消瘤汤治疗鼻内翻性乳头状瘤的疗效及其作用机理研究

Investigation on the therapeutic effect and its mechanisms of Xiaoliu Decoction on nasal inverting papilloma

目的观察消瘤汤对鼻内翻性乳头状瘤术后复发与恶变的抑制作用及对宿主细胞免疫功能的影响。方法鼻内翻性乳头状瘤患者60例,术后随机分为治疗组和对照组,每组各30例。治疗组术后服消瘤汤半年,对照组不用药物治疗,均随访8个月以上,观察病变复发和恶变情况。分别在术前及术后半年,以流式细胞仪检测患者外周血T淋巴细胞亚群及NK细胞活性,观察消瘤汤对宿主细胞免疫功能的影响。结果治疗组复发2例(2/30,6.7%),对照组复发8例(8/28,28.6%,其中3例存在轻至中度不典型增生),差异具有统计学意义(P<0.05)。与术前检测结果比较,治疗组的CD3+、CD4+T细胞及NK细胞比例升高,CD8+T细胞比例降低,对照组的CD3+、CD4+T细胞及NK细胞比例均降低,而CD8+T细胞比例升高。结论消瘤汤可降低鼻内翻性乳头状瘤患者的术后复发率,并通过改善宿主细胞免疫功能而起到抑制其复发与恶变的作用。

Objective To investigate the therapeutic and inhibitory effect of Xiaoliu Decoction （XLD） on the rates of reoccurrence and malignant transformation of nasal inverting papilloma following surgical treatment and the effect of this formula on the immune function of host with this lesion. Methods Sixty cases with nasal inverting papilloma were randomly divided into two groups following surgical treatment, with 30 cases in either treating group（TO） or controlling one（CG）. After the operation, the cases in TO were orally given XLD for six months and those in CG were given no any special medicines, and all these patients were followed up for more than 8 months since the end of surgical therapy. Then, clinical observation was carried out among all the cases to investigate the probabilities of reoccurrence and malignant transformation of the lesion following surgical procedures. Furthermore, flow cytometry was taken to determine the activities of sub-populations of T lymphocytes and that of NK cells from peripheral blood, made before the operation and six months after the surgery respectively, in order to value the effect of XLD on immune function of host with this kind of tumor. Results Reoccurrence of the lesion was seen in 2 cases of TG（2/30,6.7%） and in 8 of CG （8/28,28. 6% ） ,with 3 reoccurring cases accompanied with mild to medium atypical hyperplasia, showing a significant difference in this kind of probability between the 2 groups （ P 〈 0.05 ）. Compared with the data determined before the operation, the ratios of CD3^＋ , CD4^＋ T cells and NK cells were increased while that of CD8^＋ T cells was decreased among the cases of TO. In contrast, the ratios of CD3^＋ , CD4^＋ T cells and NK cells were decreased while that of CD8^＋ T cells was increased among the cases of CG. Conclusions XLD is effective to reduce the reoccurring probability of nasal inverting papilloma following surgery and it can inhibit the reoocurrence and malignant transformation of the lesion through improve the cellular immune function of the host.