芩黄方对DLBCL患者R-CHOP方案化疗后免疫功能的影响  

Effect of Qinhuang Formula on immune function of patients with diffuse large B-cell lymphoma after R-CHOP chemotherapy

作　　者：阮铭[1] 林瀚 王剑飚[2] 吕玲玲[1] 朱文华 徐佳悦 李维丽 朱伟嵘[1] RUAN Ming;LIN Han;WANG Jianbiao;Lü Lingling;ZHU Wenhua;XU Jiayue;LI Weili;ZHU Weirong(Department of Traditional Chinese Medicine,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Clinical Laboratory,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院中医科,上海200025 [2]上海交通大学医学院附属瑞金医院检验科,上海200025 [3]上海交通大学医学院,上海200025

出　　处：《检验医学》2022年第5期403-408,共6页Laboratory Medicine

基　　金：上海市科学技术委员会引导项目(中医)(12401906100);上海市进一步加快中医药事业三年行动计划项目(ZY3-CCCX-3-3042)。

摘　　要：目的探讨中药芩黄方对弥漫大B细胞淋巴瘤(DLBCL)患者使用R-CHOP方案化疗后免疫功能的影响。方法选取行R-CHOP方案化疗的DLBCL患者300例,根据化疗后是否接受芩黄方治疗分为中药治疗组(150例,至少接受过6个月的芩黄方治疗)和对照组(150例,未行中药治疗)。分别检测所有患者在化疗前、化疗3个月、化疗结束时、化疗结束后3个月、化疗结束后6个月、化疗结束后1年、化疗结束后2年T细胞亚群(CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞绝对值及CD4/CD8比值)和IgG、IgA、IgM水平。结果DLBCL患者化疗后CD3^(+)T细胞绝对值、CD4^(+)T细胞绝对值、CD4/CD8比值及IgG、IgA、IgM水平均显著低于化疗前(P<0.05);与化疗3个月比较,化疗结束后6个月的CD4^(+)T细胞绝对值显著升高(P<0.05),化疗结束后2年的IgG水平显著升高(P<0.05)。中药治疗组CD3^(+)T细胞及CD4/CD8比值在化疗结束后1~2年恢复至化疗前水平,而对照组在化疗结束后2年仍低于化疗前(P<0.05);中药治疗组化疗结束后2年较化疗3个月CD3^(+)T细胞、CD4^(+)T细胞绝对值及CD4/CD8比值的升高程度显著高于对照组(P<0.05)。化疗结束后各时间点中药治疗组与对照组CD8^(+)T细胞绝对值差异均无统计学意义(P>0.05)。中药治疗组和对照组化疗结束后IgG、IgA、IgM水平均显著低于化疗前(P<0.05);IgA在化疗结束后1年、IgG在化疗结束后2年恢复至化疗前水平;化疗结束后2年IgM水平仍低于化疗前(P<0.05)。中药治疗组化疗结束后2年较化疗3个月IgG、IgA、IgM水平的升高幅度与对照组比较,差异均无统计学意义(P>0.05)。结论DLBCL患者经R-CHOP方案化疗后会出现长期免疫抑制;芩黄方可促进DLBCL患者化疗后的免疫功能重建。Objective To investigate the effect of Qinhuang Formula on immune function of patients with diffuse large B-cell lymphoma(DLBCL)after R-CHOP chemotherapy.Methods A total of 300 cases of DLBCL undergoing R-CHOP chemotherapy were analyzed retrospectively and were classified into 2 groups.The treatment group(150 cases)were treated with Qinhuang Formula after chemotherapy for 6 months at least,and the control group(150 cases)were not treated with traditional Chinese medicine after chemotherapy.T cell subsets(the absolute values of CD3^(+)T,CD4^(+)T and CD8^(+)T cells,the ratio of CD4/CD8),IgG,IgA and IgM were observed in the 2 groups before chemotherapy,3 months after chemotherapy,completing chemotherapy,3 months after completing chemotherapy,6 months after completing chemotherapy,1 year after completing chemotherapy and 2 years after completing chemotherapy.Results The absolute values of CD3^(+)T,CD4^(+)T cells,CD4/CD8 ratio,the levels of IgG,IgA and IgM were decreased after chemotherapy(P<0.05).During follow-up period,the absolute value of CD4^(+)T cells increased significantly half a year after completing chemotherapy(P<0.05).IgG was higher at 2 years after completing chemotherapy(P<0.05).The absolute values of CD3^(+)T cells and the ratio of CD4/CD8 in treatment group at 1-2 years after completing chemotherapy returned to the levels before chemotherapy,while those of control group was still lower than those before chemotherapy(P<0.05).Compared with 3 months after chemotherapy,the absolute values of CD3^(+)T and CD4^(+)T cells and the ratio of CD4/CD8 at 2 years after completing chemotherapy in treatment group increased significantly than those in control group(P<0.05).There was no statistical significance in the absolute value of CD8^(+)T cells between the 2 groups at each time point after completing chemotherapy(P>0.05).The levels of IgG,IgA and IgM in the 2 groups after completing chemotherapy were lower than those before chemotherapy(P<0.05).IgA returned to pre-chemotherapy level at 1 year after completing che

关 键 词：T细胞亚群 免疫球蛋白 弥漫大B细胞淋巴瘤 芩黄方 

分 类 号：R446.63[医药卫生—诊断学]