阳和汤对晚期胃癌阳虚证患者的化疗增效及其对肿瘤炎症因子,Treg,MDSCs水平的影响  

Effect of Yanghetang in Chemotherapeutic Enhancement Response Among Patients of Advanced Gastric Cancer with Syndrome of Yang Deficiency and Cancer Inflammatory Factors Treg and MDSCs

作　　者：田同德 杨峰 岳立云 王新新 石变 

机构地区：[1]郑州大学附属肿瘤医院,郑州450008

出　　处：《中国实验方剂学杂志》2016年第22期160-164,共5页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(81373879)

摘　　要：目的:观察阳和汤对晚期胃癌"阳虚证"患者化疗的增效作用,并从肿瘤相关炎症微环境的角度,探讨其作用机制。方法:120例表现为"阳虚证"的晚期胃癌患者随机分为两组,观察组(60例)予阳和汤加减联合多柔比星(DOX)方案化疗(3周为1疗程),对照组(60例)则单纯给予同方案化疗,3个疗程化疗结束后,评价两组患者的生活质量、近期疗效,并检测炎性免疫因子的血清水平和外周血髓源性抑制细胞(MDSCs),调节性T细胞(Treg)所占外周血单个核细胞(PMBC)的比率变化。结果:观察组患者的Karnofsky评分的改善率和有效率分别为31.7%,85.0%,显著高于对照组13.3%,55.0%(P<0.05)。观察组的有效率和疾病控制率分别为45.0%,85.0%,明显优于对照组26.7%,68.3%(P<0.05)。与治疗前比较,观察组治疗后外周血缺氧诱导因子-1α(HIF-1α)显著降低(P<0.01),白细胞介素-10(IL-10),转化生长因子-β1(TGF-β1),肿瘤坏死因子-α(TNF-α),单核细胞趋化蛋白-1(MCP-1)水平及MDSCs,Treg细胞所占比率均明显降低(P<0.05),干扰素-γ(IFN-γ)水平显著升高(P<0.01),对照组治疗后MDSCs细胞比率明显降低(P<0.05),IFN-γ明显升高(P<0.05)。两组患者治疗后比较,观察组HIF-1α,IL-10,TGF-β1,TNF-α,MCP-1水平及MDSCs,Treg细胞比率均明显降低(P<0.05),IFN-γ水平明显升高(P<0.05)。结论:阳和汤能够显著提高晚期胃癌阳虚证患者化疗的近期疗效和生活质量,通过改善肿瘤相关炎症微环境,重塑肿瘤免疫可能是其发挥化疗增效的重要机制。Objective： To observe the effect of Yanghetang in chemotherapeutic enhancement response among advanced gastric cancer with syndrome of Yang deficiency, and investigate its mechanism from the perspective of cancer-related inflammation micro-environment. Method： A total of 120 patients of advanced gastric cancer with syndrome of Yang deficiency were randomly divided into two groups,the treatment group（60 cases）that was treated with modified Yanghe Tang plus Doxorubicin（DOX） chemotherapy（3 weeks for a course）,and the control group（60 cases） that was treated with the same chemotherapy alone. After three courses of chemotherapy,quality of life,short-term effectiveness of the two groups were valuated,and serum levels of inflammatory immune factors,and changes in ratio of peripheral Myeloid-derived suppressor cells（MDSCs）,regulatory T cells（Treg） in peripheral blood mononuclear cell（PBMC） between both groups were detected. Result：Improvement rate and effective rate of Karnofsky score in patients of the treatment group were 31. 7% and 85. 0%,respectively,which were higher than 13. 3% and 55. 0% of control group（P〈 0. 05）. Short-term effectiveness and disease control rate of treatment group were 45. 0% and 85. 0%,respectively,which were significantly better than26. 7% and 68. 3% of control group（P 〈0. 05）. Compared with pre-treatment,treatment group showed significant decrease in serum hypoxia induced factor-1α（HIF-1α）（P〈 0. 01）,interlukin-10（IL-10）,transforming growth factor-β1（TGF-β1）,tumor necrosis factor-α（TNF-α）,monocyte chemotactic protein-1（MCP-1） and MDSCs,and percentage of Treg（P 〈0. 05）,and increases in serum IFN-γ（P 〈0. 05）,whereas control group only showed significant advantage of higher levels of IFN-γ and lower percentage of peripheral MDSCs than pre-treatment（P〈 0. 05）. In comparison between two groups after treatment,treatment group showed significantly lower serum levels of HIF-1α,IL-10,TGF-β,TNF-α,MCP-1,r

关 键 词：阳和汤 胃癌 肿瘤炎症微环境 化疗增效 炎性免疫因子 外周血髓源性抑制细胞 调节性T细胞 

分 类 号：R287[医药卫生—中药学]