中医复合疗法联合动脉灌注化疗对中晚期非小细胞肺癌患者临床症状及免疫功能的影响

Effect of combination of traditional Chinese medicine and intraarterial infusion chemotherapy onclinical symptoms and immune function of patients with middle and advanced non-small cell lung cancer

目的观察中医复合疗法(中药汤剂+针灸)联合动脉灌注化疗对中、晚期非小细胞肺癌患者临床疗效及免疫功能影响。方法 96例中、晚期非小细胞肺癌患者随机分为A组48例(动脉灌注化疗),B组48例(A组基础上配合中药汤剂+针灸),21 d为1个治疗周期,共治疗3周期,比较2组患者治疗前后临床症状、不良反应、血清T细胞亚群及Treg、Th17表达差异。结果 2组肺癌相关症状治疗后与治疗前比较明显改善且B组优于A组(P<0.05);治疗结束后不良反应A组骨髓抑制为(47.91%)、胃肠道异常反应(39.58%)、肝功能损害(33.33%)、肾功能损害(22.91%),B组分别为:37.5%、31.25%、18.75%、14.58%,B组不良反应显著低于A组,差异具有统计学意义(P<0.05);治疗后2组免疫学指标(CD3、CD4、NK、Treg)较治疗前明显降低,Th17及Th17/Treg比值明显升高(P<0.05),治疗后B组CD3、CD4、NK、Th17和Th17/Treg比值高于A组,CD8、Treg低于A组,差异具有统计学意义(P<0.05)。结论中医复合疗法(中药汤剂+针灸)联合动脉灌注化疗可有效改善中、晚期非小细胞肺癌患者临床症状,减少化疗不良反应,改善机体免疫功能。

Objiective To observe the clinical therapeutic effects of patients with advanced nonsmall cell lung cancer by Combined therapy of Chinese medicine with arterial infusion chemotherapy. Methods 96 cases of patients with advanced non-small cell lung cancer of middle and late stage were randomly divided into group A, B, each of the group had 48 patients, the group A was treated by arterial infusion chemotherapy, the group B was treated based on the group A but additional used traditional Chinese medicine and acupuncture. 21 days for a treatment cycle, a total of 3 cycles. The clinical symptoms, adverse reactions, serum T lymphocyte subsets and the expressions of Treg and Th17 were compared between the two groups before and after treatment. Results The two groups of lung cancer related symptoms were significantly improved after treatment and before treatment, and the group B was better than A（P 〈0.05）; After the treatment of adverse reactions in A group： bone marrow suppression（47.91%）, abnormal gastrointestinal reactions（39.58%）, liver damage（33.33%）, renal dysfunction（22.91%）, B group were 37.5%, 31.25%, 18.75%, 14.58%, adverse reactions of B group was significantly lower than group A,The difference was statistically significant（P〈 0.01）; After treatment, the immunological indexes（CD3, CD4, NK, Treg） of the two groups were significantly lower than those before treatment, and the ratio of Th17 and Th17/Treg increased significantly（P 〈0.05）, after treatment, the CD3, CD4, NK, Th17 and Th17/Treg in group B were higher than those in group A, and CD8 and Treg were lower than those in group A, the difference was statistically significant（P 〈0.05）. Conclusion The combination of traditional Chinese medicine and arterial infusion chemotherapy can effectively improve the clinical symptoms, reduce the adverse reactions of chemotherapy and improve the immune function of the patients with middle and late stage non-small cell lung cancer.