Guangyan WEI, Lixin ZHANG, authorCompany=null, correspAuthors=Lixin ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322928207988654581, articleId=1322928206654865899, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=参芪汤联合化疗治疗结直肠癌对免疫蛋白因子、自噬蛋白的多层次影响研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析参芪汤联合化疗治疗结直肠癌对免疫蛋白因子、自噬蛋白的多层次影响。

方法

纳入2021年1月—2023年12月医院收治的92例结直肠癌患者进行研究，随机数字表法分为两组，46例对照组应用化疗疗法，46例观察组应用参芪汤联合化疗治疗，对比两组疗效差异、肿瘤标志物、血管新生因子水平、免疫功能及自噬相关蛋白LC3（Microtubule-associated protein 1A/1B-light chain 3，MAP1LC3）、Beclin 1变化情况。

结果

观察组客观缓解率为41.30%（19/46），疾病控制率为93.48%（43/46），高于对照组的26.09%（12/46）、76.09%（35/46），组间比较差异有统计学意义（P<0.05）；治疗后观察组肿瘤标志物CA125（Cancer Antigen 125，Carbohydrate Antigen 125）、CA19-9（Cancer Antigen 19-9，Carbohydrate Antigen 19-9）水平及VEGF（Vascular Endothelial Growth Factor，VEGF）、HIF-1α（Hypoxia-Inducible Factor 1-alpha，HIF-1α）、TGF-β1（Transforming Growth Factor Beta 1，TGF-β1）水平低于对照组（P<0.05）；治疗后两组自噬相关蛋白LC3、Beclin 1阳性率低于对照组，免疫球蛋白A（Immunoglobulin A，IgA）、免疫球蛋白G（Immunoglobulin G，IgG）、免疫球蛋白M（Immunoglobulin M，IgM）水平高于对照组（P<0.05）。

结论

对结直肠癌患者应用参芪汤联合化疗治疗能有效提高治疗效果，降低血清肿瘤标志物水平，调节免疫能力，抑制肿瘤细胞的生长及血管新生，降低自噬相关蛋白LC3、Beclin 1表达，对患者预后改善起到积极作用。

, authors=王开平1, 王瑞童2, 韦广燕3, 张利新1, authorsList=王开平, 王瑞童, 韦广燕, 张利新, authorCompany=null, correspAuthors=张利新, authorNote=

王开平（1974-），男，贵州贵阳人，副主任医师，学士，研究方向：肛肠疾病。

, correspAuthorsNote=
张利新（1980-），男，河北香河人，副主任医师，硕士，研究方向：肛肠外科疾病。E-mail：。
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王开平（1974-），男，贵州贵阳人，副主任医师，学士，研究方向：肛肠疾病。

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组别例数完全缓解部分缓解稳定进展客观缓解率疾病控制率
观察组460（0）19（41.30）24（52.17）3（6.52）19（41.30）43（93.48）
对照组460（0）12（26.09）23（50.0）11（23.91）12（26.09）35（76.09）
χ2值5.234 59.425 5
P值0.022 30.011 8
), ArticleFig(id=1322928211901940256, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=CN, label=表1, caption=

两组直肠癌患者近期疗效比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数完全缓解部分缓解稳定进展客观缓解率疾病控制率
观察组460（0）19（41.30）24（52.17）3（6.52）19（41.30）43（93.48）
对照组460（0）12（26.09）23（50.0）11（23.91）12（26.09）35（76.09）
χ2值5.234 59.425 5
P值0.022 30.011 8
), ArticleFig(id=1322928211981632033, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数CA19-9t值P值CA125t值P值
治疗前治疗后治疗前治疗后
观察组4663.58±12.5825.96±5.18*25.845 20.000 081.52±12.5435.28±9.78*15.467 20.000 0
对照组4663.48±12.4837.84±5.24*17.452 50.000 080.22±13.2849.72±11.48*11.426 40.000 0
t值0.482 312.842 20.185 613.879 2
P值0.729 50.000 00.287 80.000 0
), ArticleFig(id=1322928212052935202, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=CN, label=表2, caption=

两组直肠癌患者肿瘤标志物CA19-9、CA125水平比较

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组别例数CA19-9t值P值CA125t值P值
治疗前治疗后治疗前治疗后
观察组4663.58±12.5825.96±5.18*25.845 20.000 081.52±12.5435.28±9.78*15.467 20.000 0
对照组4663.48±12.4837.84±5.24*17.452 50.000 080.22±13.2849.72±11.48*11.426 40.000 0
t值0.482 312.842 20.185 613.879 2
P值0.729 50.000 00.287 80.000 0
), ArticleFig(id=1322928212149404195, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间VEGF/（pg/mL）HIF-1α/（ng/L）TGF-β1/（pg/mL）
观察组46治疗前726.85±56.2568.75±9.2532.58±5.48
治疗后589.52±25.4241.25±5.2111.25±5.62
t值12.489 715.795 520.185 4
P值0.000 00.000 00.000 0
对照组46治疗前729.85±53.5269.75±10.2531.25±6.21
治疗后612.54±54.8559.28±6.2919.85±6.24
t值8.482 210.456 213.254 4
P值0.000 00.000 00.000 0
治疗前t值0.248 20.148 20.342 1
治疗前P值0.314 30.246 30.214 3
治疗后t值9.152 613.482 515.264 4
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322928212220707364, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=CN, label=表3, caption=

两组直肠癌患者血管新生因子水平比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间VEGF/（pg/mL）HIF-1α/（ng/L）TGF-β1/（pg/mL）
观察组46治疗前726.85±56.2568.75±9.2532.58±5.48
治疗后589.52±25.4241.25±5.2111.25±5.62
t值12.489 715.795 520.185 4
P值0.000 00.000 00.000 0
对照组46治疗前729.85±53.5269.75±10.2531.25±6.21
治疗后612.54±54.8559.28±6.2919.85±6.24
t值8.482 210.456 213.254 4
P值0.000 00.000 00.000 0
治疗前t值0.248 20.148 20.342 1
治疗前P值0.314 30.246 30.214 3
治疗后t值9.152 613.482 515.264 4
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322928212292010533, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间IgAIgGIgM
观察组46治疗前3.62±0.289.56±1.021.89±0.25
治疗后2.45±0.218.92±1.111.78±0.23
t值13.824 519.845 222.186 4
P值0.000 00.000 00.000 0
对照组46治疗前3.63±0.279.58±1.051.89±0.24
治疗后2.09±0.197.03±1.041.34±0.27
t值9.186 511.554 216.823 3
P值0.000 00.000 00.000 0
治疗前t值0.248 20.348 50.248 2
治疗前P值0.378 50.223 30.348 7
治疗后t值14.486 215.975 219.426 2
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322928212371702310, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=CN, label=表4, caption=

两组直肠癌患者免疫功能相关指标水平比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数时间IgAIgGIgM
观察组46治疗前3.62±0.289.56±1.021.89±0.25
治疗后2.45±0.218.92±1.111.78±0.23
t值13.824 519.845 222.186 4
P值0.000 00.000 00.000 0
对照组46治疗前3.63±0.279.58±1.051.89±0.24
治疗后2.09±0.197.03±1.041.34±0.27
t值9.186 511.554 216.823 3
P值0.000 00.000 00.000 0
治疗前t值0.248 20.348 50.248 2
治疗前P值0.378 50.223 30.348 7
治疗后t值14.486 215.975 219.426 2
治疗后P值0.000 00.000 00.000 0
), ArticleFig(id=1322928212443005479, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数LC3阳性率χ2值P值Beclin 1阳性率χ2值P值
治疗前治疗后治疗前治疗后
观察组4646（100）29（63.04）12.944 20.024 846（100）27（58.70）15.922 70.014 2
对照组4646（100）36（78.26）15.975 20.034 746（100）35（76.09）11.232 50.038 5
χ2值-11.255 4-12.486 2
P值-0.015 2-0.024 8
), ArticleFig(id=1322928212522697256, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928206654865899, language=CN, label=表5, caption=

两组直肠癌患者自噬相关蛋白LC3、Beclin 1阳性率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数LC3阳性率χ2值P值Beclin 1阳性率χ2值P值
治疗前治疗后治疗前治疗后
观察组4646（100）29（63.04）12.944 20.024 846（100）27（58.70）15.922 70.014 2
对照组4646（100）36（78.26）15.975 20.034 746（100）35（76.09）11.232 50.038 5
χ2值-11.255 4-12.486 2
P值-0.015 2-0.024 8
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参芪汤联合化疗治疗结直肠癌对免疫蛋白因子、自噬蛋白的多层次影响研究
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王开平 1 , 王瑞童 2 , 韦广燕 3 , 张利新 1
中华中医药学刊 | 国家项目点击 2025,43(10): 71-75
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中华中医药学刊 |国家项目点击 2025 , 43 (10) : 71 -75
参芪汤联合化疗治疗结直肠癌对免疫蛋白因子、自噬蛋白的多层次影响研究
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王开平1, 王瑞童2, 韦广燕3, 张利新1
作者信息
  • 1.贵州中医药大学第一附属医院，贵州 贵阳 550001
  • 2.河北医科大学护理学院，河北 石家庄 050023
  • 3.延边大学药学院，吉林 延边 133000
通讯作者:
张利新（1980-），男，河北香河人，副主任医师，硕士，研究方向：肛肠外科疾病。E-mail：。
作者简介:

王开平（1974-），男，贵州贵阳人，副主任医师，学士，研究方向：肛肠疾病。

Multilevel Effect of Shenqi Decoction（参芪汤）Combined with Chemotherapy on Immune Protein Factor and Autophagy Protein in Treatment of Colorectal Cancer
Kaiping WANG1, Ruitong WANG2, Guangyan WEI3, Lixin ZHANG1
Affiliations
  • 1.The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine，Guiyang 550001，Guizhou，China
  • 2.School of Nursing，Hebei Medical University，Shijiazhuang 050023，Hebei，China
  • 3.Yanbian University School of Pharmacy，Yanbian Korean Autonomous Prefecture，Yanbian 133000，Jilin，China
出版时间: 2025-10-10 doi: 10.13193/j.issn.1673-7717.2025.10.015
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目的

分析参芪汤联合化疗治疗结直肠癌对免疫蛋白因子、自噬蛋白的多层次影响。

方法

纳入2021年1月—2023年12月医院收治的92例结直肠癌患者进行研究，随机数字表法分为两组，46例对照组应用化疗疗法，46例观察组应用参芪汤联合化疗治疗，对比两组疗效差异、肿瘤标志物、血管新生因子水平、免疫功能及自噬相关蛋白LC3（Microtubule-associated protein 1A/1B-light chain 3，MAP1LC3）、Beclin 1变化情况。

结果

观察组客观缓解率为41.30%（19/46），疾病控制率为93.48%（43/46），高于对照组的26.09%（12/46）、76.09%（35/46），组间比较差异有统计学意义（P<0.05）；治疗后观察组肿瘤标志物CA125（Cancer Antigen 125，Carbohydrate Antigen 125）、CA19-9（Cancer Antigen 19-9，Carbohydrate Antigen 19-9）水平及VEGF（Vascular Endothelial Growth Factor，VEGF）、HIF-1α（Hypoxia-Inducible Factor 1-alpha，HIF-1α）、TGF-β1（Transforming Growth Factor Beta 1，TGF-β1）水平低于对照组（P<0.05）；治疗后两组自噬相关蛋白LC3、Beclin 1阳性率低于对照组，免疫球蛋白A（Immunoglobulin A，IgA）、免疫球蛋白G（Immunoglobulin G，IgG）、免疫球蛋白M（Immunoglobulin M，IgM）水平高于对照组（P<0.05）。

结论

对结直肠癌患者应用参芪汤联合化疗治疗能有效提高治疗效果，降低血清肿瘤标志物水平，调节免疫能力，抑制肿瘤细胞的生长及血管新生，降低自噬相关蛋白LC3、Beclin 1表达，对患者预后改善起到积极作用。

结直肠癌  /  参芪汤  /  化疗  /  免疫蛋白因子  /  自噬蛋白  /  血清肿瘤标志物
Objective

To analyze the multilevel effects of Shenqi Decoction（参芪汤）combined with chemotherapy on immune protein factor and autophagy protein in the treatment of colorectal cancer.

Methods

A total of 92 patients with colorectal cancer admitted to the hospital from January 2021 to December 2023 were divided into two groups by random number table method.Forty-six patients in the control group were treated with chemotherapy，and the other 46 patients in the observation group were treated with Shenqi Decoction combined with chemotherapy.The difference of efficacy，tumor markers，angiogenesis factor levels，immune function and autophagy related proteins LC3 and Beclin 1 were compared between the two groups.

Results

The objective remission rate and disease control rate in the observation group were 41.30%（19/46）and 93.48%（43/46），respectively，which were higher than 26.09%（12/46）and 76.09%（35/46）in the control group（P<0.05）.After treatment，the levels of tumor markers［cancer antigen 125，carbohydrate antigen 125（CA125）and cancer antigen 19-9（CA19-9）］，vascular endothelial growth factor（VEGF），hypoxia-inducible factor 1-alpha（HIF-1α）and transforming growth factorβ1（TGF-β1）in the observation group were lower than those in the control group（P<0.05）.After treatment，the positive rates of autophagy related proteins LC3 and Beclin 1 were lower than those of the control group，and the levels of immunoglobulin A（IgA），immunoglobulin G（IgG）and immunoglobulin M（IgM）were higher than those of the control group（P<0.05）.

Conclusion

Shenqi Decoction combined with chemotherapy can effectively improve the therapeutic effect of colorectal cancer patients，reduce the levels of serum tumor markers，regulate the immune ability，inhibit the growth of tumor cells and angiogenesis，reduce the expressions of autophagy related proteins LC3 and Beclin 1，and plays a positive role in improving the prognosis of patients.

colorectal cancer  /  Shenqi Decoction（参芪汤）  /  chemotherapy  /  immune protein factor  /  autophagy protein  /  serum tumor markers
王开平, 王瑞童, 韦广燕, 张利新. 参芪汤联合化疗治疗结直肠癌对免疫蛋白因子、自噬蛋白的多层次影响研究. 中华中医药学刊, 2025 , 43 (10) : 71 -75 . DOI: 10.13193/j.issn.1673-7717.2025.10.015
Kaiping WANG, Ruitong WANG, Guangyan WEI, Lixin ZHANG. Multilevel Effect of Shenqi Decoction（参芪汤）Combined with Chemotherapy on Immune Protein Factor and Autophagy Protein in Treatment of Colorectal Cancer[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (10) : 71 -75 . DOI: 10.13193/j.issn.1673-7717.2025.10.015
正文
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结直肠癌为临床常见、高发恶性肿瘤之一，其发病机制较为复杂，与饮食习惯、遗传、生活方式等存在密切的联系[1-3]。目前临床针对结直肠癌患者主要以手术治疗为主，但由于该病早期症状并不明显，并无典型性，当确诊时大多数患者已属于中晚期，错过了手术最佳时机，多选择以放化疗方式延长其生存期[4]。近年来中医药在治疗恶性肿瘤方面得到广泛的应用，为临床治疗提供新的思路和方法，中医认为结直肠癌发病过程正虚邪实，对其治疗应注重标本兼顾，补虚泻实[5]。参芪汤有扶正祛邪、固本培元的作用，配合化疗治疗，对患者预后可起到积极作用[6]。鉴于此，本次研究应用参芪汤联合化疗治疗结直肠癌，获得较好效果。现报道如下。
1　资料和方法
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1.1　一般资料
纳入2021年1月—2023年12月我院收治的92例结直肠癌患者进行研究，随机数字表法分为两组。纳入标准：（1）西医诊断符合《结直肠癌诊疗规范》[7]中制定的关于结直肠癌的相关诊断标准。①腹痛、大便性质、习惯改变史；②或偶有便血，或肠梗阻症状近期加重，或腹部有包块，或不明原因消瘦、贫血；③直肠指检可触及包块；④经CT、MRI影像学及病理组织检查明确诊断，TNM（Tumor，Node，Metastasis staging system，TNM）分期Ⅲ～Ⅳ期；⑤Karnofsky功能状态评分在60分以上，预计生存期超过6个月。（2）中医诊断参照《中药新药临床研究指导原则》[8]中的相关诊断标准。主症：食谷不香、胃脘胀满、体疲倦怠、大便异常；次症：面色萎黄、胸闷腹痛；神疲懒言、恶心呕吐；排便无力、肠鸣；舌淡苔白、有瘀点、脉细。符合主症或次症中3项以上则可诊断。排除标准：①肝肾功能等存在严重器质性疾病者；②存在长期肠梗阻病史及长期慢性腹泻史者；③存在化疗禁忌证者；④合并其他恶性肿瘤者；⑤精神疾病者及无法配合研究者。对照组46例，由25例男性与21例女性组成，年龄46～73岁，平均（59.52±3.91）岁，其中结肠癌者24例，直肠癌者22例；TNM分期Ⅲ期17例，Ⅳ期29例；病理分型，腺癌39例，黏液癌5例，未分化癌2例。观察组46例，由22例男性与24例女性组成，年龄45～74岁，平均（61.15±3.25）岁，其中结肠癌者26例，直肠癌者20例；TNM分期Ⅲ期19例，Ⅳ期27例；病理分型，腺癌40例，黏液癌4例，未分化癌2例。两组患者上述资料比较差异无统计学意义（P>0.05），可比性较好。本研究经伦理委员会批准同意，患者均签署同意书以表知情。
1.2　方法
1.2.1　对照组
开展化疗疗法。第1天给予南京臣功制药股份有限公司所生产的奥沙利铂（国药准字H20123183）100 mg/m2加入5%葡萄糖溶液500 mL中行静脉滴注，滴注时间2 h；同时给予齐鲁天和惠世制药有限公司所生产的卡培他滨（国药准字H20123412）1000 mg/m2口服，每天2次，第1～14天；每14 d为1个疗程，持续治疗4个疗程。
1.2.2　观察组
在上述基础上予以参芪汤治疗。方药组成如下：黄芪20 g，党参15 g，白术15 g，茯苓15 g，陈皮15 g，当归10 g，麦冬10 g，半夏9 g，炙甘草5 g。将上述中药以800 mL水熬制，煎煮至300 mL，早晚各服用150 mL。持续治疗4个疗程。
1.3　观察指标
1.3.1　疗效评估
依据WHO实体瘤疗效评价标准[9]对近期疗效进行评价：经CT复查，患者的目标肿瘤病灶基本消失，且持续4周以上，则为完全缓解；若CT复查显示治疗后肿瘤直径缩小超过30%，且无新发病灶，则为部分缓解；若CT复查显示治疗后肿瘤直径缩小情况没有达到部分缓解水平，肿瘤直径增加没有超过20%，则为稳定；CT复查显示治疗后肿瘤直径超过20%，或有新病灶出现，则为进展，观察两组客观缓解率（完全缓解+部分缓解/例数）和疾病控制率（完全缓解+部分缓解+稳定/例数）。
1.3.2　肿瘤标志物
于治疗前后采集患者空腹肘静脉血5 mL，3000 r/min离心处理，离心半径10 cm，时间15 min，获得血清后进行检测。采用全自动生化分析仪，用酶联免疫吸附试验检测糖类抗原19-9（Cancer Antigen 19-9，Carbohydrate Antigen 19-9，CA19-9）、糖类抗原125（Cancer Antigen 125，Carbohydrate Antigen 125，CA125）水平变化情况。
1.3.3　血管新生因子水平
采集两组患者静脉血3 mL，离心处理后，采用放射免疫法检测血管内皮生长因子（Vascular Endothelial Growth Factor，VEGF）、低氧诱导因子-1α（Hypoxia-Inducible Factor 1-alpha，HIF-1α）、转化生长因子-β1（Transforming Growth Factor Beta 1，TGF-β1），观察其水平变化情况。
1.3.4　免疫功能
采集两组患者静脉血3 mL，离心处理后，采用自动免疫分析仪检测免疫球蛋白A（Immunoglobulin A，IgA）、免疫球蛋白G（Immunoglobulin G，IgG）、免疫球蛋白M（Immunoglobulin M，IgM）变化情况。
1.3.5　自噬相关蛋白LC3（Microtubule-associated Protein 1A/1B-light Chain 3，MAP1LC3）、Beclin 1
采集两组结直肠黏膜组织，采用免疫组化SP染色法进行观察，若细胞膜、细胞核、细胞质呈明显黄色或黄褐色则为SP免疫组化为染色阳性，综合染色强度及阳性细胞数比例对其进行半定量分析，观察其阳性表达率。
1.4　统计学方法
利用SPSS 22.0软件完成统计学分析。数据资料均符合正态分布，总有效率用例（%）表示，采用χ2检验；肿瘤标志物、血管新生因子水平、免疫功能指标等指标用表示，用t检验。P<0.05为差异有统计学意义。
2　结果
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2.1　两组近期疗效比较
观察组客观缓解率为41.30%，疾病控制率为93.48%，高于对照组的26.09%、76.09%，组间比较差异有统计学意义（P<0.05）。见表1。
2.2　两组肿瘤标志物CA19-9、CA125水平比较
两组治疗前CA19-9、CA125水平比较差异无统计学意义（P>0.05）；治疗后两组上述2项指标水平均有降低（P<0.05），且相较于对照组，观察组降低更为显著（P<0.05）。见表2。
2.3　两组血管新生因子水平比较
两组治疗前VEGF、HIF-1α、TGF-β1水平比较差异无统计学意义（P>0.05）；治疗后两组上述3项指标水平均有所降低（P<0.05），且相较于观察组，对照组降低更为明显（P<0.05）。见表3。
2.4　两组免疫功能相关指标水平比较
治疗前两组IgA、IgG、IgM水平比较差异无统计学意义（P>0.05）；治疗后两组IgA、IgG、IgM水平均有所降低（P<0.05），但观察组降低幅度小于对照组，组间比较差异有统计学意义（P<0.05）。见表4。
2.5　两组自噬相关蛋白LC3、Beclin 1阳性率比较
治疗前两组自噬相关蛋白LC3、Beclin 1阳性率比较差异无统计学意义（P>0.05）；治疗后两组自噬相关蛋白LC3、Beclin 1阳性率均有降低（P<0.05），且相较于对照组，观察组降低更为明显（P<0.05）。见表5。
3　讨论
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结直肠癌为临床常见消化道恶性肿瘤之一，是发生于黏膜上皮，在环境[10]、遗传[11]等众多因素共同作用下致使多基因改变及相互作用的结果；其发病率居我国肿瘤发病率第3位，病死率占第5位[12]。由于该病发病早期并无明显症状，大多数患者发现时已经属于中晚期，而现有的治疗措施对此类患者的疗效并不显著，但其治疗主要以延缓肿瘤发展、延长其生存期为主。尽管近年来免疫学[13]、分子生物学[14]得到较大发展，在包括结直肠癌在内的恶性肿瘤治疗中靶向治疗、免疫治疗发挥着重要作用，但仍有部分患者无法从中获益，故全身化疗仍是中晚期患者的主要治疗手段。但单纯化疗存在一定不良反应，容易损伤患者正气，降低其免疫能力[15-17]。故探索一种高效、合理的联合化疗治疗方案成为临床治疗的热点。
中医古籍根据结直肠癌临床症状特点将其归为“脏毒”“肠积”等范畴[18]。中医认为机体正气不足、正虚为本病的发病根源[19-20]，如《医宗必读》指出：“积之所成，正气不足，而后邪气琚之”。脾虚则为该病发病基础，脾虚邪实进一步导致结直肠癌的发展，所谓“因虚致实，因实愈虚”。故中医认为机体在阴阳失衡、正气不足的情况下，复加饮食不节、情志失调、邪毒入侵等，可致脏腑、气血、经络功能失常，使湿邪、痰凝、血瘀等蕴结，大肠为传导之官，各病理产物聚集于大肠，而发展为结直肠癌[21]。故治疗该疾病应遵循扶正祛邪、固本培元的治疗原则。本次研究对结直肠癌患者应用参芪汤联合化疗治疗，结果发现治疗后观察组自噬相关蛋白LC3、Beclin 1阳性率低于对照组（P<0.05）。正常情况下，细胞自噬有助于细胞处于自稳状态，抑制细胞癌变；但肿瘤一旦形成，细胞自噬则可为癌细胞提供营养，癌细胞通过自噬逃避凋亡，维持生存，促使肿瘤细胞的增殖和发展，故在癌细胞的发生、发展过程中细胞自噬起着重要作用[22]。Beclin 1是癌细胞分化、凋亡、自噬间衔接的重要分子，在人类癌症中扮演着重要角色。动物实验表明[23]，Beclin 1等位基因的缺失容易造成自发性的肝癌、淋巴癌等发生率明显提高。且相关研究也表明[24-25]，与正常结直肠黏膜组织相比，结直肠组织中Beclin 1呈阳性表达；LC3则是参与自噬发生的关键基因，其表达与自噬活性关系密切，是监测自噬的一个特异性标志。相关研究表明[26]，在胃癌、宫颈癌等诸多恶性肿瘤中，LC3均存在异常表达，且肿瘤发生、发展存在密切关系。本组结果提示参芪汤联合化疗能降低LC3、Beclin 1阳性率。分析原因可能是由于黄芪补气升阳，具有生津养血、行滞通痹的功效；茯苓具有健脾和胃、利尿消肿的功效；现代研究表明茯苓[27]所含的维生素、氨基酸等微量元素能抑制癌细胞产生及抗氧化的作用；党参[28]具有补中益气、养血生津的功效；陈皮[29]具有通温行气、健脾和胃、燥湿化痰的功效；当归补血活血，现代研究表明[30]，当归中含有多种生物活性物质，具有消肿止痛、能中和自由基，抑制氧化反应；麦冬[31]具有滋阴润燥、清热解毒的功效；半夏[32]有健脾祛湿、消痞散结的功效；白术[33]益气健脾、除湿化痰的功效；诸药合用共奏固本培元、扶正祛邪、活血化瘀的功效，配合化疗进行治疗，提升效果，从而降低LC3、Beclin 1阳性率。CA125、CA19-9为结直肠癌诊断及预后常用血清肿瘤标志物，在诸多恶性肿瘤中存在异常表达[34]。肿瘤血管细胞的生长与许多细胞因子水平表达密切相关，VEGF为血管内皮生长因子，可促进肿瘤血管细胞的生成；HIF-1α在低氧环境下，可促进VEGF的高表达，进一步心血管形成，使肿瘤进一步增殖；TGF-β1属于功能性生长因子，也促进肿瘤血管形成。本组治疗后观察组肿瘤标志物CA125、CA19-9水平及VEGF、HIF-1α、TGF-β1水平低于对照组（P<0.05）；可见该种治疗方式能降低血清肿瘤标志物水平，抑制肿瘤细胞血管新生，避免肿瘤的生长。分析可能是由于参芪汤可从整体上调整人体气血阴阳，使之达到阴平阳秘，其中所含微量元素能对肿瘤细胞DNA、RNA合成形成干扰，而抑制肿瘤血管细胞的增殖，达到抗肿瘤作用，降低血清肿瘤标志物水平。同时本组治疗后观察组IgA、IgG、IgM水平高于对照组（P<0.05）。可见该种治疗方式能提高患者免疫能力，对其预后起到积极作用。其原因可能是由于参芪汤中黄芪、党参中的多种成分对免疫系统具有广泛影响，可增强调节免疫能力，提高机体抗氧化能力，并能促使免疫抑制状态有一定程度的恢复，从而使患者在化疗的同时补足正气，维持患者的机体免疫功能[35-36]。
综上所述，对结直肠癌患者应用参芪汤联合化疗治疗能有效提高治疗效果，降低血清肿瘤标志物水平，调节免疫能力，抑制肿瘤细胞的生长及血管新生，降低自噬相关蛋白LC3、Beclin 1表达，对患者预后改善起到积极作用。
基金
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  • 国家重点研发计划项目(2019YFC1712504)
  • 贵州省中医药管理局中医药、民族医药科学技术研究项目(QZYY-2021-112)
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2025年第43卷第10期
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doi: 10.13193/j.issn.1673-7717.2025.10.015
  • 首发时间：2026-10-30
  • 出版时间：2025-10-10
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国家重点研发计划项目(2019YFC1712504)
贵州省中医药管理局中医药、民族医药科学技术研究项目(QZYY-2021-112)
作者信息
    1.贵州中医药大学第一附属医院，贵州 贵阳 550001
    2.河北医科大学护理学院，河北 石家庄 050023
    3.延边大学药学院，吉林 延边 133000

通讯作者:

张利新（1980-），男，河北香河人，副主任医师，硕士，研究方向：肛肠外科疾病。E-mail：。
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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