【目的】 探讨八珍化积汤（八珍汤合化积丸加减组方而成）对中晚期胃肠肿瘤气虚血瘀型患者生活质量的影响。【方法】 将65例中晚期胃肠肿瘤气虚血瘀型患者随机分为观察组33例和对照组32例。对照组给予XELOX化疗方案（奥沙利铂联合卡 培他滨）治疗，观察组在对照组的基础上加用八珍化积汤治疗，疗程为3周（其中治疗期2周、随访期1周）。观察2组患者治 疗前后肿瘤标记物糖类抗原 199（CA199），欧洲癌症治疗研究组织生命质量核心问卷（EORTC-QLQ-C30）评分的变化情况， 并比较 2 组患者的 Karnofsky 改善疗效和不良反应发生率。【结果】（1）Karnofsky 改善疗效方面，疗程结束后，观察组患者的 Karnofsky 评分提高率为 36.36%（12/33），高于对照组的 25.00%（8/32）；下降率为 9.09%（12/33），低于对照组的 15.63% （5/32），组间比较，差异均有统计学意义（P＜0.05）。（2）EORTC-QLQ-C30量表评分方面，治疗2周后和随访期，2组患者的 总体健康状况总分和功能领域评分均较治疗前升高（P＜0.05），症状领域评分均较治疗前降低（P＜0.05），且观察组在随访期 对总体健康状况总分的升高幅度明显优于对照组（P＜0.05）。亚组分析发现，观察组和对照组中的胃癌患者和肠癌患者在治 疗后及随访期的总体健康状况总分和功能领域评分均较治疗前升高（P＜0.05），症状领域评分均较治疗前降低（P＜0.05）。同 时，观察组和对照组中的胃癌患者在治疗前后和随访期的总体健康状况总分和功能领域评分均低于肠癌患者，症状领域评 分均高于肠癌患者，差异均有统计学意义（P＜0.05）。（3）血清 CA199水平方面，治疗后，2组患者的血清 CA199水平均无显著性变化，组内治疗前后及组间比较，差异均无统计学意义（P＞0.05）。（4）不良反应方面，观察组的不良反应发生率为 48.48%（16/33），明显低于对照组的 68.75%（22/32），组间比较，差异有统计学意义（P＜0.05）。【结论】 在常规化疗的基础上 联合八珍化积汤治疗中晚期胃肠肿瘤气虚血瘀型患者疗效确切，可有效降低化疗所引起的不良反应发生率，提高患者的生 活质量。

Objective To investigate the effect of Bazhen Huaji Decoction（a modified prescription of Bazhen Decoction plus Huaji Pills）on the quality of life of patients with advanced gastrointestinal cancer of qi deficiency and blood stasis type. Methods Sixty-five patients with advanced gastrointestinal cancer of qi deficiency and blood stasis type were randomly divided into an observation group（33 cases）and a control group（32 cases）. The control group was treated with XELOX chemotherapy regimen （Oxaliplatin combined with Capecitabine）， and the observation group was treated with Bazhen Huaji Decoction on the basis of treatment for the control group. The course of treatment covered 3 weeks，including 2 weeks of treatment and one week of follow-up. The changes of tumor marker carbohydrate antigen 199（CA199）and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire（EORTC-QLQ-C30）scores in the two groups were observed before and after treatment. Moreover， the efficacy for improving Karnofsky score and the incidence of adverse reactions were compared between the two groups. Results（1）After the completion of treatment， the rate for the increase of Karnofsky score in the observation group was 36.36%（12/33），which was higher than that in the control group （25.00%，8/32）；the rate for the decrease of Karnofsky score in the observation group was 9.09%（12/33），which was lower than that in the control group（15.63%， 5/32）. The difference of rate for improving Karnofsky score between the two groups was statistically significant（P＜0.05）.（2）After 2 weeks of treatment and during the follow-up period，the total score of overall health status and functional domain scores of EORTC-QLQ-C30 in the two groups were increased（P＜0.05）and the symptom domain scores were decreased compared with those before treatment（P＜0.05），and the increase of the total score of overall health status in the observation group during the follow-up period was significantly superior to that in the control group（P＜0.05）. Subgroup analysis showed that the overall health status scores and functional domain scores of gastric cancer patients and colorectal cancer patients in the two groups after treatment and follow-up period were higher（P＜0.05）and the symptom domain scores were lower than those before treatment（P＜0.05）. Moreover，the total health status scores and functional domain score of gastric cancer patients in the two groups before and after treatment and during the follow-up period were lower and the symptom scores were higher than those of the patients with colorectal cancer， and the differences were statistically significant（P＜0.05）.（3）After treatment，there were no significant changes in the serum CA199 level between the two groups in comparison with that before treatment，and there was no significant difference between the two groups after treatment（P＞0.05）. （4）The incidence of adverse reactions in the observation group was 48.48%（16/33），which was significantly lower than that in the control group（68.75%，22/32）. The difference between the two groups was statistically significant（P＜0.05）. Conclusion On the basis of conventional chemotherapy， the application of Bazhen Huaji Decoction exerts certain effect in the treatment of patients with advanced gastrointestinal cancer of qi deficiency and blood stasis type. The combined therapy can effectively reduce the incidence of adverse reactions caused by chemotherapy and improve the quality of life of patients.

R273.35

广东省中医药局科研项目（编号：20211206）