中西医结合疗法对乳腺癌患者术后免疫功能的影响

Impact of combined therapy of Chinese and Western medicine on immune function after surgery for breast cancer

目的观察中西医结合疗法对应用了新辅助化疗后的乳腺癌根治术患者术后体液及细胞免疫功能及炎症因子的影响。方法普外科90例乳腺癌患者,术前均行新辅助化疗,术后分为对照组与观察组(n=45),其中观察组在常规治疗同时给予中医药治疗。于术前( T_1)、术后24 h(T_2)、术后1周(T_3)、术后4周(T_4)、术后9周(T_5)采血用全自动生化分析仪检测T淋巴亚群CD4^+、CD8^+和NK细胞水平,免疫球蛋白IgA、IgG、IgM含量及采用酶联免疫吸附法(ELISA)检测炎症因子IL-6、IL-10、TNF-α水平。采用统计学软件SPSS 16.0处理数据。结果与 T_1比较,2组T_(2~3)时点CD8^+,T_(3~5)时点IgG及IgM水平升高;对照组T_(2~3)时点CD4^+,NK细胞以及T_(2~5)的CD4^+/CD8^+下降;观察组T_2时点CD4^+,NK细胞以及T_(2~3)的CD4^+/CD8^+下降;对照组T_(3~5)时点和观察组T_(2~3)时点IL-6及TNF-α水平升高,IL-10水平下降(P<0.05)。与对照组比较,观察组T_(3~5)时点CD4^+、CD4^+/CD8^+、NK细胞、IgG及IgM上升,CD8^+下降;T_(4~5)时点IL-6及TNF-α水平下降,IL-10水平升高(P<0.05)。结论中西医结合疗法可提高新辅助化疗后的乳腺癌根治术患者术后免疫力,减少炎症反应,促进康复。

Objective To study the impact of combined therapy of Chinese and Western medicine onpostoperation immune function and inflammatory factors of breast cancer patients with neoadjuvant chemotherapy. Methods Ninety breast cancer patients in our department undergwent the neoadjuvant chemotherapy before the operations and were randomly divided into two groups after the surgery：control group （n = 45 ）and study group （n = 45 ）. The patient in the study group received combined therapy of Chinese and Western medicine on the base of routine treatment. The levels of CD4^＋, CD8^＋, NK ceils, IgA, IgG and IgM were detected with automatic biochemical analyzer, and IL-6, IL-10 ,TNF-α with ELISA before the operation（ T1）, and 24 h（ T2 ）, 1 w（ T3 ） ,4 w（ T4 ） ,9 w（ T5 ） after the sugery. The data was analyzed using SPSS 16.0 software. Results Compared with T1 ,the levels of CD8^＋ at T2 -3 ,IgG and IgM at T3 -5 in both groups were increased. The levels of CD4^＋ and NK cell at W2-3 ,and CD4^＋/CD8^＋ at T2-5 in the control group were declined. The levels of CD4^＋ and NK cell at T2 ,and CD^4＋/CD8^＋ at T2-3 in the study groups were declined. IL-6 ,TNF-α level were increased and IL-10 were declined at T3 -5 in the contral groups and at T2 -3 in the study groups（ P 〈 0. 05 ）. Compared with the control group, the levels of CD4^＋ , CD4^＋/CD8^＋ , NK cells, IgG, IgM were increased at T3-5, but CD8^＋ was declined ; IL-6 and TNF-α level were declined at T4-5 ,but IL-10 were increased （P 〈 0.05 ）. Conclusion The combined therapy of Chinese and Western medicine can improve the postoperative immune function and decreased systemic inflammation in breast cancer patients receiving neoadjuvant chemotherapy.