归脾汤加减联合NK细胞对晚期恶性肿瘤患者生活质量和免疫功能影响  

Effect of guipi decoction combined with NK cell on the quality of life and immune function in patients with advanced malignant neoplasm

作　　者：鲁守彬 彭学芳 LU Shou-bin;PENG Xue-fang(Department of Oncology ,Junan People's Hospital of Qingdao University Medical Group ,Linyi 276600,P.R.China)

机构地区：[1]青岛大学医疗集团莒南人民医院肿瘤中心,山东临沂276600

出　　处：《中华肿瘤防治杂志》2018年第24期1733-1736,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的自然杀伤细胞(matural killer cell,NK)细胞以非特异性直接杀伤肿瘤细胞,具有广谱的抗癌活性,但其杀伤肿瘤细胞的能力受到一些肿瘤免疫抑制因子的影响。归脾汤具有益气健脾、补血养血和补肝肾益精髓等功效。本研究探讨NK细胞输注基础上联合归脾汤加减对晚期恶性肿瘤患者的疗效。方法选取2010-01-15—2015-08-26莒南人民医院肿瘤中心治疗的晚期恶性肿瘤患者200例为研究对象。采用数字表法随机分为治疗组和对照组,每组100例。治疗组采用归脾汤加减联合NK细胞回输治疗方法;对照组仅给予NK细胞回输治疗。治疗周期为4周,记录治疗前后患者的KPS评分、体质量、临床症状和T细胞各亚群比例。定量资料采用t检验,登记资料采用秩和检验。结果治疗4周后,治疗组KPS评分增加(9.08±0.19)分,体质量增加(2.91±0.06)kg,对照组KPS评分增加(3.25±0.19)分、体质量增加(0.20±0.03)kg。中医症状改善情况比较,治疗组较治疗前气短、自汗、少言、乏力和神疲症状减轻。治疗组患者治疗前外周血中T细胞亚群和NK细胞的比例,CD3+细胞(57.28±9.04)、CD4+细胞(21.84±4.02)、CD8+细胞(36.47±5.15)、NK细胞(8.92±0.08);治疗后CD3+细胞(68.25±10.03)、CD4+细胞(37.28±6.07)、CD8+细胞(46.11±5.92)、NK细胞(9.97±0.13),较治疗前显著提高,t=3.772,P<0.05;而对照组患者治疗前后外周血CD3+、CD4+T细胞亚群、CD8+T细胞亚群和NK细胞比例改变不明显,差异无统计学意义,t=1.022,P>0.05。结论在NK细胞治疗基础上联合归脾汤加减,能提高患者的免疫功能,明显改善晚期恶性肿瘤患者的生活质量,具有较高的临床应用价值。OBJECTIVE Natural-killer(NK)cell can be against tumor non-specifically and in a broad spectrum,but it's effect could be affected by some tumor immunosuppressive factors.Guipi Decoction has the functions of nourishing qi to invigorate spleen,nourishing blood,tonifying liver and kidney and benefiting essence.However,the effects of Guipi Decoction combined with NK cells is not verified.This study evaluated the effects of Guipi Decoction combined with NK cells on the patients with advanced cancer.METHODS 200 patients were enrolled in the study,all of whom were patients with advanced malignant tumor treated at the Cancer Center of Junan People's Hospital from January 2010 to May 2015.They were randomly divided into treatment group and control group.The treatment group(n=100)were treated with Guipi Decoction combined with NK cells,and the control group(n=100)were treated with NK cells only.The treatment cycle was 4 weeks.The changes of KPS score,body mass,clinical symptoms,and proportion of T cell subpopulations before and after treatment were recorded.The quantitative data were analyzed by t-test,and the registration data was analyzed by rank-sum test.RESULTS After 4 weeks treatment,in the treatment group,the KPS increased (9.08±0.19)points,and the body mass increased (2.91±0.06)kg;in the control group,the KPS increased (3.25±0.19)points,and the body mass increased (0.20±0.03)kg.After the treatment,TCM symptoms such as over alleviating shortness of breath,over fatigued spirit and tiredness in the experimental group were improved obviously,Before treatment,the proportion of T cell subsets and NK cell in peripheral blood of treatment group was (57.28±9.04)for CD3^+T cell,(21.84±4.02)for CD4^+T cell, (37.28±6.07)for CD8^+T cell,and (8.92±0.08)for NK cell.After treatment,the proportion of patients' T cell subsets and NK cell in peripheral blood of treatment group was (68.25±10.03)for CD3^+T cell,(36.47±5.15)for CD4^+T ce11,(46.11±5.92)for CD8^+T cell and (9.97±0.13)for NK cell,which were significantly increase

关 键 词：中药 NK细胞 CD4^+细胞 CD8^+细胞 KPS评分 体质量 

分 类 号：R73[医药卫生—肿瘤]