目的 探讨经腹直肠癌根治术患者术后采用胸腺肽α1联合folfox方案辅助治疗的临床应用效果。 方法 纳入2020年1月至2024年1月本院收治的直肠癌患者102例，利用随机数字表随机均分为两组，其中常规组在根治术后给予folfox方案治疗，研究组则加用胸腺肽α1治疗，观察两组治疗后肿瘤相关因子水平、免疫功能指标变化及治疗安全性、复发转移、肿瘤相关死亡率情况。 结果 相对于治疗前，两组癌胚抗原（CEA）、缺氧诱导因子-1α（HIF-1α）、金属基质蛋白酶-9（MMP-9）、血管内皮生长因子（VEGF）水平均明显降低，且研究组明显低于常规组（P < 0.05），经Bonferroni 校正后CEA、MMP-9在组间差异有统计学意义（P < 0.010）；相对于治疗前，两组CD83⁺、CD4⁺/CD8⁺、NK细胞活力均明显升高，且研究组明显高于常规组（P < 0.05），经Bonferroni 校正后CD83⁺、CD4⁺/CD8⁺、NK细胞活力在组间差异均有统计学意义（P < 0.010）；在治疗安全性方面，研究组毒副反应总发生率为23.53%，明显低于常规组的43.14%（P < 0.05）；logistic回归（逐步向前法）分析显示，神经侵犯、脉管癌栓和folfox方案是影响肿瘤复发转移的危险因素（P < 0.05），Kaplan-Meier曲线显示研究组患者表现出一定的生存获益的趋势，但Log-rank检验显示两组差异未达到统计学意义（P > 0.05）；Cox回归分析显示：脉管癌栓是影响患者肿瘤相关死亡风险的危险因素（P < 0.05）。 结论 经腹直肠癌根治术后采用胸腺肽α1联合folfox方案辅助治疗可有效激活树突细胞、NK细胞和T细胞功能，增加肿瘤细胞杀伤作用，降低肿瘤相关因子负荷，从而有助于降低复发转移率。

Objective To explore and analyze the clinical application effect of thymosin α1 combined with folfox regimen in the adjuvant treatment of patients after transabdominal radical resection of rectal cancer （RC）. Methods A total of 102 patients with RC in the hospital were included from January 2020 to January 2024， and were randomly and evenly classified into two groups by adopting random number table method. The conventional group received folfox regimen after radical resection， whereas the study group was added with thymosin α1. The levels of tumor-related factors， changes of immune function indicators， treatment safety， recurrence and metastasis， and tumor-related mortality were observed in the two groups after treatment. Results Compared with before treatment， the levels of carcinoembryonic antigen （CEA）， hypoxia-inducible factor-1α （HIF-1α）， matrix metalloproteinase-9 （MMP-9） and vascular endothelial growth factor （VEGF） in the two groups were significantly decreased， and the levels in the study group were significantly lower than those in the conventional group （P < 0.05）. After Bonferroni correction， CEA and MMP-9 were statistically different between groups （P < 0.010）. The CD83⁺， CD4⁺/CD8⁺ and NK cell activity were significantly enhanced in the two groups compared to before treatment， and the above indicators were significantly higher in the study group （P < 0.05）. After Bonferroni correction， there were statistical differences in CD83⁺， CD4⁺/CD8⁺ and NK cell activity between groups （P<0.010）. In terms of treatment safety， the total incidence rate of toxic and side effects in the study group was 23.53%， which was significantly lower than 43.14% in the conventional group （P < 0.05）. Logistic regression （stepwise forward method） analysis showed that nerve invasion， vascular tumor thrombus and folfox regimen were risk factors of tumor recurrence and metastasis （P < 0.05）. Kaplan-Meier curve revealed that patients in the study group showed a trend of survival benefit. However， Log-rank test suggested that the difference between the two groups did not reach statistical significance （P > 0.05）. COX regression analysis indicated that vascular tumor thrombus was a risk factor of tumor-related death （P < 0.05）. Conclusion The adjuvant therapy with thymosin α1 combined with folfox regimen after transabdominal radical resection of RC can effectively activate the functions of dendritic cell， NK cell and T cell， increase the killing effect of tumor cell， reduce the loads of tumor-related factors， and thus help to reduce the recurrence and metastasis rate.