目的 探討慈丹膠囊聯(lián)合注射用奧沙利鉑和替吉奧膠囊治療老年晚期膽囊癌的臨床療效。方法 選取2013年5月-2016年5月寶雞市人民醫(yī)院腫瘤科收治的老年晚期膽囊癌患者96例，采用隨機數(shù)字表法將所有患者分為對照組和治療組，每組各48例。對照組靜脈滴注注射用奧沙利鉑，130 mg/m²加入到5%葡萄糖溶液300 mL中，輸注4 h，1次/3周；治療第1~14天口服替吉奧膠囊，2片/次，2次/d，每3周重復(fù)1次。治療組在對照組基礎(chǔ)上口服慈丹膠囊，5粒/次，4次/d。兩組患者均治療6周。觀察兩組的臨床療效，比較兩組的生活質(zhì)量、免疫球蛋白（IgG、IgA和IgM）、T細胞亞群（CD³⁺、CD⁴⁺和CD⁸⁺）和毒副作用。結(jié)果 治療后，對照組和治療組的總有效率分別為70.8%、85.4%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療3~6周后，兩組KPS評分明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療4~6周后，治療組KPS評分升高程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組IgG、IgA、IgM、CD³⁺、CD⁴⁺和CD⁸⁺水平均明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的升高程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。對照組和治療組粒細胞減少發(fā)生率分別為58.3%、45.8%；血小板減少發(fā)生率分別為45.8%、33.3%；惡心嘔吐發(fā)生率分別為58.3%、43.7%；腹瀉腹痛發(fā)生率分別為27.0%、16.7%；肝功能損傷發(fā)生率分別為29.1%、16.7%；腎功能損傷發(fā)生率分別為12.5%、6.3%；皮疹發(fā)生率分別為27.0%、18.7%；口腔黏膜炎發(fā)生率分別為20.8%、14.5%，兩組毒副反應(yīng)發(fā)生率比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 慈丹膠囊聯(lián)合注射用奧沙利鉑和替吉奧膠囊治療老年晚期膽囊癌具有較好的臨床療效，可改善生活質(zhì)量，升高免疫球蛋白和T淋巴細胞亞群水平，毒副作用輕，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effects of Cidan Capsules combined with oxaliplatin and Tegafur Gimeracil and Oteracil Potassium Capsules in treatment of advanced gallbladder cancer in the elderly. Methods Elderly patients (96 cases) with advanced gallbladder cancer in Baoji People's Hospital from May 2013 to May 2016 were randomly divided into control and treatment groups, and each group had 48 cases. Patients in the control group were iv administered with Oxaliplatin for injection, 130 mg/m² added into 5% glucose solution (300 mL), infusion time of 4 h, once every 3 weeks. Patients in the control group were po administered with Tegafur Gimeracil and Oteracil Potassium Capsules on day 1 - 14, 2 tablets/time, twice daily, repeat every 3 weeks. Patients in the treatment group were po administered with Cidan Capsules on the basis of the control group, 5 grains/time, four times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical efficacies were evaluated, and quality of life, immunoglobulin (IgG, IgA, and IgM), T cell subsets (CD³⁺, CD⁴⁺, and CD⁸⁺), and toxic side effects in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 70.8% and 85.4%, respectively, and there was difference between two groups (P < 0.05). After treatment for 3 - 6 weeks, the KPS scores in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And after treatment for 4 - 6 weeks, the KPS score in the treatment group was significantly higher than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of IgG, IgA, IgM, CD³⁺, CD⁴⁺ and CD⁸⁺ in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). The observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). The incidence rate of granulocyte depletion in the control and treatment groups were 58.3% and 45.8%, respectively, the incidence rate of thrombocytopenia, nausea and vomiting, diarrhea abdominal pain, liver function injury, renal function injury, rash, and oral mucositis in the control and treatment groups were 45.8% and 33.3%, 58.3% and 43.7%, 27.0% and 16.7%, 29.1% and 16.7%, 12.5% and 6.3%, 27.0% and 18.7%, and 20.8% and 14.5%, respectively, and there was difference between two groups (P < 0.05). Conclusion Cidan Capsules combined with Oxaliplatin for injection and Tegafur Gimeracil and Oteracil Potassium Capsules has clinical curative effect in treatment of advanced gallbladder cancer in the elderly, can improve quality of life, increase the levels of immunoglobulin and T cell subsets, and mild toxic side effects, which has a certain clinical application value.