扶正祛邪方对ⅠA期微乳头/实性成分阳性浸润性肺腺癌术后患者免疫功能及无病生存期的影响  

Effect of Fuzheng Quxie Formula on immune function and disease‑free survival in postoperative patients with stageⅠA micropapillary/solid‑dominant positive invasive lung adenocarcinoma

作　　者：梅娜 吴建春[1] 驹莹滨 蒋雷[2] 李雁[1] MEI Na;WU Jianchun;LUO Yingbin;JIANG Lei;LI Yan(Department of Oncology,Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai Universityof Traditional Chinese Medicine,Shanghai 200071,China;Department of Thoracic Surgery,Shanghai PulmonaryHospital,Shanghai 200433,China)

机构地区：[1]上海中医药大学附属市中医医院肿瘤科,上海200071 [2]上海市肺科医院胸外科,上海200433

出　　处：《上海中医药杂志》2024年第12期125-129,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(82174183);上海市卫健委上海市进一步加快中医药传承创新发展三年行动计划项目[ZY(2021-2023)-0211];上海医学创新发展基金会中医药科技发展项目(WL-LXBB-2021001K,WL-HBQN-2021009K)。

摘　　要：目的观察扶正祛邪方对ⅠA期微乳头/实性成分阳性(MP/SD+)浸润性肺腺癌术后患者免疫功能及无病生存期(DFS)的影响,为ⅠA期肺腺癌患者的术后治疗提供参考。方法将216例ⅠA期MP/SD+浸润性肺腺癌术后患者分为治疗组(108例)、对照组(108例),对照组不予抗肿瘤干预,治疗组予扶正祛邪方口服,定期随访。观察两组外周血免疫指标[CD3^(+)、CD4^(+)、CD8^(+)、自然杀伤(NK)细胞表达水平及CD4^(+)/CD8^(+)比值]的变化情况,记录DFS,计算无病生存率,绘制Kaplan-Meier生存曲线,并进行安全性评价。结果①最终纳入统计者213例,其中治疗组105例、对照组108例。②治疗前后组内比较,治疗组CD3^(+)、NK细胞比例上升(P<0.05),CD8^(+)比例下降(P<0.05);对照组免疫指标变化差异无统计学意义(P>0.05)。组间治疗后比较,治疗组CD3^(+)、NK细胞比例及CD4^(+)/CD8^(+)比值高于对照组(P<0.05),CD8^(+)比例低于对照组(P<0.05)。③治疗组105例患者中,5例患者复发,1年、2年和3年无病生存率分别为98.9%、96.5%和92.0%;对照组108例患者中,11例复发,1年、2年和3年无病生存率分别为94.9%、89.8%和81.9%。绘制Kaplan-Meier生存曲线后,两组差异有统计学意义(P<0.05)。④试验期间,两组患者血常规、肝肾功能等安全性指标未见明显变化。结论扶正祛邪方可有效调节ⅠA期MP/SD+浸润性肺腺癌术后患者的免疫功能,进而延长DFS,改善预后。Objective To observe the effects of Fuzheng Quxie Formula(FQF)on immune function and disease-free survival(DFS)in postoperative patients with stageⅠA micropapillary/solid-dominant positive(MP/SD+)invasive lung adenocarcinoma,providing a reference for postoperative treatment in these patients.Methods A total of 216 postoperative patients with stageⅠA MP/SD+invasive lung adenocarcinoma were divided into a treatment group(n=108)and a control group(n=108).The control group received no antitumor intervention,while the treatment group was administered FQF orally and followed up regularly.The variations in peripheral blood immune markers,including CD3^(+),CD4^(+),CD8^(+),natural killer(NK)cell expression levels,and the CD4^(+)/CD8^(+)ratio,were assessed in both groups.DFS was recorded,the disease-free survival rate was calculated,Kaplan-Meier survival curves were plotted,and safety was assessed.Results①A total of 213 patients were included in the final analysis,with 105 in the treatment group and 108 in the control group.②Intra-group comparisons before and after treatment showed a significant increase in the proportions of CD3^(+)and NK cells in the treatment group(P<0.05),along with a decrease in the CD8^(+)proportion(P<0.05).In the control group,no statistically significant changes were observed in immune markers(P>0.05).After treatment,inter-group comparisons revealed that the treatment group had significantly higher CD3^(+),NK cell proportions,and higher CD4^(+)/CD8^(+)ratio than the control group(P<0.05),while the treatment group had lower CD8^(+)proportion than the control group(P<0.05).③Among the 105 patients in the treatment group,5 experienced recurrence,with 1-year,2-year,and 3-year disease-free survival rates of 98.9%,96.5%,and 92.0%,respectively.Among the 108 patients in the control group,11 experienced recurrence,with 1-year,2-year,and 3-year disease-free survival rates of 94.9%,89.8%,and 81.9%,respectively.Kaplan-Meier survival curves indicated statistically significant differences between the tw

关 键 词：肺癌 预后 中医药疗法 免疫功能 无病生存期 临床试验 

分 类 号：R273[医药卫生—中西医结合]