益气养阴解毒方对晚期非小细胞肺癌相关免疫指标及血清sB7-H3的影响  

Effects of Yiqi Yangyin Jiedu Formula on advanced non-small cell lung cancer related immune indexes and serum sB7-H3

作　　者：徐蔚杰[1] 刘嘉湘[1] 赵丽红[1] 李和根[1] 田建辉[1] 朱丽华[1] 周蕾[1] 周之毅[1] 

机构地区：[1]上海中医药大学附属龙华医院肿瘤科,上海200032

出　　处：《上海中医药杂志》2017年第4期53-56,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市卫计委进一步加快中医药事业发展三年行动计划项目(ZY3-CCCX-3-3023);国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2012125);国家中医药管理局第五批全国老中医药专家学术经验继承项目[2012(20)]

摘　　要：目的观察益气养阴解毒方对晚期非小细胞肺癌相关免疫指标及血清sB7-H3的影响,从共刺激分子对T淋巴细胞免疫反应的影响方面,探讨相关的作用机制。方法将60例中医辨证为气阴两虚型的晚期非小细胞肺癌患者,随机分为治疗组和对照组,每组30例。对照组单纯化疗,治疗组在化疗的基础上加服益气养阴解毒方。两组均以21天为1个治疗周期,疗程为2个周期;观察中医证候评分、体力状况评分(ECOGPS),以及免疫指标(CD3^+、CD4^+、CD8^+、IL-2)、血清可溶性协同共刺激分子sB7-H3水平的变化情况。结果 (1)治疗前后组内比较,治疗组各项中医证候积分及总积分差异均有统计学意义(P<0.05),对照组咳嗽、咯痰、胸闷、口干等积分及证候总积分差异有统计学意义(P<0.05);组间治疗后比较,胸痛、乏力、纳呆、失眠积分及总积分差异有统计学意义(P<0.05)。(2)治疗前后组内比较,治疗组ECOGPS积分差异有统计学意义(P<0.05),对照组ECOGPS积分差异无统计学意义(P>0.05);组间治疗后比较,ECOGPS积分差异有统计学意义(P<0.05)。(3)治疗前后组内比较,治疗组IL-2及sB7-H3水平差异有统计学意义(P<0.05),对照组各指标差异均无统计学意义(P<0.05);组间治疗后比较,CD4^+、IL-2、sB7-H3水平差异有统计学意义(P<0.05)。结论 (1)益气养阴解毒方能改善肺癌患者气阴两虚证候,提高机体CD4^+细胞的比例及IL-2的水平,降低血清sB7-H3水平。Objective To observe the effects of Yiqi Yangyin Jiedu Formula on advanced non-small cell lung cancer related immune indexes and serum sB7-H3, and explore the related mechanism based on the influence of costimulatory molecules on T lymphocyte immune response. Methods 60 patients with advanced non-small cell lung cancer who identified as the pattern of qi-yin deficiency in traditional Chinese medicine（TCM） syndrome differentiation were randomly divided into the treatment group and control group ,30 cases in each group. The control group was only treated with chemotherapy, the treatment group was treated with Yiqi Yangyin Jiedu Formula additionally based on the treatment for the control group. All the treatments were given with a course of two cycles and one cycle was 21 days. The scores of TCM syndrome and eastern cooperative oncology group performance status（ECOGPS） were observed, and the levels of immune indexes（ CD3＋ , CD4 ＋ , CD8 ＋ ,IL-2）and serum soluble costimulatory molecules sB7-H3 were detected and compared. Results ①For the comparison between the treatment before and after, the differences on the each and total score of TCM syndrome in the treatment group were all statistically significant（ P 〈 0.05 ）, the differences on the single score of cough, expectoration, chest tightness, dry mouth and the total score of syndrome in the control group were statistically significant（ P 〈 0. 05 ）. For the comparison after treatment, there were statistically significant differences on the single score of chest pain, fatigue, anorexia, insomnia and the total score of syndrome between the two groups （ P 〈 0.05 ）. ②For the comparison between the treatment before and after, the difference on the ECOGPS score in the treatment group was statistically significant（P 〈0.05 ） ,but the difference on the ECOGPS score in the control group was not statistically significant（ P 〉 0.05 ）. For the comparison after treatment ,there was statistically significant difference on the ECOGPS

关 键 词：非小细胞肺癌 益气养阴解毒方 s B7-H3 

分 类 号：R734.2[医药卫生—肿瘤]