参芪扶正注射液联合化疗治疗非小细胞肺癌术后及对血清中Th17/Treg细胞的调节作用

Clinical Observation of Shenqi Fuzheng Injection Combined with Chemotherapy in Treatment of Non Small Cell Lung Cancer and The Regulation of Th17/Treg Cells in Patients

目的：研究参芪扶正注射液联合化疗治疗非小细胞癌术后的，临床疗效及对外周血Th17／Treg的影响。方法：选取79例的非小细胞癌术后患者，随机分为对照组和观察组。对照组患者采用TP方案治疗，观察组患者在对照组治疗的基础上加以参芪扶正注射液治疗，两组均以21d为1化疗周期，2个周期为1个疗程。比较治疗前后两组患者外周血Th17／Treg比例，血清肿瘤标志物（CEA、CA125、CYFRA21—1和NSE）的水平；绘制生存曲线，比较两组患者PFS及OS；比较治疗后两组的临床症状评分；对两组患者进行安全性评价。结果：观察组治疗1周期、2周期后的CEA、CA125、CYFRA21—1及NSE水平均显著低于治疗前，并且明显较对照组低（P〈0．05）；观察组Treg／Th17明显较治疗前升高（P〈0．05），而对照组的Th17／Treg显著低于治疗前（P〈0．05），治疗后观察纽显著高于对照纽（P〈0．05）。观察组患者治疗后的临床症状评分也较对照纽降低的更为显著（P〈0．05）；对照组患者的中位PFS为13个月，中位OS为29个月，观察组患者的中位PFS为19个月，中位OS为43个月，两组比较差异显著（P〈0．05）。观察组患者的ORR为73．2％，DCR为90．2％；对照组患者ORR为63．2％，DCR为76．3％，两组比较差异显著（P〈0．05）；观察组不良反应总发生频次显著少于对照组（P〈0．05）。结论：参芪扶正注射液联合化疗可以提高非小细胞癌术后患者的临床疗效，提高机体免疫功能，具体机制与调节外周血Th17／Treg比例有关。

Objective： To study the clinical effect of Shenqi Fuzheng Injection combined with chemotherapy in the treatment of non small cell carcinoma and the effect of Th17/Treg on peripheral blood. Methods ： Seventy - nine patients with non small cell carcinoma treated in our hospital were randomly divided into the control group and the observation group. The patients in the control group were treated with TP regimen, and the observation group was treated with Shenqi Fnzheng Injection on the basis of the control group. The 2 groups were treated for 21d as 1 chemotherapy cycle, and the 2 periods was 1 course. We compared 2 groups＇ peripheral blood Th17/Treg ratio, serum tumor markers （ CEA, CA125, CYFRA2I - 1 and NSE） levels. The survival curves were compared between the 2 groups. PFS and OS,clinical symptom score of 2 groups after treatment were evaluated. Results ： In the treatment group after 1 and 2 cycles,CEA, CAt25, CY- FRA21 -1 and NSE levels were significantly lower than those before treatment, and significantly lower than those of the control group（P 〈0. 05）. The observation group＇s Treg/Th17 was significantly higher than that before treatment （P 〈 0. 05 ）, while the control group＇ s was significantly lower than that before treatment （ P 〈 0.05 ）. After treatment, the ob- servation group＇ s was significantly higher than the control group＇ s （ P 〈 0. 05 ）. The observation group＇ s clinical symp- tom score after treatmentdecreased more significantlythan that of the control group（P 〈 0. 05 ）. The control group＇ s PFS was 13 months and median OS was 29 months. The observation group＇ s PFS was 19 months and median OS was 43 months. There was significant difference between 2 groups （P 〈 0. 05 ）. The ORR in the observation group was 73.2% and DCR was 90.2%. The ORR in the control group was 63.2% and DCR was 76.3%. The difference between the 2 groups was significant （ P 〈 0. 05 ）. The total frequency of adverse reactions in the observation group was significantly less than that in the control group （ P 〈 0. 05 ）. Conclusion ： Shenqi Fuzheng Injection combined with chemotherapy can im- prove the clinical efficacy andthe immune function of patients with non - small cell carcinoma after operation, and the specific mechanism is related to the proportion of peripheral blood Th17/Treg.