芪参益肺汤辅助治疗老年晚期非小细胞肺癌疗效及对免疫功能、血清P53、Survivin的影响  

Curative Effect of Using Qishen Yifei Decoction in the Adjuvant Treatment of Advanced Non-small Cell Lung Cancer in the Elderly and Its Influnce on Immune Function, Serum P53and Survivin

作　　者：焦进[1] 李艳玲[2] 商琰红[1] 刘宏祥[3] 甄倩楠 JIAO Jin;LI Yanling;SHANG Yanhong(Department of Oncology,the Affiliated Hospital of Hebei University,Hebei Baoding 071000,China;Department of Tuberculosis,the Affiliated Hospital of Hebei University,Hebei Baoding 071000,China)

机构地区：[1]河北大学附属医院肿瘤内科,河北保定071000 [2]河北大学附属医院结核科,河北保定071000 [3]河北大学附属医院中西医结合科,河北保定071000

出　　处：《四川中医》2021年第6期123-126,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：河北大学附属医院重点科研基金(编号:2019Q034)。

摘　　要：目的:探讨中药芪参益肺汤辅助治疗老年晚期非小细胞肺癌(NSCLC)临床疗效,并初步探讨其治疗机制。方法:将96例老年晚期NSCLC患者按照随机数字表法分为2组,每组48例,对照组予以GP方案化疗,治疗组在对照组治疗基础上予以中药芪参益肺汤口服,两组均治疗4个疗程,比较两组治疗前后中医证候评分、实体瘤疗效、外周血自然杀伤细胞(NK)、CD4+、CD8+含量和血清P53、Survivin水平,并比较两组毒副反应发生情况。结果:治疗后治疗组主要中医证候咳嗽、胸痛、乏力、气短评分均低于对照组(P<0.01);血清P53、Survivin水平低于对照组(P<0.01);外周血NK、CD4+含量高于对照组(P<0.01),CD8+含量低于对照组(P<0.01);临床获益率高于对照组(P<0.05);白细胞降低、皮疹、血小板降低、神经毒性发生率均低于对照组(P<0.05),差异均有统计学意义。结论:芪参益肺汤有利于保护机体免疫功能,改善中医证候,提高临床获益率,辅助治疗老年晚期NSCLC效果显著,其机制可能与抑制突变型P53、Survivin蛋白表达有关。Objective: To investigate the clinical efficacy of using Qishen Yifei Decoction in the adjuvant treatment of advanced non-small cell lung cancer(NSCLC) in the elderly, and to explore its therapeutic mechanism. Methods: 96 cases of elderly patients with advanced NSCLC were divided into two groups according to the random number table, 48 cases in each group. The controlled group was treated with GP chemotherapy, and the treatment group was given Qishen Yifei Decoction orally on the basis of the treatment in the controlled group. Both groups received 4 courses of treatment. TCM syndrome score, solid tumor efficacy, peripheral blood natural killer cells(NK),CD4+,CD8+ and serum p53 and Survivin levels were compared between the two groups before and after treatment, and the occurrence of toxic and side effects was compared between the two groups. Results: After treatment, the scores of cough, chest pain, fatigue and shortness of breath in the treatment group were all lower than those in the controlled group(P<0.01). The serum p53 and Survivin levels were lower than those of the controlled group(P<0.01). The content of NK and CD4+ in peripheral blood was higher than that in the controlled group(P<0.01),and the content of CD8+ was lower than that in the controlled group(P<0.01). The clinical benefit rate was higher than the controlled group(P<0.05). The incidence of leukocyte decrease, rash, platelet decrease and neurotoxicity were all lower than the controlled group(P<0.05),and the differences were statistically significant. Conclusion: Qishen Yifei Decoction can protect the immune function of the body, improve the TCM syndrome, increase the clinical benefit rate, and has a significant effect on the adjuvant treatment of elderly advanced NSCLC. The mechanism may be related to the inhibition of the expression of mutant p53 and Survivin proteins.

关 键 词：非小细胞肺癌 老年 晚期 中药 芪参益肺汤 免疫 P53蛋白 SURVIVIN蛋白 

分 类 号：R734.2[医药卫生—肿瘤]