救必应汤联合化疗对老年晚期非小细胞肺癌患者血清Survivin、p53蛋白及免疫功能的影响

Effect of Jiubiying Decoction Combined with Chemotherapy on Serum Survinvin,p53 Protein and Immune Function in Elderly Advanced Non-Small Cell Lung Cancer

目的观察救必应汤联合DP方案(多西他赛+顺铂)治疗老年晚期非小细胞肺癌患者的临床疗效。方法将100例老年晚期非小细胞肺癌患者随机分为治疗组和对照组,每组各50例。对照组单纯予DP方案化疗,治疗组在对照组的基础上加用救必应汤,均以21d为1个周期,观察4个周期。观察2组治疗前后瘤体改变情况、中医症状评分、毒副反应、血清p53、Survivin水平和免疫情况等。结果治疗后治疗组在总有效率和疾病控制率方面均优于对照组(P<0.05);治疗后2组中医症状积分、血清p53、Survivin水平较治疗前下降(P<0.01),治疗组降低程度高于对照组(P<0.01);治疗组CD3^+、CD4^+、CD4^+/CD8^+水平明显高于治疗前及对照组(P<0.01);治疗组发生骨髓抑制、肝损害的病例均少于对照组(P<0.05)。结论救必应汤联合DP方案对老年晚期非小细胞肺癌能较好控制瘤体大小,改善临床症状,下调血清p53、Survivin水平,并具有增效减毒作用。

OBJECTIVE To observe the clinical efficacy of Jiubiying Decoction combined with DP regimen(docetaxel+cisplatin)in the treatment of elderly patients with advanced non small cell lung cancer.METHODS 100 elderly patients with advanced non small cell lung cancer were randomly divided into treatment group and control group,50 cases in each group.The control group was treated with DP chemotherapy,and the treatment group was given by Jiubiying Decoction on the basis of control group.All of them were treated with 21 days as a cycle and 4 cycles were observed.The changes of tumor size,TCM symptom score,side effects,serum p53,Survivin level and immune status were observed before and after treatment.RESULTS In terms of solid tumor changes,treatment group was superior to control group in total effective and disease control rate(P<0.05).After treatment,the TCM symptom scores,serum p53 and Survivin levels in two groups were lower than those before treatment(P<0.01),the degree of reduction in treatment group was higher than that in control group(P<0.01).For immune function,the levels of CD3+,CD4+,CD4+/CD8+in treatment group were significantly higher than those before treatment and control group(P<0.01).For side effects,the cases of myelosuppression and liver damage in treatment group were less than those in control group(P<0.05).CONCLUSION Jiubiying Decoction combined with DP regimen can better control tumor size,improve clinical symptoms,and decrease serum p53 and Survivin levels in elderly patients with advanced non small cell lung cancer,and have synergistic and attenuating effects.