肺癌术后患者证型分布及其与免疫功能、细胞因子关系

Study on Relationship between Syndrome Differentiation in Patients of Lung Cancer and Cell Immunity Function and Cytokine

目的：探讨Ⅰ-Ⅲa期非小细胞肺癌术后患者证型分布特点，及其与免疫功能、细胞因子的相关性。方法：按照中医辨证分型标准，将144例Ⅰ-Ⅲa期非小细胞肺癌术后患者分为肺脾气虚型、阴虚内热型、气阴两虚型、阴阳两虚型，分析不同手术方式、病理类型、临床分期和化疗与否对患者的证候分布情况；并对患者的T淋巴细胞亚群、NK细胞、SIL-2R和VEGF进行检测。结果：术后患者辨证分型以肺脾气虚证最多（68．5％），不同临床分期患者的证型分布有统计学差异（P〈0．01）；不同病理类型、手术方式和化疗与否对肺癌患者的证型分布均无统计学差异（P〉0．05）；肺脾气虚型患者的CD3＋、CD4＋最高，且有统计学意义（P〈0．01）；CD8＋在肺脾气虚型、阴虚内热型和气阴两虚型患者中均无统计学差异（P〉0．05）；肺脾气虚型患者的NK最高，且有统计学差异（P〈0．05）；肺脾气虚型患者的SIL-21K最低，气阴两虚型患者稍高，阴虚内热型患者最高，且有统计学差异（P〈001）；肺脾气虚型患者的VEGF最低、阴虚内热型患者稍高，气阴两虚型患者最高，且有统计学差异（P〈0．05）。结论：Ⅰ-Ⅲa期NSCLC术后患者辨证分型以肺脾气虚证最多，与临床分期有关，提示了中医证型的变化与疾病的发展阶段有密切联系；患者的中医证型与免疫功能、细胞因子有一定相关性,可能为肺癌临床辨证治疗提供较为客观的检测指标。

Objective：To investigate the relationship between the traditional Chinese medicine syndrome differentiation in patients of lung cancer and the cell immunity function and eytokine. Method： According to the diagnosis and syndrome differentiation in TCM, there are syndromes of lung and spleen deficiency, yin deficiency, qi and yin deficiency, yin and yang deficiency. The operation patterns, pathological types, clinical stages, chemotherapy and distribution of TCM were analyzed accordingly to study the T lymphocyte subsets, NK cell, SIL-2R and VEGF for 144 cases of lung cancer. Resuhs ： Most of the traditional Chinese medicine syndromes in NSCLC patients were lung and spleen deficiency syndrome （ 68.5% ）. The differences were statistically significant in the distribution of Chinese medicine patterns among the patients at different clinical stages （ P〈0.01 ）, but no significant difference was found among the patients in different operation patterns, pathological types or chemotherapies （ P〉0.05 ）. CD3＋ and CD4＋ exceeded significantly in hung and spleen deficiency （ P〈0.01 ）. In all groups, no significant difference was found among the patients＇ CD8＋ （ P〉0.05 ）. The NK was significantly high in the syndrome of lung and spleen deficiency（ P〈0.05 ）. The SIL-2R was significantly high in the syndrome of yin deficiency（ P〈0.01 ）. The VEGF was significantly high in the syndrome of qi and yin deficiency （ P〈0.05 ）. Conclusion ： Most of the traditional Chinese medicine syndromes in Ⅰ-Ⅲ a lung cancer patients were lung and spleen deficiency syndrome, relevant with the clinical stages. The traditional Chinese medicine syndrome differentiation and the cell immunity function and cytokine of the lung cancer sufferer have relativity and the possibility provides more objective index sign for the hung cancer clinical treatment based on syndrome differentiation.