石龙解毒方治疗弥漫大B细胞淋巴瘤患者的临床疗效及机制

Clinical efficacy and mechanism of Shilong Jiedu decoction in the treatment of diffuse large B-cell lymphoma

目的观察石龙解毒方治疗弥漫大B细胞淋巴瘤患者的临床疗效并探讨其可能的作用机制。方法将2016年5月—2018年5月于河北省中医院血液科治疗的72例确诊弥漫大B细胞淋巴瘤患者随机分成观察组与对照组,每组36例,对照组给予R-CHOP方案(利妥昔单抗、环磷酰胺、硫酸长春新碱、盐酸多柔比星、醋酸泼尼松片)化疗,观察组在给予对照组相同化疗方案同时口服石龙解毒方,2组均以21 d为1个疗程,连续治疗6个疗程。观察2组治疗总有效率、体力恢复情况,检测2组治疗前后血常规、T淋巴细胞亚群,记录2组中医症状(神疲乏力、腰膝酸软、盗汗、发热)持续时间。结果2组患者治疗6个疗程后治疗总有效率比较差异无统计学意义( 2=0.50,P>0.05);观察组患者治疗6个疗程后体力提高率明显高于对照组( 2=5.56,P<0.05)。治疗后,2组白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(Plt)均较治疗前明显降低(P均<0.05),但观察组治疗后Hb、Plt均明显高于对照组(P均<0.05);治疗后,2组CD3+、CD4+较治疗前明显增高(P均<0.05),且观察组明显高于对照组(P均<0.05);观察组神疲乏力、腰膝酸软、盗汗、发热持续时间均明显短于对照组(P均<0.05)。结论石龙解毒方可以促进弥漫大B细胞淋巴瘤患者R-CHOP方案化疗后的体力恢复,抑制Hb、Plt下降,缩短中医症状持续时间,其机制可能与促进骨髓造血、调节机体免疫功能、加强化疗药物抗肿瘤作用有关。

Objective It is to observe the clinical efficacy of Shilong Jiedu decoction in the treatment of diffuse large B-cell lymphoma and explore its possible mechanism.Methods 72 patients with diffuse large B-cell lymphoma treated in the department of hematology of Hebei Hospital of Traditional Chinese Medicine from May 2016 to May 2018 were randomly divided into observation group and treatment group,36 cases in each group.The observation group was treated with chemotherapy of R-CHOP regimen(toximab,cyclophosphamide,vincristine sulfate,doxorubicin hydrochloride,prednisone acetate tablets),while the treatment group was given the same chemotherapy regimen and given Shilong Jiedu decoction by oral administration.21 days as a course of treatment,and both groups were treated for 6 courses.The total treatment efficiency and physical recovery of the two groups were observed,the blood routine and T lymphocyte subsets before and after treatment were detected in the two groups,and the duration of the symptoms of traditional Chinese medicine(splenic fatigue,waist and knee weakness,night sweats,fever)were recorded in the two groups.Results There was no significant difference in the total effective rate of treatment between the two groups after 6 courses of treatment( 2=0.50,P>0.05);the improvement rate of the physical strength of the observation group after 6 courses of treatment was significantly higher than that of the control group( 2=5.56,P<0.05).After treatment,the white blood cell count(WBC),hemoglobin(Hb),and platelet count(Plt)of the two groups were significantly lower than those before treatment(all P<0.05),but Hb and Plt were significantly higher in the observation group after treatment than the control group(P<0.05);after treatment,the CD3+and CD4+of the two groups were significantly higher than those before treatment(P<0.05),and the observation group was significantly higher than the control group(P<0.05).The duration of splenic fatigue,waist and knee weakness,night sweats,fever of the observation group were significantly shorter than those of the control group(P<0.05).Conclusion Shilong Jiedu decoction can promote the physical recovery,inhibit the decline of Hb and Plt,and shorten the duration of symptoms of traditional Chinese medicine in patients with diffuse large B-cell lymphoma after R-CHOP chemotherapy.The mechanism may be related to promoting bone marrow hematopoiesis,regulating immune function,strengthen the anti-tumor effect of chemotherapy drugs.