肺康方对肺癌化疗患者造血功能、免疫功能及肿瘤标志物的影响

Effect of Feikang prescription on hematopoietic function,immune function and tumor markers in patients with lung cancer undergoing chemotherapy

目的:观察肺康方对肺癌化疗患者造血功能、免疫功能及肿瘤标志物的影响。方法:将131例纳入研究的肺癌化疗患者随机分为观察组(64例)和对照组(67例)。对照组给予包括化疗在内的西医常规治疗,观察组在对照组的基础上给予中药肺康方。治疗2个化疗周期(42 d),对比两组患者的化疗有效率,并观察两组患者的造血功能[外周血白细胞计数(White Blood Cell Count,WBC)、血红蛋白(Hemoglobin,HGB)、中性粒细胞(Neutrophil,NC)、血小板计数(Platelet,PLT)]、免疫功能[自然杀伤细胞(Natural Killer Cell,NK)、辅助性T细胞(T helper Cell 17,Th17)、调节性T细胞(Regulatory cells,Treg)及Th17/Treg]以及肿瘤相关抗原[鳞状细胞癌相关抗原(Squamous Cell Careinoma Antigen,SCC)、细胞角蛋白19片段(Cytokeratin-19-fragment,CY21-1)及神经元特异性烯醇化酶(Neuron-specific Enolase,NSE)]的变化,并观察不良反应发生情况。结果:①疗效比较:观察组临床控制率(DCR)为86.6%高于对照组65.6%,差异有统计学意义(P<0.05)。②造血功能比较:两组造血功能指标WBC、HGB、NC及PLT水平不同(F分组=14.376、16.019、21.431、24.826,P<0.05),两组指标各时间点水平不同(F时间=11.956、13.643、17.772、19.478,P<0.05),两组指标变化趋势存在差异(F交互=10.829、11.684、14.805、17.368,P<0.05)。③免疫功能比较:两组免疫功能指标NK、Th17、Treg和Th17/Treg水平不同(F分组=11.309、14.276、9.343、15.920,P<0.05),两组指标各时间点水平不同(F时间=9.487、12.851、8.825、13.274,P<0.05),两组指标变化趋势差异具有统计学意义(F交互=7.965、10.573、7.038、11.539,P<0.05)。④肿瘤相关抗原比较:两组肿瘤相关抗原SCC、CY21-1、NSE水平不同(F分组=15.337、15.628、21.389,P<0.05),两组指标各时间点水平不同(F时间=13.843、13.581、17.945,P<0.05),两组指标变化趋势比较,差异具有统计学意义(F交互=11.238、11.774、14.067,P<0.05)。⑤不良反应比较:观察组骨髓抑制39例、胃肠道反应32例、肝肾功能异常28例,对照组则分别为:21例、18例、19例,差异有统计学意义(P<0.05),其他不良反应比较,差异无统计学意义(P>0.05)。结论:肺康方可明显提高肺癌化疗患者临床控制率,可明显改善造血功能和免疫功能,可降低肿瘤相关抗原水平,且有缓解不良反应的作用。

Objective:To observe the effect of Feikang prescription(肺康方)on hematopoietic function,immune function and tumor markers in patients with lung cancer undergoing chemotherapy.Methods:131 cases of lung cancers patients with chemotherapy were randomly divided into the control group(64 cases)and the observation group(67 cases).The control group was given routine western medicine treatment including chemotherapy,while the observation group was given Feikang prescription on the basis of the treatment of the control group.After 2 cycles of chemotherapy(42D),the effective rate of chemotherapy was compared between the two groups.Hematopoietic function[peripheral blood white blood cell(WBC)count,hemoglobin(HGB),neutrophil(NC),platelet(PLT)count],immune function[natural killer(NK)cell,helper T cell(Th17),regulatory T cells(Treg)and Th17/Treg,as well as tumor associated antigens(SCC),cytokeratin 19 fragment(CY21-1)and neuron specific enolase(NSE)),and the occurrence of adverse reactions were observed.Results:①Comparison of effectiveness:The clinical control rate(DCR)of the observation group was 86.6%,which was higher than that of the control group,65.6%,the difference was statistically significant(P<0.05).②Hematopoiesis comparison:There were significant differences in WBC,Hb,NC and PLT between the two groups(F group=14.376,16.019,21.431 and 24.826,P<0.05).All indexes of the two groups were different at different time points(F group time=11.956,13.643,17.772 and 19.478,P<0.05),and trend of change showed significant differences(F interaction=10.829,11.684,14.805 and 17.368,P<0.05);③Comparison of immune function:There were significant differences in NK,Th17,Treg and Th17/Treg between the two groups(F group=11.309,14.276,9.343 and 15.920,P<0.05).All indexes of the two groups were different at different time points(F group time=9.487,12.851,8.825 and 13.274,P<0.05,and trend of change showed significant differences(Finteraction=7.965,10.573,7.038 and 11.539,P<0.05);④Comparison of tumor associated antigens:The levels of SCC,CY21-1 and NSE were different between the two groups(F group=15.337,15.628 and 21.389,P<0.05).All indexes of the two groups were different at different time points(Ftime=13.843,13.581 and 17.945,P<0.05),and trend of change showed significant differences(Finteraction=11.238,11.774 and 14.067,P<0.05)⑤Comparison of adverse reactions:In the observation group,there were 39 cases of myelosuppression,32 cases of gastrointestinal reaction and 28 cases of abnormal liver and kidney function,and 21 cases,18 cases and 19 cases respectively in the control group,which was with significant differences(P<0.05).Other adverse reactions were not statistically significant between the two groups(P>0.05).Conclusion:Feikang prescription can significantly improve the clinical control rate of lung cancer patients with chemotherapy,improve the hematopoietic function and immune function,reduce the level of tumor-related antigen,and alleviate adverse reactions.