苦参素对局部晚期鼻咽癌三维适形放疗同步化疗的疗效及免疫功能的影响  

Effects of oxymatrine on the efficacy and immune function of locally advanced nasopharyngeal carcinoma treated with three-dimensional conformal radiotherapy and chemotherapy

作　　者：刘刚[1] 张莉[1] 余丽亚[1] 严文辉[1] LIU Gang;ZHANG Li;YU Liya;YAN Wenhui(Department of Otolaryngology Hend and Neck Suegery,Hunom second people's Hospital,Changsha,410007,China)

机构地区：[1]湖南省第二人民医院耳鼻咽喉头颈外科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2019年第5期363-367,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的探讨苦参素对局部晚期鼻咽癌三维适形放疗同步化疗的临床疗效及对患者免疫功能的影响。方法选取2015年2月~2017年2月于本院就诊的鼻咽癌局部晚期患者共84例,按随机数法分为观察组和对照组各42例,对照组采用三维适形放疗同步化疗,观察组在对照组基础上联用注射用苦参素,对比两组患者疗效、免疫功能、无转移生存率、局部控制率和不良反应。结果治疗结束3个月后,两组均有明显的治疗效果,组间无明显统计学差异(χ^2=1.410,P=0.160);治疗前,两组患者免疫细胞指标无明显差异(P>0.05),治疗后观察组CD4^+/CD8^+较前明显上升,CD8^+明显下降,差异具有统计学意义(P<0.05),对照组CD4^+、CD4^+/CD8^+较前明显下降,CD8^+明显上升,差异具有统计学意义(P<0.05);观察组较CD4^+/CD8^+对照组明显升高,差异具有统计学意义(t=5.281,P=0.000);观察组2年无转移生存率和局部控制率[92.9%(39/42);95.2%(40/42)]均高于对照组[71.4%(30/42);76.2%(32/42)],差异具有统计学意义(χ^2=6.570,P=0.010;χ^2=6.220,P=0.013)观察组治疗期间不良反应发生率[9.5%(4/42)]明显低于对照组[26.2%(11/42)],差异具有统计学意义(χ^2=3.980,P=0.046)结论苦参素可改善局部晚期鼻咽癌三维适形放疗同步化疗患者的免疫功能,减少不良反应,控制病情进展,提高生存率值得应用推广。Objective To investigate the clinical effect of oxymatrine on three-dimensional conformal radiotherapy and concurrent chemotherapy for locally advanced nasopharyngeal carcinoma and its effect on immune function.Methods From February 2015 to February 2017,84 patients with locally advanced nasopharyngeal carcinoma(NPC)were randomly divided into two groups:observation group(n=42)and control group(n=42).The therapeutic effect,immune function,metastasis-free survival rate,local control rate and adverse reaction were compared between the two groups on the basis of the control group combined with oxymatrine injection.Results After three months of treatment,the two groups had obvious therapeutic effect,but there was no significant difference between the two groups(χ^2=1.410,P=0.160),Before treatment,there was no significant difference in immune cell indexes between the two groups(P>0.05).After treatment,CD4/CD8 in the observation group were significantly higher than those before treatment,while CD8 was significantly decreased(P<0.05).In the control group,CD4,CD4/CD8 decreased significantly and CD8 increased significantly(P<0.05).The CD4/CD8 in the observation group was significantly higher than that in the control group(t=5.281,P<0.000),and the 2-year metastasis-free survival rate and local control rate in the observation group[92.9%(39/42);95.2%(40/42)]were significantly higher than those of the control group[71.4%(30/42);76.2%(32/42)](χ^2=6.570,P=0.010);The incidence of adverse reactions in the observation group[9.5%(4/42)]was significantly lower than that in the control group[26.2%(11/42)](χ^2=3.980,P=0.046).Conclusion Oxymatrine can improve the immune function of locally advanced nasopharyngeal carcinoma patients with three-dimensional conformal radiotherapy and chemotherapy,reduce the adverse reactions,control the progression of the disease,and improve the survival rate.

关 键 词：苦参素 鼻咽癌 三维适形放疗 化疗 免疫功能 

分 类 号：R73[医药卫生—肿瘤]