补中益气汤加减对非小细胞肺癌术后化疗患者VEGF,IGF-1,TGF-β1,免疫功能的影响及安全性分析

Effect and Safety of Modified Buzhong Yiqitang on VEGF,IGF-1,TGF-β,and Immune Function in Postoperative Patients with Non-small Cell Lung Cancer After Chemotherapy

目的:探讨补中益气汤加减在非小细胞肺癌术后化疗患者(肺脾气虚型)治疗中的应用价值,观察其对抗肿瘤血管生成、免疫功能、肿瘤指标、肺功能指标的影响。方法:选取2018年3月至2020年2月于昆明市中医医院就诊的96例非小细胞肺癌术后化疗患者,入组时用随机数字表法分组。对照组48例单纯西医治疗,观察组48例则联合补中益气汤加减口服治疗,治疗结束后比较疗效。结果:治疗后观察组血清癌胚抗原(CEA),细胞角蛋白19片段21-1(CYFRA21-1)水平低于对照组,差异具有统计学意义(P<0.05);治疗后观察组血清胰岛素样生长因子-1(IGF-1),血管内皮生长因子(VEGF),转化生长因子-β1(TGF-β1)均低于对照组,差异具有统计学意义(P<0.05);治疗后观察组血清CD4+/CD8+,CD4+细胞及免疫球蛋白G(Ig G)水平大于对照组,差异具有统计学意义(P<0.05);治疗后观察组肺功能指标第1秒用力呼吸容积FEV1,FEV1/用力肺活量(FVC),均大于对照组(P<0.05);观察组总有效率56.25%(27/48),对照组35.42%(17/48),差异具有统计学意义(χ^(2)=4.191,P<0.05);不良反应比较,观察组骨髓抑制(χ^(2)=4.002)、胃肠道反应(χ^(2)=7.069)、肝肾功能损伤(χ^(2)=5.151)发生率低于对照组(P<0.05)。结论:对于非小细胞肺癌术后化疗患者(肺脾气虚型)而言联合补中益气汤加减可改善免疫功能,促进肺功能恢复,提高临床疗效,降低化疗不良反应发生率。

Objective:To explore the application value of modified Buzhong Yiqitang(BZYQT)in the treatment of postoperative patients with non-small cell lung cancer(Qi deficiency in lung and spleen)after chemotherapy,and to observe its effect on tumor angiogenesis,immune function,tumor indicators,and lung function indicators.Method:Ninety-six patients who were treated in the Kunming municipal hospital of traditional Chinese medicine from March 2018 to February 2020 due to postoperative chemotherapy for nonsmall cell lung cancer were selected and assigned into a control group(n=48,western medicine)and an observation group(n=48,western medicine+modified BZYQT)by the random number table.The curative efficacies were compared after the treatment.Result:After treatment,the serum levels of carcinoembryonic antigen(CEA),cytokeratin 19 fragment 21-1(CYFRA21-1),serum insulin-like growth factor-1(IGF-1),vascular endothelial growth factor(VEGF),and transforming growth factor(TGF)-β1 in the observation group were lower than those in the control group(P<0.05),while the serum CD4+/CD8+,CD4+cells,immunoglobulin G(Ig G)levels,forced expiratory volume in one second(FEV1),and FEV1/forced vital capacity(FVC)in the observation group were higher than those in the control group(P<0.05).A significant difference was observed in the total response rate between the observation group[56.25%(27/48)]and the control group[35.42%(17/48)](χ^(2)=4.191,P<0.05).For adverse reactions,the incidence of bone marrow suppression(χ^(2)=4.002),gastrointestinal reaction(χ^(2)=7.069),and hepatic and renal injury(χ^(2)=5.151)was lower in the observation group than in the control group(P<0.05).Conclusion:For postoperative patients with non-small cell lung cancer(Qi deficiency in lung and spleen)after chemotherapy,western medicine combined with modified BZYQT could ameliorate immune function,promote pulmonary function recovery,improve clinical efficacy,and reduce the incidence of adverse reactions.