疏肝益肾抗癌方对子宫内膜癌化疗后癌因性疲乏的疗效及对血清miR-222、miR-146a的影响  

Curative effect of Shuganyishenkangai prescription on cancer-induced fatigue after chemotherapy for endometrial cancer and its influence on serum miR-222and miR-146a

作　　者：吴迪 王巧荣 WU Di;WANG Qiaorong(Heze Traditional Chinese Medicine Hospital Gynecology,Heze Shandong 274000,China)

机构地区：[1]菏泽市中医医院妇科,山东菏泽274000

出　　处：《四川中医》2024年第2期178-184,共7页Journal of Sichuan of Traditional Chinese Medicine

基　　金：山东省中医药科技项目(编号:2021Q003)。

摘　　要：目的:探讨疏肝益肾抗癌方对子宫内膜癌化疗后癌因性疲乏(Cancer-Related Fatigue,CRF)的疗效及对血清miR-222、miR-146a的影响。方法:选取2019年5月~2021年12月在我院住院治疗的晚期子宫内膜癌化疗后CRF患者98例为研究对象,随机分为观察组和对照组,每组各49例。对照组口服地塞米松片,观察组在对照组基础上服用疏肝益肾抗癌方,疗程4周。比较两组疗效、Piper量表积分、中医证候积分、免疫功能、miR-222、miR-146a等指标。采用Pearson相关分析miR-222、miR-146a与免疫指标的关系,多因素Logistic回归和ROC曲线分析miR-222、miR-146a对CRF复发的影响。结果:观察组总有效率为95.92%,对照组为75.51%,观察组疗效优于对照组(χ^(2)=8.257,P=0.041)。观察组治疗后的Piper量表行为、情感、躯体、认知、总分均低于对照组(P均<0.001)。观察组治疗后的神疲乏力、胁肋胀满、腰膝酸软、胸闷气短证候积分均高于对照组(P均<0.001)。观察组治疗后的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,CD8^(+)水平低于对照组(P均<0.001)。观察组治疗后miR-222水平低于对照组,miR-146a水平高于对照组(P均<0.001)。血清miR-222水平与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平呈负相关,与CD8^(+)水平呈正相关(P均<0.001),血清miR-146a水平与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平呈正相关,与CD8^(+)水平呈负相关(P均<0.001)。miR-222为CRF复发的独立危险因素(OR=2.185,P<0.001),miR-146a、CD4^(+)为CRF复发的独立保护因素(OR=0.276、0.335;P均<0.001)。miR-222、miR-146a及二者联合预测的AUC分别为0.851、0.741、0.942,二者联合预测优于各自单独预测效能(Z=6.357、9.415,P均<0.001)。结论:疏肝益肾抗癌方能明显提高CRF疗效,改善CRF症状,提高免疫功能,减少miR-222水平,增加miR-146a水平,miR-222和miR-146a均是CRF复发的独立影响因素,二者联合对CRF复发有很好的预测价值。Objective:To investigate the curative effect of Shugan-Yishen prescription on cancer-related Fatigue(CRF)and its effect on serum miR-222and miR-146a after chemotherapy for endometrial Cancer.Methods:Ninety-eight patients with CRF after chemotherapy for advanced endometrial cancer in our hospital from May 2019to December 2021were selected as the study objects,and randomly divided into observation group and control group,with 49cases in each group.The control group was given dexamethasone tablets,and the observation group was given Shuganyishenkangai prescription on the basis of the control group.The course of treatment was 4weeks.The efficacy,Piper scale score,TCM syndrome score,immune function,miR-222,miR-146a and other indexes were compared between the two groups.Pearson correlation was used to analyze the relationship between miR-222and miR-146a and immune indexes,and the influence of miR-222and miR-146a on CRF recurrence was analyzed by multivariate Logistic regression and ROC curve.Results:The total effective rate was 95.92%in the observation group and 75.51%in the control group.The curative effect of the observation group was better than that of the control group((2=8.257,P=0.041).The Piper scores of behavior,emotion,body,cognition and total scores of the observation group were lower than those of the control group after treatment(P<0.001).After treatment,the syndrome scores of fatigue,full side and ribs,waist and knee soreness and short chest breath in the observation group were higher than those in the control group(P<0.001).After treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)in observation group were higher than those in control group,but the levels of CD8^(+)were lower than those in control group(P<0.001).After treatment,the level of miR-222in observation group was lower than that in control group,and the level of miR-146a was higher than that in control group(P<0.001).Serum miR-222levels were negatively correlated with CD3^(+),CD4^(+),CD4^(+)/CD8^(+)levels,and positively correlated with CD8^(+)

关 键 词：疏肝益肾抗癌方 子宫内膜癌 癌因性疲乏 MIR-222 MIR-146A 

分 类 号：R737.33[医药卫生—肿瘤]