健脾补肾方对肿瘤患者放疗后造血及免疫系统的影响  

Effects of Jianpi Bushen Prescription on Hematopoiesis and Immune System in Tumor Patients After Radiotherapy

作　　者：孙君阳[1] 何东初 SUN Junyang;HE Dongchu(Hubei University of Chinese Medicine,Hubei 430065,China;Central Theater General Hospital of PLA,Hubei 430070,China)

机构地区：[1]湖北中医药大学,湖北430065 [2]中国人民解放军中部战区总医院,湖北430070

出　　处：《中国实验方剂学杂志》2024年第21期219-226,共8页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金面上项目(81273905,81873153);湖北省中医药重点项目(ZY2023Z010)。

摘　　要：目的:探讨健脾补肾方对肿瘤患者放疗后造血和免疫系统损伤的防治作用。方法:选取2023年1月至2023年12月在中国人民解放军中部战区总医院肿瘤放疗科病区首次接受放射治疗且确诊为气血亏虚型肿瘤患者64例,以1∶1的比例随机分为健脾补肾方联合放疗组(观察组)和单纯放疗组(对照组),每组各有32例患者。比较两组患者治疗前后西医临床疗效、中医证候疗效、中医证候积分、血常规、免疫学指标、细胞因子、卡氏功能状态量表(KPS)。观察治疗过程中的不良反应以评估治疗的安全性。结果:本研究最终纳入61例患者,其中观察组29例,对照32例。与本组治疗前比较,治疗后观察组患者气血亏虚主证、次证、症状总积分、外周血白细胞计数(WBC)、红细胞计数(RBC)、血红蛋白(HGB)、血小板(PLT)、淋巴细胞(LYM)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、白细胞介素(IL)-4、IL-10水平均明显降低(P<0.05,P<0.01),外周血CD8^(+)、IL-6、γ干扰素(IFN-γ)、肿瘤坏死因子-α(TNF-α)、IL-17、KPS评分水平均明显上升(P<0.05,P<0.01);对照组气血亏虚主证、症状总积分、外周血WBC、RBC、HGB、PLT、LYM、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IL-4、IL-10、IL-17水平均明显降低(P<0.05,P<0.01),外周血CD8^(+)、IL-6、IFN-γ、TNF-α、KPS评分明显上升(P<0.05,P<0.01)。治疗后观察组中医证候总有效率为86.2%(26/29),对照组中医证候总有效率50.0%(22/32),观察组显著高于对照组(χ^(2)=16.543,P<0.01)。观察组临床总缓解率为51.7%(15/29),对照组临床总缓解率为25.0%(8/32),观察组明显高于对照组(χ^(2)=9.159,P<0.05)。治疗后观察组患者血常规WBC、RBC、HGB、PLT、LYM、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IL-4、IL-10、KPS评分水平均高于对照组(P<0.05),观察组外周血CD8^(+)、IL-6、IFN-γ、TNF-α、IL-17水平均低于对照组(P<0.05)。两组最常发生的不良事件为骨髓抑制、放射性皮炎、放射性�Objective:To explore the preventive and therapeutic effects of Jianpi Bushen prescription(JBP)on hematopoiesis and immune system damage in tumor patients after radiotherapy.Method:Sixty-four patients diagnosed with tumors of qi and blood deficiency syndrome,who received radiotherapy for the first time at the department of oncology and radiotherapy of Central Theater General Hospital of PLA from January 2023 to December 2023,were enrolled and randomly divided into the JBP combined with radiotherapy group(observation group)and the radiotherapy alone group(control group)at a ratio of 1∶1,with 32 patients in each group.The clinical efficacy of Western medicine,traditional Chinese medicine(TCM)syndrome efficacy,TCM syndrome scores,blood routine tests,immunological indicators,cytokines,and Karnofsky Performance Status(KPS)scores were compared between the two groups before and after treatment.Adverse reactions during the treatment process were observed to assess the safety of the treatment.Result:A total of 61 patients were ultimately included in this study,with 29 patients in the observation group and 32 in the control group.Compared with pre-treatment levels,the observation group showed significant reductions in the primary and secondary symptoms of qi and blood deficiency syndrome,total symptom score,peripheral blood white blood cell count(WBC),red blood cell count(RBC),hemoglobin(HGB),blood platelet(PLT),lymphocyte(LYM),CD3^(+),CD4^(+),CD4^(+)/CD8^(+)ratio,interleukin(IL)-4,and IL-10 levels after treatment(P<0.05,P<0.01).Meanwhile,the levels of peripheral blood CD8^(+),IL-6,interferon(IFN)-γ,tumor necrosis factor(TNF)-α,IL-17,and KPS scores significantly increased(P<0.05,P<0.01).In the control group,significant reductions were also observed in the primary symptoms of qi and blood deficiency syndrome,total symptom score,peripheral blood WBC,RBC,HGB,PLT,LYM,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)ratio,IL-4,IL-10,and IL-17 levels(P<0.05,P<0.01),along with significant increases in peripheral blood CD8^(+),IL-6,IFN-γ,TNF-α

关 键 词：肿瘤 放疗 放疗损伤 健脾补肾方 造血功能 免疫功能 

分 类 号：R2-031[医药卫生—中西医结合] R287[医药卫生—中医学] R259R730.5