银翘三黄膏联合中药塌渍对肺癌靶向药物所致药疹的干预作用  

Interventional effect of Yinqiao Sanhuang Ointment combined with traditional Chinese medicine collapse stains on lung cancer-related rash caused by targeted drugs

作　　者：马小莉[1] 霍志刚[2] 毕俊芳[1] 张华[1] MA Xiaoli;HUO Zhigang;BI Junfang;ZHANG Hua(Department of Integrated Traditional Chinese and Western Medicine;Department of Oncology,Shijiazhuang Municipal Hospital of Traditional Chinese Medicine,Shijiazhuang,Hebei 050051,China)

机构地区：[1]河北省石家庄市中医院中西医结合科,河北石家庄050051 [2]河北省石家庄市中医院肿瘤科,河北石家庄050051

出　　处：《检验医学与临床》2024年第12期1692-1696,1703,共6页Laboratory Medicine and Clinic

基　　金：河北省中医药管理局科研计划项目(2019435)。

摘　　要：目的观察银翘三黄膏联合中药塌渍对肺癌靶向药物所致药疹的干预作用。方法选择2019年10月至2021年10月于该院治疗的92例肺癌靶向药物所致药疹患者作为研究对象,按随机数字表法将患者分为研究组和对照组,每组46例。对照组给予丁酸氢化可的松乳膏治疗,研究组在对照组基础上给予银翘三黄膏联合中药塌渍治疗。比较两组治疗前后Th17细胞、Treg细胞、CD4+T淋巴细胞、CD3+T淋巴细胞比例及肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-1β(IL-1β)、基质金属蛋白酶-9(MMP-9)、基质金属蛋白酶-2(MMP-2)、CC趋化因子受体1(CCR1)、趋化因子C-C-基元配体3(CCL3)、C反应蛋白(CRP)、CXC趋化因子配体10(CXCL10)、趋化因子受体3(CXCR3)水平。治疗前后对患者药疹进行分级,并采用皮肤病生活质量指数量表(DLQI)评价两组患者生活质量;比较两组临床疗效。结果治疗前,两组Th17细胞、Treg细胞、CD4+T淋巴细胞、CD3+T淋巴细胞比例比较,差异均无统计学意义(P>0.05);治疗1个月后,两组CD3+T淋巴细胞、Th17细胞、CD4+T淋巴细胞比例均较治疗前降低(P<0.05),且研究组低于对照组(P<0.05);治疗1个月后两组Treg细胞比例均较治疗前升高(P<0.05),且研究组高于对照组(P<0.05)。治疗前,两组TNF-α、IFN-γ、IL-1β、CRP水平比较,差异均无统计学意义(P>0.05);治疗1个月后,研究组IL-1β、TNF-α、IFN-γ、CRP水平均低于对照组(P<0.05)。治疗前,两组CCL3、CCR1、CXCL10、CXCR3水平比较,差异均无统计学意义(P>0.05);治疗1个月后,两组CCR1水平均较治疗前升高(P<0.05),且研究组高于对照组(P<0.05);治疗1个月后,两组CXCL10、CCL3、CXCR3水平均较治疗前降低(P<0.05),且研究组低于对照组(P<0.05)。治疗前,两组MMP-2、MMP-9水平比较,差异均无统计学意义(P>0.05);治疗1个月后,研究组MMP-2、MMP-9水平低于对照组(P<0.05)。治疗1个月后,研究组药疹分级明显改善(Z=3.Objective To observe the intervention effect of Yinqiao Sanhuang Ointment combined with traditional Chinese medicine collapse stains on drug rash caused by lung cancer targeted drugs.Methods A total of 92 patients with drug rash caused by lung cancer targeted drugs treated in this hospital from October 2019 to October 2021 were selected and divided into the study group and control group according to the random number table method,46 cases in each group.The control group was treated with hydrocortisone butyrate cream,while the study group was treated with Yinqiao Sanhuang Ointment combined with traditional Chinese medicine collapse stains on the basis of the control group.Compared the proportions of Th17 cells,Treg cells,CD4+T lymphocytes,CD3+T lymphocytes,as well as the levels of tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-1β(IL-1β),matrix metalloproteinase-9(MMP-9),matrix metalloproteinase-2(MMP-2),CC chemokine receptor 1(CCR1),chemokine C-C-primitive ligand 3(CCL3),C-reactive protein(CRP),CXC chemokine ligand 10(CXCL10),chemokine receptor 3(CXCR3)between two groups before and after one month of treatment.The drug eruption was graded before and after treatment,and the quality of life of the two groups was evaluated by dermatology life quality index(DLQI).The clinical efficacy of the two groups was compared.Results Before treatment,there were no significant differences in the proportion of Th17 cells,Treg cells,CD4+T lymphocytes and CD3+T lymphocytes between the two groups(P>0.05).After one month of treatment,the proportions of CD3+T lymphocytes,Th17 cells,and CD4+T lymphocytes in both groups decreased compared to before treatment(P<0.05),and the study group was lower than the control group(P<0.05);after treatment,the proportion of Treg cells in both groups increased compared to before treatment(P<0.05),and the study group was higher than the control group(P<0.05).Before treatment,there were no significant differences in the levels of TNF-α,IFN-γ,IL-1βand CRP between the two groups(P>0

关 键 词：银翘三黄膏 中药塌渍 肺癌 药疹 免疫功能 炎症指标 基质金属蛋白酶 

分 类 号：R275.9[医药卫生—中西医结合] R446.11[医药卫生—中医皮科]