复方中药联合TP方案治疗晚期非小细胞肺癌的临床疗效观察

Observation of the clinical effect of compound traditional Chinese medicine combined with TP regimen for advanced NSCLC

目的探讨复方中药艾迪注射液联合多西他赛+奈达铂(TP)化疗方案治疗晚期非小细胞肺癌(NSCLC)的临床疗效及对Treg/Th17的影响。方法采用回顾性分析的方法,将95例晚期NSCLC患者按照治疗方法的不同分为对照组47例和观察组48例。对照组患者给予TP化疗方案进行治疗,观察组患者在TP化疗方案的基础上加用艾迪注射液进行治疗。比较两组患者的临床疗效和不良反应发生情况,流式细胞仪检测Treg、Th17细胞比例,液相芯片检测血清IL-10、TGF-β、IL-17、IL-23含量。结果治疗后,观察组患者的临床获益率为91.7%,高于对照组的76.6%,差异有统计学意义(P=0.044);观察组患者的3~4级中性粒细胞减少、血小板减少的发生率分别为4.2%和2.1%,均低于对照组患者的17.0%和12.8%,差异有统计学意义(P=0.044、0.028);治疗前,两组患者的各指标比较,差异无统计学意义(P﹥0.05);治疗后,两组患者的Treg、Th17细胞比例及相关细胞因子(IL-10、TGF-β、IL-17、IL-23)的含量较治疗前降低,Treg/Th17比例较治疗前升高(P﹤0.05);且观察组患者的各指标均优于对照组患者(P﹤0.05)。结论艾迪注射液联合TP方案治疗晚期NSCLC的疗效肯定,安全性好,且可调节Treg/Th17,值得临床推广。

Objective To observe the clinical curative effect of Addie injection combined with docetaxel plus nedaplatin（TP） regimen for advanced NSCLC,and to evaluate the impact on Treg/Th17.Method 95 patients with advanced non-small cell lung cancer（NSCLC） were included and divided into control group（47 cases） or study group（48 cases） according to respective treatment administered.The control group received TP regimen,while the study group was treated with Addie injection additionally.The clinical efficacy and adverse reactions were observed and compared,furthermore,the Treg and Th17 cells were detected by flow cytometry,and the serum levels of IL-10,TGF-β,IL-17 and IL-23 were determined by liquid chip.Result After treatment,for study group,the clinical benefit rate was 91.7%,which was higher than that in control group at 76.6%,with statistically significant difference observed（P=0.044）; the incidence of neutropenia and thrombocytopenia at grade 3~4 was 4.2% and 2.1%,which were lower than those in control group at 17.0% and12.8%,respectively,indicating significant differences（P=0.044,0.028）; before treatment,there were no significant differences between the two groups regarding all the measures concerned（P〈0.05）; after treatment,compared with those before treatment,the proportion of Treg and Th17 cells,the levels of related cytokines（IL-10,TGF-β,IL-17 and IL-23） decreased greatly in both groups,and the ratio of Treg/Th17 increased markedly,and all these measures were better than those of control group（P〈0.05）.Conclusion Addie injection combined with TP chemotherapy regimen is effective and safe for advanced NSCLC,and could adjust the ratio of Treg/Th17,which is clinically applicable.