针灸联合放化疗治疗鼻咽癌效果及对患者VEGF、TGF-β1和免疫功能的影响

Effect of acupuncture combined with radiochemotherapy on VEGF,TGF-β1 and immune function in patients with nasopharyngeal carcinoma

目的探讨针灸联合放化疗治疗气血亏虚型鼻咽癌的效果及对其血清中血管内皮生长因子(VEGF)、转化生长因子β1(TGF-β1)和免疫功能的影响。方法选择中医证型属于气血亏虚型的89例鼻咽癌患者,按照随机数字表法分成两组。对照组45例单纯采用放化疗,观察组44例则联合针灸治疗,治疗7周后比较临床疗效,以及治疗前后的VEGF、TGF-β1和免疫功能的变化。结果观察组治疗后CD^4+、CD^3+、CD^4+/CD^8+均高于对照组,基质金属蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平均低于对照组(t分别=9.16、11.24、7.31、11.36、8.21,P均<0.05);观察组治疗后TGF-β1水平低于对照组,Karnofsky功能状态评分(KPS)高于对照组(t分别=13.81、10.38,P均<0.05);观察组总有效率93.18%高于对照组73.33%,差异有统计学意义(χ^2=6.25,P<0.05);观察组治疗后1年、2年及3年生存率均高于对照组(χ^2分别=4.89、4.05、4.45,P均<0.05);观察组口腔黏膜反应、食少纳呆、骨髓抑制、肝功能损伤、周围神经损伤等不良反应发生率均低于对照组,差异均有统计学意义(χ^2分别=9.08、21.21、6.25、4.78、5.64,P均<0.05)。结论针灸联合放化疗治疗气血亏虚型鼻咽癌效果明显,可抑制新生血管再生,提高免疫力,预防放化疗不良反应。

Objective To investigate the effect of acupuncture combined with radiochemotherapy on serum vascular endothelial growth factor(VEGF),transforming growth factor β1(TGF-β1)and immune function in patients with qi-blood deficiency nasopharyngeal carcinoma.Methods Eighty-nine patients with nasopharyngeal carcinoma with qi-blood deficiency type were selected and divided into two groups according to the random number table method.The 45 patients in the control group were treated with radiotherapy and chemotherapy,and the 44 patients in the observation group were treated with acupuncture based on radiochemotherapy.The clinical efficacy after 7 weeks of treatment was compared,and the changes of VEGF,TGF-β1 and immune function before and after treatment were compared too.Results The levels of CD^4+,CD^3+,CD^4+/CD^8+ in the observation group were higher than those in the control group,while the levels of matrix met alloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)were lower than those in the control group(t=9.16,11.24,7.31,11.36,8.21,P<0.05).The level of TGF-β1 in the observation group after treatment was lower than that in the control group,and the karnofsky performance status(KPS)was higher than that in the control group(t=13.81,10.38,P<0.05).The total effective rate in the observation group was 93.18%,which was higher than that in the control group(73.33%)(χ^2=6.25,P<0.05).The 1 year,2 years,and 3 years survival rate in the observation group were higher than those in the control group(χ^2=4.89,4.05,4.45,P<0.05).The incidence of adverse reactions such as oral mucosal reaction,osteopenia,bone marrow suppression,liver injury,and peripheral nerve injury in the observation group were lower than those in the control group(χ^2=9.08,21.21,6.25,4.78,5.64,P<0.05).Conclusion Acupuncture combined with radiochemotherapy has a significant effect on qi-blood deficiency nasopharyngeal carcinoma,which can inhibit the regeneration of new blood vessels,improve immunity,and prevent adverse reactions.