参麦注射液联合脐疗对恶性肿瘤保守治疗患者细胞角蛋白19片段水平及生存率的影响

Effect of Shenmai Injection Combined with Umbilical Therapy on Cytokeratin-19 Fragment and Survival Rates in Patients with Malignant Tumors Undergoing Expectant Treatment

目的:观察参麦注射液联合脐疗对恶性肿瘤保守治疗患者细胞角蛋白19片段(Cyfra21-1)水平及生存率的影响。方法:选取187例恶性肿瘤患者作为研究对象,按随机数字表法分为对照组92例及研究组95例。对照组保守治疗的同时进行脐疗,研究组在对照组基础上加用参麦注射液。比较2组临床疗效及生存率,比较2组治疗前后细胞因子[γ干扰素(IFN-γ)、白细胞介素-2 (IL-2)、肿瘤坏死因子-α (TNF-α)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、免疫功能指标、血常规指标、脂蛋白相关磷脂酶(Lp-PLA2)、Cyfra21-1、血管内皮生长因子C (VEGF-C)水平、中医证候积分的变化。结果:治疗后,2组IFN-γ、IL-2、TNF-α水平均较治疗前升高,IL-6、IL-10水平均较治疗前下降,差异均有统计学意义(P<0.05);研究组IFN-γ、IL-2、TNF-α水平均高于对照组,IL-6、IL-10水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,2组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高(P<0.05),研究组上述4项水平均高于对照组(P<0.05)。治疗后,2组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均较治疗前升高,CD8^(+)较治疗前下降(P<0.05),研究组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平高于对照组,CD8^(+)水平低于对照组(P<0.05)。治疗后,2组Lp-PLA2、Cyfra21-1、VEGF-C水平均较治疗前下降(P<0.05),研究组上述4项水平均低于对照组(P<0.05)。治疗后,2组中医证候积分均较治疗前下降(P<0.05),研究组低于对照组(P<0.05)。研究组临床疗效总有效率为84.21%,对照组为70.65%,2组比较,差异有统计学意义(P<0.05)。治疗后6个月,研究组生存率高于对照组,差异无统计学意义(P>0.05)。治疗后12个月、18个月、24个月,研究组生存率高于对照组(P<0.05)。结论:参麦注射液联合脐疗能使恶性肿瘤保守治疗患者的免疫功能增强,改善临床症状,提高生存率。

Objective:To observe the effect of Shenmai Injection combined with umbilical therapy on cytokeratin-19 fragment(Cyfra 21-1) and survival rates in patients with malignant tumors undergoing expectant treatment. Methods:A total of 187 cases of patients with malignant tumors were selected as the study subjects and divided into the control group and the study group according to the random number table method,with 92 and 95 cases in each group respectively. The control group was treated with expectant treatment and umbilical therapy,and the study group was additionally treated with Shenmai Injection based on the treatment of the control group. The clinical effects and the survival rates in the two groups were compared. Before and after treatment, the changes in the levels of cytokines including interferon-γ(IFN-γ),interleukin-2(IL-2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6) and interleukin-10(IL-10), immune function indexes, blood routine indexes, lipoprotein associated phospholipase A2(Lp-PLA2), Cyfra21-1, and vascular endothelial growth factor-C(VEGF-C), as well as the traditional Chinese medicine(TCM) syndrome scores were compared between the two groups. Results: After treatment,the levels of IFN-γ,IL-2 and TNF-α in the two groups were increased when compared with those before treatment,and the levels of IL-6 and IL-10 were decreased,differences being significant(P<0.05);the levels of IFN-γ,IL-2 and TNF-α in the study group were higher than those in the control group, and the levels of IL-6 and IL-10 were lower, differences being significant(P<0.05). After treatment, the levels of CD3^(+), CD4^(+), and CD4^(+)/CD8^(+)in the 2 groups were higher and CD8^(+)lower than before treatment(P < 0.05), and the levels of CD3^(+), CD4^(+), and CD4^(+)/CD8^(+)in the study group were higher and CD8^(+)lower than those in the control group(P<0.05). After treatment,the levels of erythrocytes,hemoglobin and leucocytes in the two groups were increased when compared with those before treatment(P<0.05),and the above three levels in the study group were higher than those in the control group(P<0.05). After treatment,the levels of Lp-PLA2,Cyfra21-1 and VEGF-C in the two groups were decreased when compared with those before treatment(P<0.05),and the above four levels in the study group were lower than those in the control group(P<0.05). After treatment,TCM syndrome scores in the two groups were decreased when compared with those before treatment(P<0.05),and the score in the study group was lower than that in the control group(P<0.05). The total effective rate of clinical effect was 84.21% in the study group and 70.65% in the control group, the difference being significant(P<0.05). Six months after treatment,the survival rate in the study group was higher than that in the control group,and there being no significance in the difference(P>0.05). At the twelfth,eighteenth and twenty-fourth months after treatment, the survival rates in the study group were higher than those in the control group(P<0.05).Conclusion: Shenmai Injection combined with umbilical therapy can enhance immune function, and improve clinical symptoms and survival rates of patients with malignant tumors undergoing expectant treatment.