脾肾双补法中药对Ⅳ期非小细胞肺癌伴恶病质患者细胞因子和营养状态的影响

Effects of Chinese medicine for tonifying spleen and kidney on the cytokines and nutritional status of patients with stage Ⅳ non-small cell lung cancer complicated with cachexia

目的观察脾肾双补法中药治疗Ⅳ期非小细胞肺癌伴恶病质患者疗效及对细胞因子和营养状态的影响。方法 2016年6月~2018年6月收集Ⅳ期非小细胞肺癌伴恶病质患者84例,随机分为两组,对照组42例给予甲地孕酮片口服,治疗组42例给予脾肾双补法为组方原则的中药汤剂口服,检测两组患者治疗前、治疗后14 d和28 d的血清中恶病质相关细胞因子(白介素-1、白介素-6和肿瘤坏死因子-α)变化,并同期观察患者营养状态变化,包括体重指数、血清白蛋白、食欲和进食量、KPS评分、中医临床证候积分。结果组内对比,治疗组恶病质相关细胞因子水平在治疗后呈逐步下降,营养状态在治疗后均逐步明显改善;对照组恶病质相关细胞因子水平在治疗后有部分下降趋势,营养状态部分改善,血清白蛋白水平无明显变化,KPS评分有所下降。组间对比,治疗组恶病质相关细胞因子水平均明显低于对照组同时间段水平,治疗组降低趋势更明显。治疗组营养状态改善程度对比同时间段对照组改善更明显。结论脾肾双补法中药治疗Ⅳ期非小细胞肺癌伴恶病质患者可有效降低恶病质相关细胞因子水平,改善营养状态,提高生活质量。

Objective To observe the efficacy of Chinese medicine for tonifying spleen and kidney in the treatment of stage Ⅳ non-small cell lung cancer complicated with cachexia and its effect on cytokines and nutritional status.Methods From June 2016 to June 2018, 84 patients with stage Ⅳ non-small cell lung cancer complicated with cachexia were collected and randomly divided into two groups. In the control group, 42 patients were given megestrol tablets orally. In the treatment group, 42 patients were given oral administration of Chinese medicine recipe with the prescription principle of tonifying spleen and kidney. Changes in serum cachexia-associated cytokines(interleukin-1,interleukin-6 and tumor necrosis factor-α) were measured in the two groups before treatment, 14 days and 28 days after treatment. At the same time, the changes in nutritional status of the patients was observed, including body mass index,serum albumin, appetite and food intake, KPS score, and TCM clinical syndrome scores. Results In the comparison within groups, the levels of cachexia-associated cytokines in the treatment group were decreased gradually after treatment, and the nutritional status was gradually improved after treatment;the levels of cachexia-associated cytokines in the control group showed a trend of partial decrease after treatment, and the nutritional status was improved partially.Serum albumin levels were not significantly different, and the KPS score was decreased. In the comparison between groups, the levels of cachexia-associated cytokines in the treatment group were significantly lower than those in the control group, and the treatment group was in a more obvious trend of decreasing. The improvement of nutritional status in the treatment group was more obvious than that in the control group at the same time. Conclusion Chinese medicine for tonifying spleen and kidney can effectively reduce the levels of cachexia-associated cytokines, improve nutritional status and improve quality of life in the patients with stage Ⅳ non-small cell lung cancer complicated with cachexia.