补益消徵方对晚期卵巢癌患者化学疗法“窗口期”免疫微环境的影响  

Effect of Buyi Xiaozheng Prescription on immune microenvironment in window period of chemotherapy for advanced ovarian cancer

作　　者：丁忱欢[1] 李瑾[1] 张旭 李鹤[1] DING Chenhuan;LI Jin;ZHANG Xu;LI He(Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127)

机构地区：[1]上海交通大学医学院附属仁济医院,上海200127

出　　处：《上海中医药杂志》2023年第5期76-79,共4页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82174135);上海市卫健委进一步加快中医药传承创新发展三年行动计划项目(ZY-〔2021-2023〕-0209-04);上海交通大学“交大之星”计划医工交叉研究基金项目(YG2021ZD09);上海市科委科研计划项目(19401932600)。

摘　　要：目的观察补益消徵方对晚期卵巢癌患者化学疗法(简称“化疗”)“窗口期”免疫微环境的影响及临床疗效。方法将60例晚期卵巢癌患者随机分为对照组和治疗组,每组30例,对照组采用常规治疗,治疗组在对照组治疗措施的基础上加用补益消徵方口服。比较两组CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD4^(+)T细胞/CD8^(+)T细胞、CD25^(+)调节性T(Treg)细胞、自然杀伤(NK)细胞水平变化情况,并观察近期临床疗效。结果①试验过程中,治疗组脱落2例,对照组脱落3例,最终完成试验者55例,治疗组28例、对照组27例。②近期疗效比较,治疗组12个月治疗有效率为42.86%、肿瘤控制率为71.42%,分别优于对照组的33.33%和44.44%(P<0.05)。③化疗后7 d与治疗前组内比较,两组CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD25^(+)Treg细胞水平均明显降低(P<0.05);化疗后14 d、化疗后28 d组间比较,治疗组CD3^(+)T细胞、CD4^(+)T细胞、CD8^(+)T细胞、CD25^(+)Treg细胞水平高于对照组(P<0.05)。④化疗后14 d与治疗前组内比较,两组NK细胞水平均下降(P<0.05);化疗后14 d、化疗后28 d组间比较,治疗组NK细胞水平高于对照组(P<0.05)。结论补益消徵方能够有效抑制晚期卵巢癌的进展,并在化疗后的免疫“窗口期”起到正向调控T细胞、NK细胞的作用,使得化疗后患者体内的免疫抑制暂时逆转,为进一步的免疫治疗提供良好治疗环境。Objective To study the effect of Buyi Xiaozheng Prescription(BXP)on the immune microenvironment in the window period of chemotherapy for advanced ovarian cancer,and to observe the clinical efficacy of BXP.Methods Sixty patients diagnosed with advanced ovarian cancer were randomly divided into a control group(n=30)and a treatment group(n=30).The control group was given conventional chemotherapy,and the treatment group was given the conventional treatment measures of the control group together with the oral administration of BXP.The changes in the number and proportion of CD3^(+)T,CD4^(+)T,CD8^(+)T,CD4^(+)/CD8^(+)T,CD25^(+)Treg and NK cells were compared between the two groups,and the recent clinical efficacy was observed.Results①During the trial,there were 2 drop-out cases in the treatment group and 3 drop-out cases in the control group,and 55 cases finally completed the trial with 28 cases in the treatment group and 27 cases in the control group.②In terms of recent efficacy comparison,the 12-month treatment efficiency of the treatment group was 42.86%and the tumor control rate was 71.42%,which were better than 33.33%and 44.44%of the control group,respectively(P<0.05).③The levels of CD3^(+)T,CD4^(+)T,CD8^(+)T,and CD25^(+)Treg cells were lowered significantly in both groups 7 d after chemotherapy compared with those before treatment(P<0.05);and the levels of CD3^(+)T,CD4^(+)T,CD8^(+)T,and CD25^(+)Treg cells in the treatment group were higher than those in the control group 14 d and 28 d after chemotherapy(P<0.05).④The levels of NK cells in both groups decreased 14 d after chemotherapy compared with those before treatment(P<0.05);and the levels of NK cells in the treatment group were higher than those in the control group 14 d and 28 d after chemotherapy(P<0.05).Conclusion Buyi Xiaozheng Prescription can effectively inhibit the progression of advanced ovarian cancer and positively regulate T cells and NK cells in the immune“window period”after chemotherapy,which can temporarily reverse the immune suppres

关 键 词：卵巢癌 补益消癥方 化学疗法 窗口期 免疫调节 中医药疗法 

分 类 号：R273[医药卫生—中西医结合]