还原型谷胱甘肽注射液联合TP方案化疗对晚期恶性肿瘤患者的影响

Effects of Reduced Glutathione Injection Combined with TP Regimen Chemotherapy on Patients with Advanced Malignant Tumor

目的评估还原型谷胱甘肽与多西他赛联合顺铂(TP)方案化学治疗(化疗)对晚期恶性肿瘤患者的疗效、免疫功能及不良反应的影响。方法于2017—2019年招募行TP方案化疗的晚期恶性肿瘤患者共90例,并采用随机数字表法分为对照组30例,治疗组60例;对照组给予TP方案治疗,治疗组加用还原型谷胱甘肽注射液0.9~1.8 g,加入0.9%氯化钠注射液100 m L中静脉滴注,qd,化疗前后用药>1周,以21 d为1个周期,化疗2个周期后比较两组间化疗疗效、免疫功能指标变化及不良反应发生的差异。结果两组间各疗效及疾病控制率比较差异无统计学意义(P>0.05)。在免疫功能方面,与对照组比较,化疗后治疗组CD_(3)^(+)T细胞及CD_(4)^(+)T细胞数量差异无统计学意义(P>0.05),而CD_(8)^(+)T细胞、NK细胞数量及CD_(4)^(+)/CD_(8)^(+)比值变化差异有统计学意义(均P<0.01)。在不良反应方面,与对照组比较,治疗组在骨髓抑制、胃肠道反应方面差异无统计学意义,在神经毒性及肝肾功能异常方面发生率明显降低(P<0.05)。结论对于采用TP方案化疗的晚期恶性肿瘤患者,化疗期间联合使用还原型谷胱甘肽注射液可以改善机体免疫功能、减少化疗相关不良反应发生。

Objective To evaluate the effects of reduced glutathione and docetaxel combined with cisplatin(TP)chemotherapy on efficacy,immune function,and adverse reactions in patients with advanced malignant tumor.Methods A total of 90 patients with advanced malignant tumor who recruited TP chemotherapy from 2017 to 2019,were collected and randomly divided into control group(n=30)and treatment group(n=60).Patients in the control group were treated with TP regimen,and patients in the treatment group were treated with reduced glutathione injection(0.9-1.8 g added to 100 m L of 0.9%sodium chloride injection,intravenous drip,once a day,at least one week before and after chemotherapy),with 21 days as a cycle.After two cycles of chemotherapy,the differences of chemotherapy efficacy,immune function index changes,and adverse reactions between the two groups were compared.Results After 2 cycles of TP chemotherapy,there was no significant difference in efficacy and disease control rate between the two groups(P>0.05).In the aspect of immune function,compared with the control group,there were no significant differences in the number of CD_(3)^(+)T cells and CD_(4)^(+)T cells(P>0.05),but there were significant differences in the number of CD_(8)^(+)T cells and NK cells and the ratio of CD_(4)^(+)/CD_(8)^(+)in the treatment group after chemotherapy(all P<0.01).In terms of adverse reactions,compared with the control group,there were no significant statistical differences in myelosuppression and gastrointestinal reactions in the treatment group,and the incidences of neurotoxicity and abnormal liver and kidney function in the treatment group were significantly reduced(P<0.05).Conclusion Combined with reduced glutathione and TP chemotherapy in patients with advanced cancer can improve the immune function and reduce the occurrence of chemotherapy-related adverse reactions.