乾坤胶囊对中晚期非小细胞肺癌化疗的增效减毒机制研究  

Study of Qiankun capsule on mechanism of raising efficiency and reducing toxicity during chemotherapy in non-small cell lung cancer

作　　者：张书臣 张翠卿 周凤伟 杨林凤 赵翠娟 

机构地区：[1]河北省石家庄平安医院肿瘤科,河北石家庄050021

出　　处：《河北中医》2010年第10期1448-1450,1461,共4页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省科学技术研究与发展指导计划(第2批)(编号:052761377)

摘　　要：目的观察乾坤胶囊对中晚期非小细胞肺癌(NSCLC)患者化疗前后外周血中肺癌转化生长因子(TGF-α)、T淋巴细胞亚群变化及对患者活检组织中增殖细胞核抗原(PCNA)阳性细胞数及多药耐药相关蛋白(MRP)、肺耐药相关蛋白(LRP)基因表达的影响,探讨其对化疗的增效减毒作用机制。方法将60例NSCLC患者随机分为2组,治疗组30例予乾坤胶囊联合化疗治疗,对照组30例予单纯化疗治疗。测定外周血中TGF-α、CD3、CD4、CD8、CD4/CD8含量,检测活检组织中PCNA阳性细胞数,检测活检组织中MRP、LRP基因的表达。结果 2组治疗后TGF-α含量均较本组治疗前降低(P<0.01,P<0.05),治疗组治疗后TGF-α含量低于对照组(P<0.05)。治疗组治疗后CD3、CD4、CD8、CD4/CD8与本组治疗前比较差异有统计学意义(P<0.05,P<0.01),对照组治疗后CD4/CD8较本组治疗前升高(P<0.05),治疗组治疗后CD3、CD4、CD4/CD8均高于对照组(P<0.05)。2组治疗后PCNA阳性细胞数均较本组治疗前降低(P<0.01),治疗组PCNA阳性细胞数下降较对照组更显著(P<0.05),治疗组治疗后MRP、LRP基因表达水平均较本组治疗前下降(P<0.05)。结论乾坤胶囊治疗NSCLC疗效确切,通过降低TGF-α含量,调节T淋巴细胞亚群的比例,影响PCNA阳性细胞数及MRP、LRP基因表达,从多种机制上对NSCLC化疗起到增效减毒的作用。Objective To observe the effect of combination Qiankun capsule and chemotherapy on the change of TGF-α and T lymphocyte subset in blood,and the PCNA and MRP,LRP gene expression in tissues of patients with advanced non-small cell lung cancer（NSCLC） before and after treatment.And to explore mechanism of raising efficiency and reducing toxicity during chemotherapy.Methods 60 patients with NSCLC（identified by cytopathology） were randomly divided into two groups.Patients in control group（n = 30） were treated by routine chemotherapy.30 cases in treatment group were treated by combination Qiankun capsule and chemotherapy.The level of the TGF-α、CD3、CD4、CD8、CD4 /CD8 in peripheral blood were detected by ELISA method and flow cytometer.Expression of PCNA in tissues was detected by LSAB immunohistochemistry;Expression of MRP and LRP genes in tissues were detected by SP immunohistochemistry.Results The level of TGF-αafter treatment were significantly decreased than before treatment in two groups（P〈0.01 or P〈0.05）.And the level of TGF-α in treatment group was lower than that in control group（P〈0.05）.After treatment the levels of the CD3,CD4,CD4 /CD8 in treatment group were all increased than those before treatment（P〈0.05）,but the level of the CD8 was decreased than before treatment（P〈0.01）.After treatment the level of the CD3、CD4、CD4 /CD8 in treatment group were all increased than those in control group（P〈0.05）.After treatment the PCNA in the two groups were significantly decreased（P〈0.01） ;and the PCNA in the treatment group was significantly decreasedthan that in control group（P〈0.05）.After treatment the MRP and LRP gene expression in treatment group were decreased than before treatment（all P〈0.05）.Conclusion Qiankun capsule can enhance the clinical therapeutic effect on non-small-cell lung cancer,and decrease the level of the TGF-α,adjust to the ratio of T lymphocyte subset,affect the MRP,LRP gene expression.It has a marked effect on multiple mec

关 键 词：癌 非小细胞肺 药物疗法 肺肿瘤 顺铂 投药和剂量 T淋巴细胞亚群 中药疗法 增殖细胞核抗原 转化生长因子Α 多药耐药相关蛋白质类 

分 类 号：R730.26[医药卫生—肿瘤] R734.21[医药卫生—临床医学]