益气化痰方抗肺癌化疗多药耐药的作用

Effect of Yiqi Huayu Recipe on Multidrug Resistance of Lung Cancer After Chemotherapy

目的:分析益气化痰方抗肺癌化疗多药耐药的作用,通过检测肺癌患者外周血中MDR1 mRNA和CK20 mRNA的表达,从分子水平进一步阐明益气化痰方抗肿瘤细胞多药耐药的机制。方法:非小细胞肺癌患者200例随机平均分为观察组与对照组。观察组给予益气化痰方+化疗;对照组给予益肺清化颗粒+化疗。观察两组临床症状、瘤灶、生存质量、免疫指标、肿瘤标志物以及外周血中MDR1 mRNA和CK20 mRNA的表达。结果:观察组治疗前后外周血MDR1 mRNA比较,差异无统计学意义(P> 0. 05);对照组治疗后明显高于治疗前(P <0. 05);两组治疗后比较,差异有统计学意义(P <0. 05)。两组外周血CK20 mRNA水平在治疗后均有所下降(P <0. 05),但观察组下降更为明显,两组比较,差异有统计学意义(P <0. 05)。两组患者治疗后症状积分均较治疗前明显下降,差异均有统计学意义(P <0. 05);观察组治疗后症状积分低于对照组,差异有统计学意义(P <0. 01)。两组患者治疗后外周血CD_3^+、CD_4^+、CD_4^+/CD_8^+及NK细胞分布均高于治疗前,而CD_8^+细胞比例低于治疗前,差异均有统计学意义(P <0. 05);观察组以上指标改善优于对照组,差异均有统计学意义(P <0. 05)。观察组稳定率为86%,对照组为69%,两组比较,差异有统计学意义(P <0. 05)。治疗后,两组患者CEA、NSE、Cyfra21-1水平均下降,且观察组显著低于对照组,差异均有统计学意义(P <0. 05)。结论:益气化痰方可抑制化疗对MDR1 mRNA水平的升高作用,降低CK20 mRNA表达水平,对化疗有一定增效的作用;还可减轻患者临床症状,提高生存质量,提高肿瘤患者免疫功能。

Objective: To analyze the effect of Yiqi Huayu Recipe on multidrug resistance of lung cancer after chemotherapy and by detecting the expression of MDR1 mRNA and CK20 mRNA in peripheral blood of patients with lung cancer to further elucidate the mechanisms of its anti-multidrug resistance of Yiqi Huayu Recipe against tumor cells. Methods: A total of 200 inpatients with nonsmall cell lung cancer in Henan Cancer Hospital were selected and randomly divided into observation group and control group. The observation group was given Yiqi Huayu Recipe + chemotherapy; the control group was given Yifei Qinghua Granule + chemotherapy. The clinical symptoms,tumor focus,quality of life,immune index,tumor markers and expression of MDR1 mRNA and CK20 mRNA in peripheral blood were observed. Results: There was no significant difference in MDR1 mRNA between the observation group and the control group before and after treatment( P > 0. 05). That of the control group was significantly higher than that before treatment( P < 0. 05). The difference of that between the two groups was statistically significant( P < 0. 05). The levels of CK20 mRNA in peripheral blood of both groups decreased after treatment( P < 0. 05),but the decrease in the observation group was more obvious. The difference was statistically significant( P < 0. 05). The symptom scores of the two groups were significantly lower than those before treatment( P < 0. 05). The symptom scores of the observation group were significantly lower than those of the control group( P < 0. 01). The tumor stability rate of the observation group was significantly better than that of the control group. The difference was statistically significant( P < 0. 01). The distribution of CD3+,CD4+,CD4+/CD8+ and NK cells in the peripheral blood of the two groups was significantly higher than that before treatment,while the proportion of CD8+ cells was significantly lower than that before treatment,the difference was statistically significant( P < 0. 05). Compared with that of the control group,the difference was statistically significant( P < 0. 05). The stability rate of the observation group was 86%,and that of the control group was 69%. The difference between the two groups was statistically significant( P < 0. 05). After treatment,the levels of CEA,NSE and Cyfra21-1 in the two groups decreased,and the observation group was significantly lower than that of the control group( P < 0. 05). Conclusion: Yiqi Huayu Recipe can inhibit the increase of MDR1 mRNA level and decrease the expression level of CK20 mRNA,which has certain synergistic effect on chemotherapy. It can also alleviate clinical symptoms,improve the quality of life and improve the immune function of cancer patients.