扶正祛邪方对肺癌患者外周血免疫指标的影响及与预后的相关性
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摘要
目的观察扶正祛邪方对肺癌患者免疫功能的影响,分析肺癌患者外周血免疫功能分布特点及与预后的相关性。方法收集就诊于我科的肺癌患者116例作为中医组,健康体检者105例作为健康组,中医组予扶正祛邪方口服,疗程6个月;采用流式细胞术检测2组入组时及中药组治疗6个月后晨空腹外周免疫功能水平并进行相关分析。结果中医组治疗前CD4~+、CD4~+/CD8~+、NK低于健康组,CD3~+、CD8~+水平高于健康组(P<0.05);与治疗前相比,中医组治疗后CD3~+、CD8~+水平降低、NK水平升高,差异有统计学意义(P<0.05),与健康人水平相比,免疫功能有向健康人水平改善的趋势;单因素生存分析提示早期患者和CD4~+≥38.73%的肺癌患者可获得更长的无进展生存期,多因素生存分析提示分期为影响肺癌患者预后的独立影响因素。结论患者外周血T淋巴细胞亚群水平较正常人相比存在异常,扶正祛邪方能够改善肺癌患者的免疫功能,其对肺癌患者预后及疗效观察具有一定意义。
Objective To observe the effect of Fuzheng Quxie decoction on immune function of patients with lung cancer and analyze the distribution characteristics of peripheral blood immune function and its correlation with prognosis of patients with lung cancer.Methods 116 cases of lung cancer patients admitted to our department were collected as the TCM group,and 105 cases of healthy physical examination were collected as the health group.TCM group was given Fuzheng Quxie decoction oral,the course of treatment for fix months Flow cytometry was used to detect the level of fasting peripheral immune function at the time of admission of the two groups and 6 months after treatment in the traditional Chinese medicine group.Results Before treatment,CD4~+,CD4~+/CD8~+ and NK in the TCM group were lower than those in the healthy group,and CD3~+ and CD8~+ levels were higher than those in the healthy group(P<0.05).Compared with before treatment,CD3~+ and CD8~+ levels decreased and NK levels increased in the TCM group after treatment,with statistically significant differences(P<0.05).Compared with the level of healthy people,immune function showed a trend of improvement to the level of healthy people.Univariate survival analysis indicated that early patients and patients with CD4~+ or more than 38.73% of lung cancer patients could obtain longer Progression-free survival,and multivariate survival analysis indicated that TNM stage was an independent factor affecting the prognosis of lung cancer patients.Conclusion The level of T lymphocyte subsets in peripheral blood of patients is abnormal compared with that of normal people.Fuzheng Quxie decoction can improve the immune function of patients with lung cancer,and it has certain significance for the prognosis and efficacy observation of patients with lung cancer.
Objective To observe the effect of Fuzheng Quxie decoction on immune function of patients with lung cancer and analyze the distribution characteristics of peripheral blood immune function and its correlation with prognosis of patients with lung cancer.Methods 116 cases of lung cancer patients admitted to our department were collected as the TCM group,and 105 cases of healthy physical examination were collected as the health group.TCM group was given Fuzheng Quxie decoction oral,the course of treatment for fix months Flow cytometry was used to detect the level of fasting peripheral immune function at the time of admission of the two groups and 6 months after treatment in the traditional Chinese medicine group.Results Before treatment,CD4~+,CD4~+/CD8~+ and NK in the TCM group were lower than those in the healthy group,and CD3~+ and CD8~+ levels were higher than those in the healthy group(P<0.05).Compared with before treatment,CD3~+ and CD8~+ levels decreased and NK levels increased in the TCM group after treatment,with statistically significant differences(P<0.05).Compared with the level of healthy people,immune function showed a trend of improvement to the level of healthy people.Univariate survival analysis indicated that early patients and patients with CD4~+ or more than 38.73% of lung cancer patients could obtain longer Progression-free survival,and multivariate survival analysis indicated that TNM stage was an independent factor affecting the prognosis of lung cancer patients.Conclusion The level of T lymphocyte subsets in peripheral blood of patients is abnormal compared with that of normal people.Fuzheng Quxie decoction can improve the immune function of patients with lung cancer,and it has certain significance for the prognosis and efficacy observation of patients with lung cancer.
引文
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[12]罗斌,阙祖俊,朱丽华,等.非小细胞肺癌患者外周血CD11b~+CD33~+CD15~+CD14~-及CD11b~+CD33~+CD15~-CD14~+髓系细胞的比例变化及临床意义[J].现代免疫学,2017,37(1):25-31.
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[15]赵鹏飞,田艳生,李玮.不同分期肺癌患者外周血淋巴细胞亚群检测与临床意义[J].世界中医药,2016(b06):1704.
[16]占小莉.中性粒细胞与淋巴细胞的比值、CD3和CD8阳性的T细胞在结直肠癌患者预后中的作用[D].杭州:浙江大学2017.
[17]江虹,李菊湘.T淋巴细胞亚群在恶性肿瘤患者外周血中的变化[J].检验医学与临床,2010(13):1361.
[18]吉顺荣,姚宛彤,张波.胰腺癌患者外周血CD8~+CD28~+和CD8~+CD28~-T淋巴细胞亚群的分析[J].上海医学,2012,35(4):316-319.
[19]赵鹏飞,陈坤,赵要顺.流式细胞术检测健康成年人淋巴细胞亚群[J].生命科学仪器,2012,10(1):19-22.
[20]李莉,张玲珍,陈育贵.中国人外周血淋巴细胞37种表型正常值的测定[J].现代免疫学,1998(5):267-270.
[2]VACHANI A,MOON E,WAKEAM E,et al.Gene therapy for mesothelioma and lung cancer[J].Am J Respir Cell Mol Biol,2010,42(4):385-393.
[3]DEEPAK P,ACHARYA.Anti-tumor immunity and mechanism of immunosuppression mediated by tumor cells:role of tumor-derived soluble factors and cytokines[J].International Reviews of Immunology,2010,29(4):421-458.
[4]方志红,李雁,徐静,等.扶正祛邪方联合化疗治疗45例晚期非小细胞肺癌临床观察[J].辽宁中医杂志,2013(12):2498-2500.
[5]袁颖.非小细胞肺癌患者外周血T淋巴细胞亚群和Treg的检测及临床意义[D].石家庄:河北医科大学,2013.
[6]张斌,吴勉华.益气养阴中药联合化疗对中晚期非小细胞肺癌免疫功能的影响[J].吉林中医药,2013,33(3):259-261.
[7]钱芳芳,罗斌,阙祖俊,等.中医药调控免疫功能防治肺癌的研究进展[J].辽宁中医杂志,2018,45(5):1098-1102.
[8]陶辰楠,李世敏,关丽娜.支气管肺癌患者外周血T淋巴细胞亚群表达情况及其与预后的关系研究[J].实用心脑肺血管病杂志,2018,26(3):37-40.
[9]陈岳青,邹学森,黄秀珍,等.非小细胞肺癌患者外周血T淋巴细胞亚群及NK细胞亚群分析及临床意义[J].实用癌症杂志,2006(5):476-478.
[10]于宝丹,刘忠民,林勇平.非小细胞肺癌患者TGF-β1水平与免疫状态的关系研究[J].中国医药科学,2018,8(3):29-31.
[11]刘桂芹,董强,刘建新,等.补虚扶正法联合化疗对中晚期小细胞肺癌患者免疫功能及临床疗效的影响[J].中医药导报,2014,20(12):33-36.
[12]罗斌,阙祖俊,朱丽华,等.非小细胞肺癌患者外周血CD11b~+CD33~+CD15~+CD14~-及CD11b~+CD33~+CD15~-CD14~+髓系细胞的比例变化及临床意义[J].现代免疫学,2017,37(1):25-31.
[13]HAMAKAWA T,KUROKAWA Y,TAKIGUCHI S,et al.Combination chemotherapy using docetaxel,cisplatin,and S-1 for far advanced gastric cancer[J].Gan to Kagaku Ryoho Cancer&Chemotherapy,2011,38(12):2342.
[14]李孝男.CD4+、CD8+细胞水平变化与恶性肿瘤疗效关系的初步探讨[D].长春:吉林大学,2015.
[15]赵鹏飞,田艳生,李玮.不同分期肺癌患者外周血淋巴细胞亚群检测与临床意义[J].世界中医药,2016(b06):1704.
[16]占小莉.中性粒细胞与淋巴细胞的比值、CD3和CD8阳性的T细胞在结直肠癌患者预后中的作用[D].杭州:浙江大学2017.
[17]江虹,李菊湘.T淋巴细胞亚群在恶性肿瘤患者外周血中的变化[J].检验医学与临床,2010(13):1361.
[18]吉顺荣,姚宛彤,张波.胰腺癌患者外周血CD8~+CD28~+和CD8~+CD28~-T淋巴细胞亚群的分析[J].上海医学,2012,35(4):316-319.
[19]赵鹏飞,陈坤,赵要顺.流式细胞术检测健康成年人淋巴细胞亚群[J].生命科学仪器,2012,10(1):19-22.
[20]李莉,张玲珍,陈育贵.中国人外周血淋巴细胞37种表型正常值的测定[J].现代免疫学,1998(5):267-270.
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