苦参碱注射液对中晚期口腔癌患者免疫功能及预后的影响

Effects of matrine injection combined with chemotherapy on the immune function and prognosis of patients with advanced oral cavity carcinomas

目的研究苦参碱注射液联合化疗对中晚期口腔癌患者免疫功能及预后的影响。方法中晚期口腔癌患者60例随机分为对照组和治疗组,每组30例,对照组给予常规化疗方案,治疗组在常规化疗基础上加用苦参碱注射液。疗程均为12周。观察2组外周血淋巴细胞亚群、免疫球蛋白、血清细胞因子、体力状况、生活质量。随访3年,观察2组生存率、生存时间和复发率。结果治疗前2组外周血CD3^+、CD4^+、CD8^+、NK、CD19^+、CD4^+/CD8^+、IgG、IgA、IgM、IL-2、IFN-γ、IL-4、KPS评分、QOL评分比较差异无统计学意义(P>0.05)。治疗后2组外周血CD3^+、CD4^+、NK、CD4^+/CD8^+、IgG、IgA、IgM、IL-2、IFN-γ、KPS和QOL评分均明显高于治疗前,CD8^+、CD19^+、IL-4均明显低于治疗前(P<0.05),且治疗组外周血CD3^+、CD4^+、NK、CD4^+/CD8^+、IgG、IgA、IgM、IL-2、IFN-γ、KPS和QOL评分高于对照组,CD8^+、CD19^+、IL-4低于对照组(P<0.05)。随访3年,治疗组生存率高于对照组,生存时间长于对照组(P<0.05)。治疗组复发率低于对照组(P<0.05)。结论苦参碱注射液联合化疗治疗中晚期口腔癌疗效确切,能够显著增强机体免疫功能,改善体力状况,延长生存时间并提高生活质量,同时复发率显著低于常规化疗方案。

Objective To investigate the effects of matrine injection combined with chemotherapy on the immune function and prognosis of patients with advanced oral cavity carcinomas.Methods A total of 60 patients with middle and advanced stage mouth cancer were randomly divided into treatment group(n=30)and control group(n=30).The patients in control group were treated by conventional chemotherapy,however,the patients in treatment group,on the basis of control group,were treated by matrine injection,with a treatment course of 12 weeks for both groups.After treatment,lymphocyte subsets,immunoglobulin,serum cytokines,KPS scores,QOL scores,survival rates,survival time and recurrence rate were observed and compared between two groups.Results Before treatment,there were no significant differences in the levels of CD3^+,CD4^+,CD8^+,NK,CD19^+,CD4^+/CD8^+,IgG,IgA,IgM,IL-2,IFN-γ,IL-4,KPS scores and QOL scores between two groups(P>0.05).After treatment,the levels of CD3^+,CD4^+,NK,CD4^+/CD8^+,IgG,IgA,IgM,IL-2,IFN-γ,KPS scores and QOL scores were significantly increased in both groups,however,the levels of CD8^+,CD19^+and IL-4 were significantly decreased(P<0.05).After treatment,the levels of CD3^+,CD4^+,NK,CD4^+/CD8^+,IgG,IgA,IgM,IL-2,IFN-γ,KPS scores and QOL scores in treatment group were significantly higher than those in control group,but the levels of CD8^+,CD19^+and IL-4 were significantly lower than those in control group(P<0.05).The 2-year and 3-year survival rates in treatment group were significantly higher than those in control group(76.67%vs 56.67%and 66.67%vs 46.67%,respectively,P<0.05).Moreover the median survival time in treatment group was significantly longer than that in control group,and the recurrence rate in treatment group was significantly lower than that in control group(10.00%vs 30.00%,P<0.05).Conclusion The matrine injection combined with chemotherapy in treatment of middle and advanced stage mouth cancer can obtain significant therapeutic effects,which can effectively improve the immune function of patients,improve the physical condition and quality of life,prolong survival time,moreover,the recurrence rate is significantly lower than that by conventional chemotherapy.