Ⅲ/Ⅳ期非小细胞肺癌中医证型与淋巴细胞亚群、生化指标的相关性分析

Correlation analysis of traditional Chinese medicine syndrome type, lymphocyte subsets, and biochemical indexes of stage Ⅲ/Ⅳ non-small cell lung cancer

目的 探索Ⅲ/Ⅳ期非小细胞肺癌(NSCLC)患者中医证型与淋巴细胞亚群、生化指标的相关性。方法 选取2020年11月至2022年2月就诊于北京中医药大学东方医院的Ⅲ/Ⅳ期NSCLC患者153例,其中肺脾气虚证45例,肺阴虚证33例,痰瘀互结证75例,比较不同中医证型患者淋巴细胞亚群及生化指标的差异,采用多分类logistic回归模型分析中医证型与淋巴细胞亚群、生化指标的相关性。结果 不同中医证型Ⅲ/Ⅳ期NSCLC患者CD4+、CD8+、CD4+/CD8+、自然杀伤细胞、总胆红素、肌酐、低密度脂蛋白胆固醇比较,差异有统计学意义(P<0.05)。多分类logistic回归模型分析结果显示,Ⅲ/Ⅳ期NSCLC肺脾气虚证患者与痰瘀互结证比较,CD4+(OR=0.885,95%CI:0.808~0.970)、自然杀伤细胞(OR=0.918,95%CI:0.850~0.991)、总胆红素(OR=0.885,95%CI:0.814~0.962)越低,越可能为肺脾气虚证(P<0.05)。Ⅲ/Ⅳ期NSCLC肺阴虚证患者与痰瘀互结证比较,CD4+(OR=0.824,95%CI:0.733~0.925)越低,越可能为肺阴虚证(P<0.05)。结论 Ⅲ/Ⅳ期NSCLC患者中CD4+、自然杀伤细胞、总胆红素水平与中医证型有关,临床可据此辅助辨证分型。

Objective To explore the correlation between traditional Chinese medicine syndrome type,lymphocyte subsets,and biochemical indexes in patients with stageⅢ/Ⅳnon-small cell lung cancer(NSCLC).Methods From November 2020 to February 2022,153 patients with stageⅢ/ⅣNSCLC admitted to Dongfang Hospital,Beijing University of Chinese Medicine were selected,including 45 patients with spleen-lung qi deficiency pattern,33 patients with syndrome of deficiency of lung yin,and 75 patients with syndrome of intermin-gled phlegm and blood stasis.The differences of lymphocyte subsets and biochemical indexes in patients with different traditional Chinese medicine syndrome types were compared.Multiple logistic regression model was used to analyze the correlation between traditional Chinese medicine syndrome types,lymphocyte subsets,and biochemical indexes.Results There were significant differences in CD4+,CD8+,CD4+/CD8+,natural killer cells,total bilirubin,creatinine,and low density lipoprotein-cholesterol among patients with different traditional Chinese medicine syndrome types in stageⅢ/ⅣNSCLC(P<0.05).The results of multiple logistic regression model analysis showed that stageⅢ/ⅣNSCLC patients with spleen-lung qi deficiency pattern compared with syndrome of intermin-gled phlegm and blood stasis,the lower CD4+(OR=0.885,95%CI:0.808-0.970),natural killer cells(OR=0.918,95%CI:0.850-0.991),and total bilirubin(OR=0.885,95%CI:0.814-0.962),the more likely it was spleen-lung qi deficiency pattern(P<0.05).In stageⅢ/ⅣNSCLC patients with syndrome of deficiency of lung yin compared with syndrome of intermin-gled phlegm and blood stasis,the lower CD4+(OR=0.824,95%CI:0.733-0.925),the more likely it was syndrome of deficiency of lung yin(P<0.05).Conclusion The levels of CD4+,natural killer cells,and total bilirubin in patients with stageⅡ/ⅣNSCLC are related to traditional Chinese medicine syndrome types,which can be used to assist syndrome differentiation.