CIK细胞联合顺铂胸腔灌注并温肺化饮方治疗癌性胸腔积液  

Thoracic Perfusion with CIK Cells Combined with Cisplatin and Traditional Chinese Medicine in Treating Patients with Malignant Pleural Effusion

作　　者：李柳宁[1] 王叙煌 何春霞[1] 柴小姝[1] 逯敏[1] 张力文[1] 刘柏[1] 陈志坚[1] 洪宏喜[1] 

机构地区：[1]广州中医药大学附属第二临床医院,广州510120

出　　处：《中国实验方剂学杂志》2014年第20期190-194,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：吴阶平医学基金会临床科研专项(320.6750.10003)

摘　　要：目的:观察细胞因子激活杀伤(CIK)细胞联合顺铂胸腔灌注并温肺化饮方治疗癌性胸腔积液的疗效和毒性作用。方法:采用随机对照单盲分组前瞻性研究,选取病人符合纳入标准病例随机分配到试验组与对照组共73例;对照组和试验组均采用常规胸腔内中心静脉导管留置引流术。试验组36例:先采用顺铂腔内灌注,再予CIK细胞胸腔内灌注3次,1次/d,两者先后间隔2周左右用药。对照组37例:仅采用顺铂腔内灌注。对照组与试验组均按照中医温肺化饮方,治疗结束4周后观察两组患者恶性胸腔积液疗效、临床证候疗效、Karnofsky评分、治疗前后患者T淋巴细胞亚群检测及毒性反应。结果:治疗组恶性胸腔积液有效率为95%,对照组为82%,两组比较差异有统计学意义(P<0.05);治疗组疗后Karnofsky评分及证候评分改善情况优于对照组(P<0.05);治疗后CD3+T,CD4+T,CD8+T,NK细胞均较治疗前提高,治疗组治疗前后CD3+T,NK差异有统计学意义(P<0.05),对照组治疗前后差异无统计学意义;治疗组毒性反应少于对照组。结论:CIK细胞联合顺铂胸腔灌注并温肺化饮方治疗癌性胸腔积液有较好的疗效,能有效控制患者胸腔积液,提高行为状况评分,改善其临床症状,提高患者机体免疫功能,安全性良好,不良反应轻,值得在临床上推广运用。Objective：To observe the safety and efficacy of cytokine-induced kill （CIK） cells combined with cisplatin and traditional Chinese Medicine （TCM） in treating patients with malignant pleural effusion （MPE）.Method：A prospective randomised single-blind study was performed,seventy-three MPE patients who meet the inclusion criteria were divided into the experimental group and the control group.Patients in both groups received conventional central venous catheter drainage for pleural effusion.Thirty-six patients in experimental group received thoracic perfusion with cisplatin and 2 weeks later added CIK cellsonce daily for 3 days.Thirty-seven patients received thoracic perfusion with cisplatin alone.Patients in both groups took orally Wenfei Huayin recipe for 4 weeks.The disease control rate （DCR） of MPE,symptoms score and Karnofsky performance status （KPS） score were evaluated after the treatment.T lymphocyte subsets was analysised and adverse reactions were carefully monitored before and after the treatment.Result：The DCR of MPE was 95.0％ in the experimental group and that incontrol group were 82.0％ with statistically significant differences （P ＜ 0.05）.Scoresof symptoms and KPS in experimental group were superior to that in control group （P ＜ 0.05）.The CD3 ＋ T,CD4 ＋ T,CD8 ＋ T and NK lymphocytesinboth groupsshowed an increase after the treatment,and there was statistically significant differences for CD3 ＋ T and NK lymphocytesin experimental group （P ＜ 0.05）.Less adverse reactions were found in experimental group than that in control group.Conclusion：Thoracic perfusion with CIK cells combined with cisplatin and TCM canreduce watery phlegm,increase scores of symptoms and KPS,boost the immune systemand improve the quality of life in MPE patients.Meanwhile,it has good safty and few adverse reactions.Therefore,it is worthy to be applied widely in clinic.

关 键 词：癌性胸腔积液 CIK细胞胸腔灌注 温肺化饮方 

分 类 号：R287.6[医药卫生—中药学]