不同治则对非小细胞肺癌患者调节性T细胞、髓源抑制性细胞的影响

Effect of Different Treatment on Non-small Cell Lung Cancer on Regulatory T Cells and Myeloid Derived Suppressor Cells

目的:通过研究扶正(益气养阴方)、祛邪(清热解毒方)、扶正祛邪(益气养阴解毒方)三种治则对非小细胞肺癌患者调节性T细胞(Regulatory T cell,Treg)、髓源抑制细胞(Myeloid-derived suppressor cells,MDSC)免疫指标的作用,探究不同治则对非小细胞肺癌患者的免疫功能的影响。方法:采用完全随机、平行对照的实验设计,将166例非小细胞肺癌患者按照随机数字表纳入研究,完成益气养阴方组(A组)39例、清热解毒方组(B组)46例、益气养阴解毒方组(C组)49例,分别给予相应的中药汤剂,4周为一个疗程,治疗3个疗程(12周)后观察对Treg和MDSC的影响。结果:治疗前非小细胞肺癌患者外周血Treg、MDSC水平明显高于健康人群组,具有统计学意义(P<0.001)。治疗后,B组和C组能够显著降低肺癌患者的Treg、MDSC,改善机体免疫功能(P<0.05)。治疗后,A组对非小细胞肺癌患者外周血Treg、MDSC无显著调节作用(P>0.05)。治疗后,三组之间比较,B组对降低非小细胞肺癌患者的Treg、MDSC水平更有优势。结论:祛邪和扶正祛邪治则均可调控肺癌患者的免疫功能,而祛邪治则在抑制MDSC和Treg方面作用更强。

Objective: To study the effects of the methods of strengthening vital qi(Yiqi Yangyin Prescription), eliminating pathogens(Qingre Jiedu Prescription), strengthening vital qi and eliminating pathogens(Yiqi Yangyin Jiedu Prescription)on the immune index of regulatory T cells(Treg) and myelinated cells(MDSC), and to explore the effects of different treatments on the immune function of patients with non-small cell lung cancer. Methods: A completely random, parallelcontrolled experimental design was used. A total of 166 patients with non-small cell lung cancer were divided into 39 cases of Yiqi Yangyin Prescription group(group A), 46 cases of Qingre Jiedu Prescription group(group B) and 49 cases of Yiqi Yangyin Jiedu Prescription group(group C) according to the random number table, which were treated with the corresponding Chinese medicine decoction and 4 weeks as a course of treatment. After 3 courses(12 weeks), the effects of Treg and MDSC were observed. Results: The levels of peripheral blood regulatory Treg and MDSC in patients with nonsmall cell lung cancer before treatment were significantly higher than those in the healthy group, with statistical significance(P < 0.001). After treatment, group B and group C could significantly reduce the Treg and MDSC of lung cancer patients and improve their immune function(P < 0.05). After treatment, group A had no significant regulatory effects on Treg and MDSC in peripheral blood of patients with non-small cell lung cancer(P > 0.05). After treatment,compared with 3 groups, the group B had an advantage in reducing the level of Treg and MDSC in patients with nonsmall cell lung cancer. Conclusion: Eliminating pathogens and strengthening vital qi and eliminating pathogens can regulate the immune function of lung cancer patients, while Eliminating pathogens is more effective in inhibiting MDSC and Treg.