芪归益肾汤治疗应用PD-1/PD-L1抑制剂后肿瘤患者急性肾损伤的临床研究  

Clinical study of Qigui Yishen Decoction in treating acute kidney injury of tumor patients after application of PD-1/PD-L1 inhibitor

作　　者：吴玲艳[1] 米虽才 许正锦[1] 贺斐 苏雨田 周燕妮 WU Lingyan;MI Suicai;XU Zhengjin;HE Fei;SU Yutian;ZHOU Yanni(Department of Nephrology,Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,China;Department of Oncology,Xiamen Hospital of Traditional Chinese Medicine,Xiamen 361009,China)

机构地区：[1]厦门市中医院肾病科,福建厦门361009 [2]厦门市中医院肿瘤科,福建厦门361009

出　　处：《中国现代医生》2021年第23期124-128,共5页China Modern Doctor

基　　金：福建省科技厅自然科学基金项目(青年创新)(2020D032)。

摘　　要：目的探讨芪归益肾汤治疗应用PD-1/PD-L1免疫检查点抑制剂治疗恶性肿瘤导致患者并发急性肾损伤的疗效。方法在我院肿瘤科2019年3月至2020年12月收治的应用ICIs治疗肿瘤并发急性肾损伤的患者,共48例。治疗前、治疗2周后、及治疗4周后检测其肾功能指标(BUN、Scr和eGFR),计算对比两组患者临床症状疗效,客观评价肾毒性分级及对原ICPIs治疗方案的影响。结果治疗后,两组患者的肾功能均有改善,临床症状疗效均较好,患者肾毒性改善显著(P<0.05),治疗组患者的临床疗效评定的总有效率较高(P<0.05);经治疗4周后,治疗组肾功能恢复人数显著高于对照组(Z=2.076,P<0.05),进一步评估提示治疗组原ICIs使用率较高为83.33%,提示中药治疗较糖皮质激素治疗增加了患者抗肿瘤治疗方案的延续性(P<0.01)。结论芪归益肾汤对肿瘤免疫治疗后致急性肾损伤的患者的改善作用疗效显著,可以明显的改善患者肾功能,降低ICIs相关肾毒性。Objective To explore the curative effect of Qigui Yishen Decoction in the treatment of patients with acute kidney injury caused by malignant tumors with PD-1/PD-L1 immune checkpoint inhibitors.Methods A total of 48 tumor patients with acute kidney injury who were treated with ICIs in the oncology department of our hospital from March 2019 to December 2020 were enrolled.The renal function indexes(BUN,Scr,and eGFR)were measured before treatment,after two weeks and four weeks of treatment.The clinical symptoms of the two groups were calculated and compared.The grade of nephrotoxicity and the impact on the original ICPIs treatment plan were objectively evaluated.Results After treatment,the renal function of the two groups was improved,the clinical symptoms and the renal toxicity of the patients were significantly improved(P<0.05).The total effective rate of the clinical efficacy evaluation of the treatment group was higher(P<0.05).After four weeks of treatment,the number of people recovering renal function in the treatment group was significantly higher than that in the control group(Z=2.076,P<0.05).The further evaluation indicated that the original ICIs use rate in the treatment group was 83.33%,suggesting that traditional Chinese medicine treatment increased the continuity of the anti-tumor treatment plan of patients compared with glucocorticoid treatment(P<0.01).Conclusion Qigui Yishen Decoction has a significant effect on improving patients with acute kidney injury after tumor immunotherapy.It can significantly improve the renal function of patients and reduce ICIs-related nephrotoxicity.

关 键 词：芪归益肾汤 肿瘤免疫治疗 急性肾损伤 ICPIs相关肾毒性 

分 类 号：R692.5[医药卫生—泌尿科学]