补肾益精法对中晚期非小细胞肺癌免疫稳态的影响和临床疗效的观察  

Clinical observation on the effect of Kidney-tonifying and Essence-replenishing Therapy to immune homeostasis of non-small cell lung cancer in middle and late stage

作　　者：刘声[1] 吴洁[2] 胡凤山[1] LIU Sheng;WU Jie;HU Feng-shan(Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China;Guanganmen Hospital of Chinese Academy of Traditional Chinese Medicine,Beijing 100053,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]中国中医科学院广安门医院,北京100053

出　　处：《时珍国医国药》2025年第4期692-696,共5页Lishizhen Medicine and Materia Medica Research

基　　金：北京市卫生系统高层次卫生技术人才培养项目(2015-3-115)。

摘　　要：目的观察补肾益精法对中晚期非小细胞肺癌(NSCLC)患者HPAA轴及外周血Treg/TH17的调节和临床疗效。方法80例中晚期NSCLC患者,依照随机数字表法随机分作对照组和试验组,每组均40例。采集两组治疗前1天及治疗后外周静脉血,应用流式细胞技术检测血清HPAA轴相关激素水平、外周血Treg/TH17百分比;比较两组实体瘤近期疗效,生活质量QLQ-C30评分,中医证候积分。结果中药治疗组中医证候积分、血清HPAA轴相关激素水平如:ACTH、CRH及CORT,外周血Treg/TH17百分比明显低于对照组(P<0.05);两组生活质量QLQ-C30评分较对照组显著升高(P<0.05);两组实体瘤近期疗效比较无显著差异(P>0.05)。结论中医补肾益精法在实体瘤疗效上虽无明显优势,但通过调节血清HPAA轴相关激素水平,进一步影响Treg/TH17百分比,以提高机体自身的免疫功能及抑瘤机制,可以使患者在带瘤生存状况下,机体获得新的免疫平衡及内环境稳态,改善临床症状,提高生活质量。Objective To investigate the regulatory effects of Kidney-tonifying and Essence-replenishing Therapy(KET)on the hypo⁃thalamic-pituitary-adrenal axis(HPAA)and peripheral blood Treg/Th17 balance,as well as its clinical efficacy in advanced non-small cell lung cancer(NSCLC)patients.Methods Eighty patients with advanced NSCLC were randomly assigned to the control group and the experimental group with 40 cases in each group.Peripheral blood was collected before and after treatment,then the levels of ser⁃um HPAA-related hormones and the percentage of Treg/TH17 in peripheral blood were analyzed by flow cytometry(FCM).Clinical outcomes including short-term efficacy of solid tumors,QLQ-C30 scores,and TCM syndrome scores in the two groups were compared.Results Compared with the control group,the TCM treatment group demonstrated significantly lower TCM syndrome scores,serum HPAA-related hormone levels(ACTH,CRH,CORT),and the percentage of Treg/TH17 in peripheral blood(P<0.05).Both treatment groups exhibited significantly higher QLQ-C30 scores than the control group(P<0.05),while no significant difference in short-term solid tumor efficacy was observed between the groups(P>0.05).Conclusion Although KET did not demonstrate significant therapeutic superiority in the efficacy of solid tumors,it modulates serum HPAA-related hormone levels to influence the percentage of Treg/TH17,thereby enhancing the immune function and tumor suppression mechanisms.This approach enables tumor-bearing patients to achieve a novel immune balance and internal homeostasis,thus alleviating clinical symptoms and improving quality of life.

关 键 词：非小细胞肺癌 补肾益精法 扶正防癌方 HPAA轴 

分 类 号：R285.5[医药卫生—中药学]