补肾益气扶正汤联合化疗对肾癌根治性切除术后外周血CD4^+CD45RA^+和CD4^+CD45RO^+T细胞的影响

Effect of Bushen Yiqi Fuzheng decoction combined with chemotherapy on peripheral blood CD4^+CD45RA^+ and CD4^+CD45RO^+T cells in patients with renal cell carcinoma after radical nephrectomy

目的观察补肾益气扶正汤联合化疗对肾癌根治性切除术后外周血CD4^+CD45RA^+和CD4^+CD45RO^+T细胞及不良反应发生情况的影响。方法将146例肾癌根治性切除术后患者随机分为2组,对照组73例给予化疗治疗,研究组73例给予补肾益气扶正汤联合化疗治疗,2组均持续治疗3个化疗疗程。记录2组治疗前后中医症状积分及KPS评分,检测2组治疗前后外周血CD4^+CD45RA^+和CD4^+CD45RO^+T细胞水平,统计2组治疗后临床疗效及治疗期间不良反应发生情况。结果治疗后,2组中医症状积分均较治疗前显著降低(P均<0.05),且研究组显著低于对照组(P<0.05);研究组临床治疗总有效率显著高于对照组(P<0.05);2组CD4^+CD45RA^+T细胞均较治疗前显著降低(P均<0.05)、CD4^+CD45RO^+T细胞均较治疗前显著升高(P均<0.05),且研究组CD4^+CD45RA^+T细胞均显著低于对照组(P均<0.05)、CD4^+CD45RO^+T细胞均显著高于对照组(P均<0.05);2组KPS评分均较治疗前显著升高(P均<0.05),且研究组显著高于对照组(P<0.05)。治疗期间,研究组消化道反应、感冒样症状、神经系统症状以及白细胞降低发生率均显著低于对照组(P均<0.05)。结论补肾益气扶正汤联合化疗可明显减轻肾癌根治性切除术后患者症状体征,调节外周血CD4^+CD45RA^+和CD4^+CD45RO^+T细胞水平,减少不良反应,且疗效更好。

Objective It is to observe the influence of Bushen Yiqi Fuzheng decoction combined with chemotherapy on peripheral blood CD4^＋CD45RA^＋and CD4^＋CD45RO^＋T cells in treatment of patients with renal cell carcinoma after radical nephrectomy and the incidence of adverse reactions.Methods One hundred and forty-six cases of patients with renal cell carcinoma after radical nephrectomy were randomly divided into 2 groups,seventy-three cases in the control group were treated with chemotherapy,seventy-three cases in the study group were treated with Bushen Yiqi Fuzheng decoction combined with chemotherapy,the two groups were treated continuously for 3 courses of chemotherapy.The TCM symptom scores and Karnofsky（KPS） scores of the 2 groups before and after treatment were recorded,the levels of CD4^＋CD45RA^＋and CD4^＋CD45RO^＋T cells in peripheral blood of 2 groups before and after treatment were detected,and the clinical efficacy and adverse reactions during treatment were compared between the 2 groups after treatment.Results After treatment,the symptom scores of the 2 groups were significantly lower than those before treatment（all P〈0.05）,and the study group was significantly lower than the control group（P〈0.05）.The total effective rate of the study group was significantly higher than that of the control group（P〈0.05）.The levels of CD4^＋CD45RA^＋T cells were significantly lower but CD4^＋CD45RO^＋T cells were significantly higher than those before treatment in the 2 groups（all P〈0.05）,and the CD4^＋CD45RA^＋T cells in the study group were significantly lower and the CD4^＋CD45RO^＋T cells were significantly higher than those in the control group（all P〈0.05）.The KPS scores of the 2 groups were significantly higher than those before treatment（all P〈0.05）,and the study group was significantly higher than the control group（P〈0.05）.During the treatment period,the alimentary tract reaction,cold like symptoms,nervous system symptoms and the incidence of leukocyte reduction in the study group were significantly lower than those in the control group（all P〈0.05）.Conclusion Bushen Yiqi Fuzheng decoction combined with chemotherapy can significantly reduce symptoms and signs after radical nephrectomy for renal cell carcinoma,regulate the level of CD4^＋CD45RA^＋and CD4^＋CD45RO^＋T cells in peripheral blood,decrease the adverse reaction,and the curative effect is better.