完带汤辨治子宫内膜癌术后患者的临床分析

Clinical Effect of Wandaitang on Endometrial Carcinoma After Operation

目的:观察完带汤辨证治疗子宫内膜癌(EC)术后患者的症状、生活质量和免疫功能的影响,并从EC微环境的调控方面探讨了其作用机制。方法:将109例EC术后患者,采用随机按数字表法分为对照组54例和观察组55例。对照组术后根据不同分期给予放射治疗或(和)化疗;观察组在对照组治疗的基础上,采用完带汤辨证治疗,1剂/d。两组疗程均为连续治疗3个月。进行治疗前后症状、体征评分,进行癌症治疗前后功能评价量表(FACT-G)评分;检测治疗前后T淋巴细胞亚群(CD3+,CD4+,CD8+,CD4+/CD8+)和自然杀伤细胞(NK)水平;检测治疗前后血管内皮生长因子(VEGF),转化生长因子-β(TGF-β),胰岛素样生长因子(IGF-1),白细胞介素-17(IL-17)和IL-10水平。结果:治疗后观察组患者各症状、体征评分和总积分均低于对照组(P <0. 01);观察组FACT-G量表各维度评分和总分均高于对照组(P <0. 01);治疗后观察组NK,CD3+,CD4+和CD4+/CD8+均高于对照组(P <0. 01),CD8+低于对照组(P <0. 01);治疗后观察组患者血清VEGF,TGF-β,IGF-1,IL-17和IL-10水平均低于对照组(P <0. 01)。结论:完带汤辨证治疗EC术后患者,可进一步改善患者的临床症状,提高患者生活质量和机体免疫功能,可改变子宫内膜癌肿瘤微环境,对患者多种细胞因子具有调节作用。

Objective: To observe the effect of syndrome differentiation and treatment with Wandaitang on symptoms,quality of life and function of immunologic after operation of endometrial carcinoma ( EC),in order to discuss the mechanism of action according to regulation of microenvironment of EC. Method: The 109 patients were divided into control group ( 54 cases) and observation group ( 55 cases) by random number table. Patients in control group got radiotherapy and /or chemotherapy according to different stages after operation. Patients in observation group were additionally given syndrome differentiation and treatment with Wandaitang,1 dose /day. And a course of treatment was 3 months. Before and after treatment,symptoms,sign,functional assessment of cancer therapy-general ( FACT-G) were scored. And levels of T lymphocyte subsets ( CD3 ^+,CD4^+,CD8^+, CD4^+/CD8 ^+),natural killer cell ( NK),vascular endothelial growth factor ( VEGF),transforming growth factor-β( TGF-β),insulin-like growth factor-1 ( IGF-1 ),interleukin-17 ( IL-17 ) and IL-10 were detected. Result: After treatment,the scores of symptoms,signs and total scores of the patients in the observation group were lower than the control group ( P < 0.01). The scores of each dimension and total score of FACT-G scale in the observation group were higher than those in the control group ( P < 0. 01). After treatment,NK,CD3^+,CD4 ^+ and CD4 ^+/CD8^+ in the observation group were higher than those in the control group ( P < 0. 01),lower than the control group ( P < 0.01). After treatment,the serum levels of VEGF,TGF-β,IGF-1,IL-17 and IL-10 in the observation group were lower than those in the control group. Conclusion: Wandaitang can ameliorate clinical symptoms,improve quality of life of patients and immune function of organism,regulate multiple cytokines,change the tumor microenvironment of endometrial carcinoma.