补肾健脾方对原发性肝癌介入术后患者细胞免疫功能的调节作用  

Regulatory Effect of Bushen Jianpi Recipe on Cellular Immunity of Patients with Primary Liver Cancer after Intervention Therapy

作　　者：王文海[1] 周荣耀[1] 颜志平[2] 林均华[3] 叶正宝[4] 吴达明[4] 吴丽英[1] 吴海良[5] 

机构地区：[1]上海中医药大学附属曙光医院肿瘤科,上海200021 [2]上海复旦大学附属中山医院 [3]上海复旦大学附属肿瘤医院 [4]上海交通大学附属瑞金医院 [5]山东省胸科医院

出　　处：《中国中西医结合杂志》2008年第7期583-587,共5页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金重大研究计划资助项目(No90209033)

摘　　要：目的观察补肾健脾方对原发性肝癌介入术后中医辨证属肝肾阴虚兼脾气虚型患者细胞免疫功能的调节作用。方法采用多中心随机对照原则,将117例患者分为治疗组60例、对照组57例。治疗组肝动脉化疗栓塞(TACE)术后服补肾健脾方12周,对照组术后服保肝药(水飞蓟素与维生素C)12周。观察患者临床中医证候疗效、生活质量、瘤体近期疗效、生存期及细胞免疫功能〔3H掺入法检测T淋巴细胞增殖,流式细胞仪检测单核细胞表面MHCⅠ/Ⅱ类分子及B7分子表达,酶联免疫吸附法(ELISA)检测细胞因子IL-10、干扰素-γ(IFN-γ)、IL-12〕。结果服用补肾健脾方可明显提高中医证候疗效(73.33%,44/60例),对照组为52.63%(30/57例);提高0.5年生存率(83.33%,50/60例),对照组为70.18%(40/57例);两组比较,差异均有统计学意义(P<0.05);提高患者生活质量,无明显不良反应。但对照组疾病控制率92.7%(CR+PR+SD,51/55例)高于治疗组(78.0%,46/59例),P=0.035;治疗组单核细胞表面MHCⅡ类分子(CD14+/HLA-DR)表达提高,IFN-γ及IL-12的表达提高。结论补肾健脾方与介入术同用可增强患者细胞免疫功能,对提高原发性肝癌临床疗效有一定作用。Objective To observe the regulatory effect of Bushen Jianpi Recipe （BSJPR） on cellular immunity the of primary liver cancer patients of Gan-Shen yin-deficiency and Pi qi-deficiency syndrome type after intervention therapy. Methods According to the multi-center randomized controlled principle, 117 patients after tran- scatheter arterial chemoembolization （TACE） were assigned to two groups, 60 in the treated group and 57 in the control group, who were treated respectively with BSJPR and liver protecting remedy （ silymarin and vitamin c） for 12 weeks. Changes in TCM syndrome, quality of life （QOL）, immediate effect on tumor size and survival time were observed. Meantime, the cellular immune function was also observed, including the T lymphocyte response determined by 3H-TdR, expression of MHC class Ⅰ / Ⅱ and B7 molecule detected by FACS, and interleukin 10 and 12 （IL-10, IL-12）, interferon-γ （IFN-γ） tested by ELISA. Results In the treated group after treatment, the efficacy for improving TCM syndrome reached 73.33% （44/60 cases）, their half-year survival rate being 83.33% （50/60 cases）; while those in the control group were 52.63% （30/57 cases） and 70. 18% （40/57 cases） respectively, significant difference was shown between the two groups （P 〈0. 05）. The patients＇ QOL was improved in the treated group after treatment, with no obvious adverse reaction. However, the clinical benefit rate in the control group （92.7%, 51/55 cases） was higher than that in the treated group （78.0%, 46/59 cases, P =0. 035）. Laboratory examination showed increases of MHC class Ⅱ （CD14 ^＋/HLA-DR） expression on monocyte surface as well as IFN-γ/and IL-12 production in the treated group. Conclusion Using BSJPR together with TACE could enhance patients＇ cellular immune function to elevate the clinical curative effect on primary liver cancer.

关 键 词：补肾健脾方 原发性肝癌 肝动脉化疗栓塞 HLA—DR 细胞因子 

分 类 号：R273[医药卫生—中西医结合]