加减阳和汤联合免疫检查点抑制剂对复发转移性宫颈癌患者疗效的影响  

Effect of Modified Yanghe Decoction(加减阳和汤)Combined with Immune Checkpoint Inhibitors on Serum Tumour Markers in Patients with Recurrent and Metastatic Cervical Cancer

作　　者：李本珊 王瑞丽 布占红 LI Benshan;WANG Ruili;BU Zhanhong(People's Hospital of Jiangmen,Jiangmen 529000,Guangdong,China)

机构地区：[1]江门市人民医院,广东江门529000

出　　处：《中华中医药学刊》2024年第11期206-209,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20231380)。

摘　　要：目的探究加减阳和汤联合免疫检查点抑制剂对复发转移性宫颈癌患者血清肿瘤标志物的影响。方法收集2022年1月—2023年3月收治的晚期复发转移性宫颈癌患者60例,采用随机数字分配法,分为试验组与对照组,每组30例。对照组予以替雷利珠单抗200 mg+紫杉醇135 mg/m^(2)d1联合顺铂30 mg/m^(2)d2~d4化疗方案,试验组在对照组基础上予加减阳和汤治疗。对比两组临床疗效、中医症状积分、血清肿瘤标志物和水平、T细胞亚群指标、并发症、生存率。结果按实体瘤疗效评价标准(response evaluation criteria in solid tumors,RECIST 1.1)评价标准,两组治疗后均获得临床疗效。治疗后与对照组相比,试验组总有效率较高(P<0.05)。经治疗,与治疗前相比,治疗后两组阴道流血、腰酸膝冷、神疲乏力、少腹坠胀疼痛、面色萎黄等中医症状评分降低(P<0.05);与对照组相比,试验组中医症状评分较低(P<0.05)。经治疗,与治疗前相比,治疗后两组血清肿瘤标志物水平均降低(P<0.05);与对照组相比,试验组血清糖类抗原153(carbohydrate antigen 153,CA153)、糖类抗原125(carbohydrate antigen 125,CA125)、鳞状上皮细胞抗原(squa-mous cell carcinoma antigen,SCC)水平较低(P<0.05)。与治疗前相比,治疗后两组CD_(8)^(+)♂、CD_(4)^(+)♂及CD_(4)^(+)♂/CD_(8)^(+)♂增高(P<0.05);与对照组相比,试验组CD_(8)^(+)♂、CD_(4)^(+)♂及CD_(4)^(+)♂/CD_(8)^(+)♂较高(P<0.05)。两组不良反应发生率相比差异无统计学意义(P>0.05)。对照组无进展生存率(progression free survival,PFS)为70.00%(21/30),试验组PFS率为96.67%(29/30),与对照组相比,试验组PFS率较高(P<0.05)。结论加减阳和汤联合免疫检查点抑制剂能提高复发转移性宫颈癌患者的临床疗效,下调血清肿瘤标志物水平,安全性较高。Objective To investigate the effect of Modified Yanghe Decoction(加减阳和汤)combined with immune checkpoint inhibitors on serum levels of carbohydrate antigen 153(CA153),carbohydrate antigen 125(CA125)and squamous cell carcinoma antigen(SCC)in patients with recurrent and metastatic cervical cancer.Method Sixty patients with advanced recurrent and metastatic cervical cancer admitted to the hospital from January 2022 to March 2023 were collected and randomly assigned into an experimental group and a control group,with 30 cases in each group.The control group was treated with a combination of tislelizumab and paclitaxel combined with cisplatin chemotherapy regimen.The experimental group added Modified Yanghe Decoction based on the basis of control group.Both groups were treated for 21 days.The clinical efficacy,traditional Chinese medicine syndrome scores,the levels of serum CA153,CA125 and SCC,T cell subgroup indicators,complications and survival rate were compared between the two groups.Result After treatment,compared with that of the control group,the total effective rate of the experimental group was higher(P<0.05).After treatment,compared with those before treatment,the scores of traditional Chinese medicine symptoms such as vaginal bleeding,soreness in the waist and knees,fatigue,low abdominal distension,pain and pale complexion in the two groups decreased after treatment(P<0.05).Compared with the control group,the experimental group had a lower TCM symptom scores(P<0.05).After treatment,compared with those before treatment,the levels of CA153,CA125 and SCC in both groups decreased after treatment(P<0.05).And the levels in the experimental group were lower than those of the control group(P<0.05).Compared to those before treatment,the levels of CD_(8)^(+),CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)were increased in both groups after treatment(P<0.05).The levels in the experimental group were higher(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two group

关 键 词：加减阳和汤 免疫检查点抑制剂 复发转移性宫颈癌 血清CA153、CA125 血清SCC 

分 类 号：R273.733[医药卫生—中西医结合]