四君子汤加减结合细胞因子诱导杀伤细胞对消化道恶性肿瘤患者免疫机制的影响

Effect of Sijunzi decoction combined with cytokine-induced killer cells on the immune mechanism in patients with digestive tract malignant tumors

目的探讨四君子汤加减结合细胞因子诱导的杀伤(CIK)细胞对消化道恶性肿瘤患者免疫机制的影响。方法选取2014年1月至2015年1月间陕西省肿瘤医院收治的100例晚期消化道恶性肿瘤患者,按照随机数字表法随机分为观察组和对照组,每组50例。观察组患者给予CIK细胞联合中药四君子汤加减治疗,对照组患者仅给予CIK治疗。两组患者治疗时间均为1个月,比较两组患者卡氏体力状态(KPS)评分、体质量、中医症候评分、外周血T细胞CD_3^+、CD_4^+、CD_8^+和自然杀伤(NK)细胞的变化。结果治疗前,两组患者的KPS评分和体质量间比较,差异无统计学意义(P>0.05)。治疗后,观察组患者KPS评分显著提高,差异有统计学意义(P<0.05)。治疗后对照组患者的中医证候评分无明显改善,观察组患者的气短、神疲、乏力和少言症状评分显著提高,差异有统计学意义(P<0.05)。治疗前后对照组患者的各T细胞亚群水平改变比较,差异无统计学意义(P>0.05)。治疗后,观察组患者CD_3^+和CD_4^+水平显著提高,CD_8^+水平降低,与治疗前比较,差异有统计学意义(P<0.05)。结论四君子汤加减结合CIK细胞治疗消化道恶性肿瘤,能有效改善患者的生活质量和症候评分,提高机体的免疫机能,值得临床推广应用。

Objective To investigate the effect of Sijunzi decoction combined with cytokine-induced killer（ CIK） cells on immune mechanism in patients with malignant tumor localized in digestive tract. Methods 100 patients with digestive tract malignant tumors treated in Shaanxi Provincial Tumor Hospital from January 2014 to January 2015 were randomly divided into an observation group and a control group,with 50 patients in each group. The patients in the observation group received Sijunzi decoction with addition and subtraction according to the disease combined with CIK cell therapy and those in the control group only received CIK therapy. Changes of Karnofsky performance status（ KPS） score,body weight,TCM symptom score,and CD4,CD3＋,CD8＋of peripheral blood T cell and natural killer（ NK） were compared. Results Before treatment,KPS score and body weight between the two groups showed no significant difference. After treatment,KPS score in the observation group increased significantly（ P〈 0. 05）; TCM score in the control group showed no significant improvement,but scores of shortness of breath,fatigue and taciturn in the observation group significantly increased（ P〈 0. 05）. For the control group,changes of levels of T cell subsets showed no significant difference before and after treatment（ P〉 0. 05）; After treatment,levels of CD3＋and CD4＋in the observation group significantly enhanced and levels of CD8＋decreased（ P〈 0. 05）. Conclusion Sijunzi decoction with addition and subtraction according to the disease combined with CIK cells in the treatment of digestive tract malignant tumors can effectively improve the quality of life and symptoms scores,and also improve immune function. It is worthy of clinical promotion and application.