益胃消癌方配合紫杉醇酯质体对晚期胃癌T淋巴细胞亚群及血清DKK-1、miR-21、AFP的影响

Effect of Yiwei Xiaoai Formula(益胃消癌方)Combined with Paclitaxel Liposome on T Lymphocyte Subsets and DKK-1,miR-21 and AFP in Serum of Patients with Advanced Gastric Cancer

目的研究益胃消癌方配合紫杉醇酯质体对晚期胃癌患者T淋巴细胞亚群及血清Dickkopf-1(DKK-1)蛋白、miR-21、甲胎蛋白(AFP)的影响。方法选择2014年3月—2020年3月医院66例晚期胃癌患者按照抽签法分为研究组和对照组各33例,对照组采用紫杉醇脂质体治疗,研究组采用益胃消癌方配合紫杉醇脂质体治疗。比较治疗后近期治疗效果,KS评分对比,不良反应发生率,治疗前后红细胞计数、白细胞计数、血小板计数、血红蛋白指标、癌胚抗原水平、T淋巴细胞亚群、DKK-1、miR-21、AFP水平变化。结果研究组缓解率为63.63%(21/33),明显高于对照组[36.36%(12/33)](P<0.05);研究组红细胞计数、白细胞计数、血小板计数、血红蛋白指标、癌胚抗原水平[(3.51±0.15)×10^(12)/L,(5.12±0.35)×10^(9)/L,(166.51±8.42)×10^(9)/L,(112.50±8.47)g/L,(20.01±1.26)ng/mL]均明显低于对照组的[(3.40±0.23)×10^(12)/L,(4.70±0.31)×10^(9)/L,(152.08±7.61)×10^(9)/L,(108.56±7.58)g/L,(26.03±2.85)ng/mL],差异有统计学意义(P<0.05);研究组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平[(63.98±2.49)%,(37.57±3.49)%,(1.62±0.23)]均明显高于对照组[(52.81±1.45)%,(30.89±1.42)%,(1.13±0.12)],差异有统计学意义(P<0.05);研究组DKK-1、miR-21、AFP水平[(31.50±6.87)pg/mL,(1.50±0.31)%,(5.56±1.23)ng/mL]均明显低于对照组[(53.71±8.26)pg/mL,(2.37±0.62),(8.65±1.80)ng/mL],差异有统计学意义(P<0.05);研究组KS评分提高率60.60%(20/33),明显高于对照组36.36%(12/33),研究组的降低率18.18%(6/33),明显低于对照组45.45%(15/33),差异有统计学意义(P<0.05);研究组不良反应发生率为9.09%(3/33),明显低于对照组45.45%(15/33),差异有统计学意义(P<0.05)。结论益胃消癌方配合紫杉醇酯质体能够有效提高晚期胃癌患者T淋巴细胞亚群表达,改善免疫功能,降低血清DKK-1、miR-21、AFP水平,抑制肿瘤病灶生长,减少不良反应。

Objective To study the effect of Yiwei Xiaoai Formula(益胃消癌方)combined with paclitaxel liposome on T lym-phocyte subsets and levels of DKK-1,miR-21 and AFP in serum of patients with advanced gastric cancer.Methods Sixty-six patients with advanced gastric cancer who received treatment in the hospital from March 2014 to March 2020 were selected for this study.According to the method of drawing lots,they were divided into the study group and the control group with 33 cases in each group.The control group was treated with liposomal paclitaxel.The study group was treated with Yiwei Xiaoai Formula com-bined with paclitaxel liposome.The short-term therapeutic effect,KS score,incidence of side effects,red blood cell count,white blood cell count,platelet count,hemoglobin index,carcinoembryonic antigen level,T lymphocyte subsets,the levels of DKK-1,miR-21 and AFP before and after treatment were compared.Results The remission rate of the study group was 63.63%(21/33),significantly higher than the control group(36.36%,12/33)and the difference was statistically significant(P<0.05).The red blood cell count[(3.51±0.15)×10^(12)/L],white blood cell count[(5.12±0.35)×10^(9)/L],platelet count[(166.51±8.42)×10^(9)/L],hemoglobin index[(112.50±8.47)g/L],carcinoembryonic antigen level[(20.01±1.26)ng/mL]of the study group were significantly lower than those of the control group[(3.40±0.23)×10^(12)/L,(4.70±0.31)×10^(9)/L,(152.08±7.61)×10^(9)/L,(108.56±7.58)g/L,(26.03±2.85)ng/mL]and the difference was statistically significant(P<0.05).The levels of CD_(3)^(+)[(63.98±2.49)%],CD_(4)^(+)[(37.57±3.49)%]and CD_(4)^(+)/CD_(8)^(+)(1.62±0.23)in the study group were significantly higher than those of the control group[(52.81±1.45)%,(30.89±1.42)%,(1.13±0.12)]and the differ-ence was statistically significant(P<0.05).The levels of DKK-1[(31.50±6.87)pg/mL],miR-21(1.50±0.31)%and AFP[(5.56±1.23)ng/mL]of the study group were were significantly lower than those of the control group[(53.71±8.26)pg/mL,(2.37±0.62)%,(8.65±1.80)ng/mL]and the difference was statistically significant(P<0.05).The improvement rate of KS score in the study group was 60.60%(20/33),which was significantly higher than 36.36%(12/33)in the control group,and the reduction rate of KS score in the study group was 18.18%(6/33),which was significantly lower than 45.45%(15/33)in the control group and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was 9.09%(3/33),which was significantly lower than 45.45%(15/33)in the control group and the difference was statistically significant(P<0.05).Conclusion Yiwei Xiaoai Formula combined with paclitaxel liposome can effectively im-prove the expressions of T lymphocyte subsets in patients with advanced gastric cancer,improve the immune function,reduce the levels of DKK-1,miR-21 and AFP in serum,inhibit the growth of tumor lesions and reduce toxic and side effects.