温阳扶正方联合PD-1免疫治疗影响阳虚型肝癌微环境的临床研究  

A Clinical Study on the Effect of Wenyang Fuzheng Formula Combined with PD-1 Immunotherapy on the Microenvironment of Yang Deficiency Type of Liver Cancer

作　　者：曹晨 刘志勇 张翔 陈康海 CAO Chen;LIU Zhiyong;ZHANG Xiang;CHEN Kanghai(Traditional Chinese Medicine Department,Qingpu Branch of Zhongshan Hospital Affiliated to Fudan,Shanghai 201700,China)

机构地区：[1]复旦大学附属中山医院青浦分院中医科,上海201700

出　　处：《标记免疫分析与临床》2024年第6期1042-1048,共7页Labeled Immunoassays and Clinical Medicine

基　　金：长三角数字干线青浦区科学发展基金项目(编号:QKY2022-05)。

摘　　要：目的探讨温阳扶正方联合PD-1免疫治疗影响阳虚型肝癌微环境的临床疗效。方法选取复旦大学附属中山医院青浦分院2021年10月至2023年7月的阳虚型原发性肝癌行PD-1免疫治疗的住院患者80例为研究对象,按照随机数字表法将其分为对照组(予PD-1免疫治疗)和中药组(予PD-1免疫治疗联合用温阳扶正方治疗),对两组患者的中医疗效、中医证候积分、主症评分、行为能力状况、免疫功能指标及血清中标志物水平进行对比。结果中药组的总有效率为72.50%,明显高于对照组的50.00%(P<0.05);两组患者治疗后中医证候积分明显低于治疗前(P<0.05),且中药组治疗后中医证候积分明显低于对照组(P<0.05);两组患者治疗后主症右胁胀痛、畏寒、乏力、纳差、便溏、舌质淡或淡暗、苔白腻评分明显低于治疗前(P<0.05),且中药组治疗后主症右胁胀痛、畏寒、乏力、纳差、便溏、舌质淡或淡暗、苔白腻评分明显低于对照组(P<0.05);两组患者治疗后Karnofsky得分明显高于治疗前(P<0.05),且中药组治疗后Karnofsky得分明显高于对照组(P<0.05);两组患者治疗后的CD4^(+)T细胞、CD4^(+)/CD8^(+)明显高于治疗前(P<0.05),且中药组治疗后CD4^(+)T细胞、CD4^(+)/CD8^(+)明显高于对照组(P<0.05);两组患者治疗后血清中的bFGF、VEGF、TGF-β1、AFP水平明显低于治疗前(P<0.05),且中药组治疗后bFGF、VEGF、TGF-β1、AFP水平明显低于对照组(P<0.05)。结论温阳扶正方联合PD-1免疫治疗阳虚型肝癌疗效显著,有利于改善免疫功能和抑制肿瘤标志物的释放,具有良好的参考、推广及借鉴价值。Objective To investigate the clinical efficacy of Wenyang Fuzheng Formula combined with PD-1 immunotherapy on the microenvironment of liver cancer with yang deficiency.Methods 80 hospitalized patients with primary liver cancer who underwent PD-1 immunotherapy at Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University from October,2021 to July,2023 were selected as the research subjects.These patients were randomly divided into a matched group(receiving PD-1 immunotherapy)and a traditional Chinese medicine group(receiving PD-1 immunotherapy combined with Wenyang Fuzheng Fang treatment)according to the random number table method.The traditional Chinese medicine efficacy,traditional Chinese medicine syndrome score,main symptom score,behavioral ability status of the two groups of patients were evaluated by comparing immune function indicators and serum biomarker levels between groups.Results The total effective rate of traditional Chinese medicine in the Chinese medicine group was 72.50%,significantly higher than the rate of 50.00%in the matched group(P<0.05);The traditional Chinese medicine syndrome score after treatment was significantly lower than before treatment(P<0.05),and the traditional Chinese medicine syndrome score after treatment in the Chinese medicine group was significantly lower than that in the matched group(P<0.05).After treatment,scores of the main right hypochondriac pain,fear of cold,fatigue,poor appetite,loose stool,pale or dark tongue,and white and greasy fur in the two groups were significantly lower than before treatment(P<0.05),and scores of the main right hypochondriac pain,fear of cold,fatigue,poor appetite,loose stool,pale or dark tongue,white and greasy fur in the Chinese medicine group were significantly lower than those in the matched group(P<0.05).Karnofsky score after treatment was significantly higher than that before treatment(P<0.05),and Karnofsky score after treatment in Chinese medicine group was significantly higher than that in matched group(P<0.05).CD4^(+)T cells a

关 键 词：阳虚型肝癌 温阳扶正方 PD-1免疫治疗 肿瘤标志物 

分 类 号：R735.7[医药卫生—肿瘤]