麻黄附子细辛汤加减治疗晚期肿瘤发热的疗效及部分机制

Observation on Efficacy of Modified Mahuang Fuzi Xixin Decoction on Advanced Tumor Fever and Study on Partial Mechanism

目的:探讨麻黄附子细辛汤加减治疗晚期肿瘤发热的疗效,同时探讨该药物实现降温作用的可能机制。方法:选取2014年8月至2018年1月巴彦淖尔市人民医院收治放化疗的晚期胃癌患者119例为研究对象,回顾性分析其治疗方案并进一步分为对照组(n=61)和观察组(n=58),对照组患者接受常规降温治疗,观察组患者接受麻黄附子细辛汤加减联合常规降温治疗,均持续治疗7d。评估2组患者的治疗后降温效果并检测血清中炎性反应指标[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)]的水平以及外周血中T淋巴细胞亚群(CD3^+、CD4^+、CD8^+T细胞)的分布水平。结果:治疗7d后,观察组患者的治疗有效率高于对照组患者,差异有统计学意义(P<0.05);观察组患者血清中TNF-α、CRP、IL-6的水平低于对照组患者;外周血中CD3^+、CD4^+T细胞分布比例及CD4^+/CD8^+比值高于对照组患者,CD8^+T细胞分布比例低于对照组患者,差异有统计学意义(P<0.05)。结论:晚期肿瘤发热患者接受麻黄附子细辛汤加减辅助治疗,可显著提高降温效果,其具体作用机制可能与抗炎、免疫调节相关。

Objective: To explore the efficacy of modified Mahuang Fuzi Xixin Decoction on advanced tumor fever and its possible mechanism of reducing fever. Methods: A total of 119 cases of patients with advanced gastric cancer admitted in Bayannur People′s Hospital during August 2014 to January 2018 were selected as research subjects.After their treatment methods were retrospectively analyzed,they were divided into control group(n = 61,underwent routine cooling treatment)and observation group(n = 58,underwent modified Mahuang Fuzi Xixin Decoction plus routine cooling treatment),with the treatment lasting for 7 d.Cooling effects of the 2 groups were evaluated and serum content of each inflammatory response index [tumor necrosis factor alpha(TNF-α),C reactive protein(CRP),interleukin-6(IL-6)] and distribution levels of T lymphocyte subsets(CD3^+,CD4 ^+,CD8^+ T cells)in peripheral blood were measured. Results: After the 7 d treatment,therapeutic effective rate in the observation group was higher than that in the control group( P <0.05);the serum content of TNF-α,CRP and IL-6 in the observation group was lower than that in the control group;the distribution proportion of CD3 ^+ and CD4^+ T cells in peripheral blood and CD4 ^+/CD8 ^+ in the observation group were higher than those in the control group,while the distribution proportion of CD8 ^+ T cells was lower than that in the control group( P <0.05). Conclusion: Modified Mahuang Fuzi Xixin Decoction can improve the cooling effects in patients with advanced tumor fever,and the specific mechanism may be related to the anti-inflammation and immunoregulation.