中晚期胃癌患者情绪与免疫功能的关系及疏肝健脾和胃方的干预作用

Relevance of Emotion and Immunologic Function of Patients with Advanced Gastric Cancer and Intervention of Soothing Liver and Strengthening Spleen and Stomach Prescription

目的：观察中晚期胃癌患者情绪与免疫功能的关系及中药疏肝健脾和胃方的干预作用。方法：将符合纳入标准的86例病例,采用焦虑自评量表（SAS）和抑郁自评量表（SDS）筛选出有焦虑抑郁情绪与无焦虑抑郁情绪患者,采用流式细胞技术,比较有焦虑抑郁情绪患者与无焦虑抑郁情绪患者外周血T细胞亚群（CD3^＋、CD4^＋、CD8^＋细胞）和NK细胞（CD16^＋/CD56^＋细胞）比例;有焦虑抑郁情绪的患者予以疏肝健脾和胃方进行治疗,比较治疗前后患者外周血中T细胞亚群和NK细胞比例。结果：有焦虑抑郁情绪患者外周血中CD3^＋细胞、CD4^＋细胞和NK细胞比例均低于无焦虑抑郁情绪患者（P〈0.05或P〈0.01）,CD8^＋细胞比例升高,疏肝健脾和胃方可升高有焦虑抑郁情绪患者外周血中CD3^＋细胞、CD4^＋细胞和NK细胞比例,降低CD8^＋细胞比例。结论：中晚期胃癌患者的情绪与免疫功能呈正相关,疏肝健脾和胃方可改善患者免疫功能,调节患者的焦虑和抑郁情绪。

Objective：To investigate the relevance of emotion and immunologic function of patients with advanced gastric cancer,and intervention characteristics of Soothing Liver and Strengthening Spleen and Stomach Prescription. Methods：A total of 86 case with advanced gastric cancer were collected. Self-Rating Anxiety Scale（ SAS） and Self-rating depression scale（ SDS）were adopted to filter patients with anxiety and depression and without anxiety and depression. Flow cytometry was used to test the proportion of T cell subclassification（ CD3^＋,CD4^＋,CD8^＋cell） and NK cells（ CD16^＋/CD56^＋cell） in peripheral serum. The Soothing Liver and Strengthening Spleen and Stomach Prescription was used to the patients with anxiety and depression emotion,pre-treatment and post-treatment proportion of T cell subclassification and NK cells were compared between two groups. Results：The proportion of serum CD3^＋,CD4^＋and NK cells was decreased,while CD8^＋cells raised among patients had anxiety and depression compared with patients without negative emotions（ P〈0.05 or P〈0.01）. Soothing Liver and Strengthening Spleen and Stomach Prescription can upregulated the serum levels of CD3^＋,CD4^＋and NK cells and downregulated CD8^＋cells level.Conclusion：Emotion and immunologic function of patients with advanced gastric cancer have positive correlation. Soothing Liver and Strengthening Spleen and Stomach Prescription can improve the patients immunologic function and accommodate the cacoethic emotion such as anxiety and depression.