益气化瘀汤联合^(131)I治疗老年分化型甲状腺癌的疗效及对免疫功能、CK19、MUC1表达的影响

Curative Effect of Yiqi Huayu Decoction(益气化瘀汤)Combined with ^(131)I in Treatment of Differentiated Thyroid Carcinoma in The Elderly and The Influence on Immune Function,Expressions of CK19 and MUC1

目的探讨益气化瘀汤联合^(131)I治疗老年分化型甲状腺癌(DTC)的效果及对免疫功能、血细胞角蛋白19(CK19)、多态性上皮黏蛋白(MUC1)表达的影响。方法选取2016年4月—2019年4月该院收治的老年DTC患者300例为研究对象,采用随机数字表法将其分为对照组和观察组各150例,对照组采用^(131)I治疗;观察组在对照组的基础上采用益气化瘀汤治疗。比较两组临床疗效、治疗前和治疗2个月后免疫功能、CK19和MUC1水平、甲状腺功能指标[游离三碘甲状腺原氨酸(FT3)、血清游离甲状腺素(FT4)、促甲状腺激素(TSH)、甘油三酯(TG)],并进行1年随访,记录两组复发率。结果观察组总有效率高于对照组[88.67%(133/150)vs 75.33%(113/150)](P<0.05);治疗后2个月后,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、FT3、FT4水平均升高,CD8^(+)、TSH、TG水平及CK19和MUC1阳性表达率均降低(P<0.05);且观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、FT3、FT4水平高于对照组,CD8^(+)、TSH、TG水平及CK19和MUC1阳性表达率低于对照组(P<0.05);观察组1年复发率低于对照组[1.33%(2/150)vs 13.33%(20/150)](P<0.05)。结论益气化瘀汤联合^(131)I治疗老年DTC的效果显著,可降低CK19、MUC1水平,提高免疫功能和甲状腺功能,降低复发率。

Objective To investigate the effect of Yiqi Huayu Decoction(益气化瘀汤)combined with ^(131)I in the treatment of differentiated thyroid cancer(DTC)in the elderly,and its influence on immune function,expressions of blood cell keratin 19(CK19)and polymorphic epithelial mucin(MUC1).Methods Three hundred elderly patients with DTC admitted to the hospital between April 2016 and April 2019 were selected as the research subjects,and divided into control group and observation group by random number method with 150 patients in each group.Patients in the control group were treated with 131I,and those in the observation group were treated with Yiqi Huayu Decoction combined with 131I.Clinical effects,immune function,levels of CK19 and MUC and thyroid function indicators[free triiodothyronine(FT3),serum free thyroxine(FT4),thyroid stimulating hormone(TSH),triglyceride(TG)]were compared between the two groups.A year of follow-up was performed,and the recurrence rate was recorded.Results The total response rate of the observation group was higher than that of the control group[88.67%(133/150)vs 75.33%(113/150)](P<0.05).After 2 months of treatment,levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),FT3 and FT4 were in⁃creased,while levels of CD8^(+),TSH and TG and the positive expression rate of CK19 and MUC1 were reduced in the two groups(P<0.05).Meanwhile,levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),FT3 and FT4 in the observation group were higher than those in the control group.Levels of CD8^(+),TSH and TG and the positive expression rate of CK19 and MUC1 were lower than those in the con⁃trol group(P<0.05).The 1-year recurrence rate in the observation group was lower than that in the control group[1.33%(2/150)vs 13.33%(20/150)](P<0.05).Conclusion Yiqi Huayu Decoction combined with ^(131)I is markedly effective in the treat⁃ment of elderly DTC,which can reduce the levels of CK19 and MUC1,improve immune function and thyroid function,and reduce the recurrence rate.