中医药对非小细胞肺癌免疫调节作用研究进展
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摘要
中医药在改善非小细胞肺癌患者免疫功能方面的研究主要涉及细胞免疫部分,如T细胞亚群、自然杀伤细胞、白细胞介素-4、白细胞介素-13、转化生长因子-β、干扰素-γ及肿瘤相关巨噬细胞等,但还存在以下问题和不足:①临床研究样本量较小,大多数为单中心,个别研究并未设置对照组,缺乏令人信服的循证医学资料,可信度不高;②中医对肺癌的辨证分型尚未统一,疗效判定缺乏统一标准,影响中医药对肺癌的深入研究和学术交流;③大部分研究都是中医药结合化疗,缺乏单纯中医药治疗肺癌的研究报道;④对于中医药影响肺癌免疫功能的机制尚不明确。今后研究的主要内容:①由于不同患者间遣方用药存在差异性,故对中医药进行标准化研究还需要进一步探索;②中医药有关肿瘤免疫调节机制的研究以扶正类中医药为主,今后应加强清热解毒药、活血化瘀药、软坚散结药等在肿瘤免疫中的研究;③扩大中医药在肿瘤免疫调节中的研究范围;④应尽快统一中医证型,确立疗效标准,提高中医药研究科学性。
The research of Chinese medicine in improving the immune function of patients with non-small cell lung cancer mainly involves cellular immune parts,such as T cell subsets,natural killer cells,interleukin-4,interleukin-13,transforming growth factor-β,interferon-γ and tumor-associated macrophages and so on,but the following problems and deficiencies exist:(1)Clinical studies have small sample sizes,most of which are single-center. Individual studies do not have a control group,lacking convincing evidence-based medical data,and the credibility is not high;(2)The syndrome differentiation of lung cancer in Chinese medicine has not been unified,and there is no unified standard for efficacy judgment,which affects the in-depth study and academic exchange of Chinese medicine on lung cancer;(3)Most of the studies are Chinese medicine combined with chemotherapy,and there is no research report on the treatment of lung cancer by simple Chinese medicine;(4)The mechanism of Chinese medicine affecting the immune function of lung cancer is not clear. The main content of future research:(1)Due to the differences in the use of different patients,it is necessary to further explore the standardization of Chinese medicine;(2)The research on the mechanism of tumor immune regulation in Chinese medicine is mainly based on Chinese medicine of strengthening vital qi type. In the future,research on tumor immunity should be strengthened on Chinese medicine of clearing heat and removing toxicity,promoting blood circulation for removing blood stasis and softening and resolving hard mass;(3)Expand the scope of research on traditional Chinese medicine in tumor immune regulation;(4)The Chinese medicine syndrome type should be unified as soon as possible. The efficacy standard should be established and the scientific research of Chinese medicine should be improved.
The research of Chinese medicine in improving the immune function of patients with non-small cell lung cancer mainly involves cellular immune parts,such as T cell subsets,natural killer cells,interleukin-4,interleukin-13,transforming growth factor-β,interferon-γ and tumor-associated macrophages and so on,but the following problems and deficiencies exist:(1)Clinical studies have small sample sizes,most of which are single-center. Individual studies do not have a control group,lacking convincing evidence-based medical data,and the credibility is not high;(2)The syndrome differentiation of lung cancer in Chinese medicine has not been unified,and there is no unified standard for efficacy judgment,which affects the in-depth study and academic exchange of Chinese medicine on lung cancer;(3)Most of the studies are Chinese medicine combined with chemotherapy,and there is no research report on the treatment of lung cancer by simple Chinese medicine;(4)The mechanism of Chinese medicine affecting the immune function of lung cancer is not clear. The main content of future research:(1)Due to the differences in the use of different patients,it is necessary to further explore the standardization of Chinese medicine;(2)The research on the mechanism of tumor immune regulation in Chinese medicine is mainly based on Chinese medicine of strengthening vital qi type. In the future,research on tumor immunity should be strengthened on Chinese medicine of clearing heat and removing toxicity,promoting blood circulation for removing blood stasis and softening and resolving hard mass;(3)Expand the scope of research on traditional Chinese medicine in tumor immune regulation;(4)The Chinese medicine syndrome type should be unified as soon as possible. The efficacy standard should be established and the scientific research of Chinese medicine should be improved.
引文
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[2]ZHENG Y W,LI R M,ZHANG X W,et al.Current adoptive immunotherapy in non-small cell lung cancer and potential influence of therapy outcome[J].Cancer Invest,2013,31(3):197-205.
[3]李雁.刘嘉湘在肺癌治疗中温肾法的运用[J].中医杂志,2003,44(11):818-820
[4]刘嘉湘,施志明,徐振哗,等.金复康口服液治疗非小细胞肺癌的临床观察[J].中医杂志,1997,38(12):727-728.
[5]唐文秀,张宗岐,林红生,等.中医药治疗晚期原发性非小细胞肺癌临床观察[J].中医杂志,l994,35(5):283-285.
[6]秦金霞.中晚期非小细胞肺癌中医证候分布规律的研究[J].现代中药,2010,30(4):65.
[7]张学哲,张宁苏.晚期肺癌中医辨证规律探讨[J].实用中医内科志,2008,22(6):85-86.
[8]任明.安肺汤对晚期肺癌免疫功能调节的实验研究[D].济南:山东中医药大学,2012.
[9]黎金华,田菲,邱崇笙,等.扶正散结方调控Lewis肺癌小鼠TAMs免疫重塑作用的相关研究[J].中国中药杂志,2015,40(6):1161-1165.
[10]徐朝军,宋岚,尹晓清,等.参芪扶正注射液对肺癌化疗后小鼠血清IL-2/INF-γ及免疫功能的影响[J].实用临床医学,2008,9(4):1-2,5.
[11]侯桂兰,芦柏震,王春雷,等.抗癌扶正协定方对荷瘤小鼠外周血免疫细胞的影响[J].中华中医药学刊,2015,33(1):113-115.
[12]张甘霖,王笑民,李萍,等.固本抑瘤Ⅱ号对Lewis肺癌荷瘤小鼠免疫功能的影响[J].中华中医药学刊,2007,25(3):489-492.
[13]李璘,邱蓉丽,周长慧,等.女贞子多糖对荷瘤小鼠免疫功能的影响[J].南京中医药大学学报,2008,24(6):388-390.
[14]文志勇,金召英,杨西晓.四逆汤对荷瘤小鼠免疫功能的影响[J].中国医院药学杂志,2011,24(24):2015-2018.
[15]杨兴斌,梅其炳,周四元,等.当归多糖对小鼠腹腔巨噬细胞释放细胞效应分子的诱导作用[J].细胞与分子免疫学杂志,2004,20(6):747-749.
[16]乔世岩,韩翠俊,王岩.非小细胞肺癌化疗前后机体免疫指标的相关研究[J].中国现代医生,2008,25(1):111-112.
[17]LAKSHMI NARENDRA B,ESHVENDAR REDDY K,SHANTIKUMAR S,et al.Immune system:a double-edged sword in cancer[J].Inflamm Res,2013,62(9):823-834.
[18]胡小梅,张文艺,李道睿,等.晚期非小细胞肺癌中医证型与免疫功能相关性研究[J].陕西中医,2007,28(10):1343-1344.
[19]马科,马立凤,施志明.原发性支气管肺癌中医证型与免疫指标、细胞因子的相关性研究[J].北京中医药大学学报,2008,31(1):64-66.
[20]李雁.益气补血方辨证治疗联合化疗对NSCLC患者T细胞亚群的影响[J].中国中医药科技,2013,23(6):657.
[21]胡志萍,甘宁,张光顺,等.白龙灵沙汤对非小细胞肺癌免疫功能的影响[J].中国实验方剂学杂志,2015,21(4):182-185.
[22]杨杨.益气解毒法结合化疗对晚期非小细胞肺癌临床疗效分析及对T细胞亚群和自然杀伤细胞活性的影响[J].四川中医,2015,33(1):84-86.
[23]刘俊波,黄常江,韦赤勇,等.益气清肺汤联合化疗对晚期非小细胞肺癌患者生活质量及免疫功能的影响[J].中医学报,2013,28(5):626-628.
[24]于滨,肖菊香.加味香砂六君子汤对晚期肺癌患者免疫功能的影响[J].湖北中医杂志,2015,37(3):3-4.
[25]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,2013,40(24):2498-2500.
[2]ZHENG Y W,LI R M,ZHANG X W,et al.Current adoptive immunotherapy in non-small cell lung cancer and potential influence of therapy outcome[J].Cancer Invest,2013,31(3):197-205.
[3]李雁.刘嘉湘在肺癌治疗中温肾法的运用[J].中医杂志,2003,44(11):818-820
[4]刘嘉湘,施志明,徐振哗,等.金复康口服液治疗非小细胞肺癌的临床观察[J].中医杂志,1997,38(12):727-728.
[5]唐文秀,张宗岐,林红生,等.中医药治疗晚期原发性非小细胞肺癌临床观察[J].中医杂志,l994,35(5):283-285.
[6]秦金霞.中晚期非小细胞肺癌中医证候分布规律的研究[J].现代中药,2010,30(4):65.
[7]张学哲,张宁苏.晚期肺癌中医辨证规律探讨[J].实用中医内科志,2008,22(6):85-86.
[8]任明.安肺汤对晚期肺癌免疫功能调节的实验研究[D].济南:山东中医药大学,2012.
[9]黎金华,田菲,邱崇笙,等.扶正散结方调控Lewis肺癌小鼠TAMs免疫重塑作用的相关研究[J].中国中药杂志,2015,40(6):1161-1165.
[10]徐朝军,宋岚,尹晓清,等.参芪扶正注射液对肺癌化疗后小鼠血清IL-2/INF-γ及免疫功能的影响[J].实用临床医学,2008,9(4):1-2,5.
[11]侯桂兰,芦柏震,王春雷,等.抗癌扶正协定方对荷瘤小鼠外周血免疫细胞的影响[J].中华中医药学刊,2015,33(1):113-115.
[12]张甘霖,王笑民,李萍,等.固本抑瘤Ⅱ号对Lewis肺癌荷瘤小鼠免疫功能的影响[J].中华中医药学刊,2007,25(3):489-492.
[13]李璘,邱蓉丽,周长慧,等.女贞子多糖对荷瘤小鼠免疫功能的影响[J].南京中医药大学学报,2008,24(6):388-390.
[14]文志勇,金召英,杨西晓.四逆汤对荷瘤小鼠免疫功能的影响[J].中国医院药学杂志,2011,24(24):2015-2018.
[15]杨兴斌,梅其炳,周四元,等.当归多糖对小鼠腹腔巨噬细胞释放细胞效应分子的诱导作用[J].细胞与分子免疫学杂志,2004,20(6):747-749.
[16]乔世岩,韩翠俊,王岩.非小细胞肺癌化疗前后机体免疫指标的相关研究[J].中国现代医生,2008,25(1):111-112.
[17]LAKSHMI NARENDRA B,ESHVENDAR REDDY K,SHANTIKUMAR S,et al.Immune system:a double-edged sword in cancer[J].Inflamm Res,2013,62(9):823-834.
[18]胡小梅,张文艺,李道睿,等.晚期非小细胞肺癌中医证型与免疫功能相关性研究[J].陕西中医,2007,28(10):1343-1344.
[19]马科,马立凤,施志明.原发性支气管肺癌中医证型与免疫指标、细胞因子的相关性研究[J].北京中医药大学学报,2008,31(1):64-66.
[20]李雁.益气补血方辨证治疗联合化疗对NSCLC患者T细胞亚群的影响[J].中国中医药科技,2013,23(6):657.
[21]胡志萍,甘宁,张光顺,等.白龙灵沙汤对非小细胞肺癌免疫功能的影响[J].中国实验方剂学杂志,2015,21(4):182-185.
[22]杨杨.益气解毒法结合化疗对晚期非小细胞肺癌临床疗效分析及对T细胞亚群和自然杀伤细胞活性的影响[J].四川中医,2015,33(1):84-86.
[23]刘俊波,黄常江,韦赤勇,等.益气清肺汤联合化疗对晚期非小细胞肺癌患者生活质量及免疫功能的影响[J].中医学报,2013,28(5):626-628.
[24]于滨,肖菊香.加味香砂六君子汤对晚期肺癌患者免疫功能的影响[J].湖北中医杂志,2015,37(3):3-4.
[25]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,2013,40(24):2498-2500.
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