二陈汤加减联合微波消融术对晚期非小细胞肺癌患者Th17/Treg失衡和血管生成因子的影响

Effect of Modified Erchen Decoction Combined with Microwave Ablation on Th17/Treg Imbalance and Angiogenic Factors in Patients with Advanced Non-small Cell Lung Cancer

目的:探讨二陈汤加减联合微波消融术(MWA)对晚期非小细胞肺癌(NSCLC)患者辅助性T细胞17(Th17)/调节性T细胞(Treg)失衡和血管生成因子的影响。方法:选择2020年9月~2022年9月期间我院收治的120例不可或不愿手术切除或体部立体定向放疗的ⅢB-Ⅳ期并同意MWA治疗的NSCLC患者。采用随机对照的方法将所有患者分为观察组(二陈汤加减联合MWA治疗,60例)及对照组(MWA治疗,60例)。对比两组中医主要证候总评分、EORTC生命质量测定量表(EORTC QLQ-C30)评分、Th17/Treg失衡、血清肿瘤标志物、血管生成因子和不良反应发生率。结果:治疗后,观察组中医主要证候总评分、EORTC QLQC30评分低于对照组(P<0.05)。治疗后,观察组Th17细胞比例、Treg细胞比例低于对照组,Th17/Treg比值高于对照组(P<0.05)。治疗后,观察组癌胚抗原(CEA)、鳞状细胞癌相关抗原(SCC-Ag)和角化素蛋白片段19(Cyfra21-1)低于对照组(P<0.05)。治疗后,观察组血管内皮生长因子(VEGF)和碱性成纤维细胞生长因子(bFGF)低于对照组(P<0.05)。两组不良反应发生率组间对比未见差异(P>0.05)。结论:二陈汤加减联合MWA对晚期NSCLC患者,可有效降低血清肿瘤标志物水平,促进临床症状改善,调节Th17/Treg比例失衡和血管生成因子。

Objective:To explore the Effect of modified erchen decoction combined with microwave ablation(MWA)on T helper cell 17(Th17)/regulatory T cell(Treg)imbalance and angiogenic factors in patients with advanced non-small cell lung cancer(NSCLC).Methods:120 patients with stage ⅢB-Ⅳ NSCLC who were unable or unwilling to undergo surgical resection or stereotactic radiotherapy and agreed to MWA treatment in our hospital from September 2020 to September 2022 were selected.All patients were divided into observation group(modified erchen decoction combined with MWA treatment,60 cases)and control group(MWA treatment,60 cases)by randomized controlled method.Total score of main syndromes in traditional chinese medicine,EORTC quality of life measurement scale(EORTC QLQ-C30)score,Th17/Treg imbalance,serum tumor markers,angiogenic factors and incidence of adverse reactions were compared between two groups.Results:After treatment,the total score of main syndromes in traditional chinese medicine and EORTC QLQ-C30 score in observation group were lower than those in control group(P<0.05).After treatment,the proportion of Th17 cells and Treg cells in observation group were lower than those in control group,the ratio of Th17/Treg was higher than that in control group(P<0.05).After treatment,the carcinoembryonic antigen(CEA),squamous cell carcinoma-associated antigen(SCC-Ag)and keratin protein fragment 19(Cyfra21-1)in observation group were lower than those in control group(P<0.05).After treatment,the levels of vascular endothelial growth factor(VEGF)and basic fibroblast growth factor(bFGF)in observation group were lower than those in control group(P<0.05).There was no difference in the incidence of adverse reactions between two groups(P>0.05).Conclusion:Modified erchen decoction combine with MWA for patients with advanced NSCLC,which can effectively reduce the level of serum tumor markers,promote the improvement of clinical symptoms,and regulate Th17/Treg imbalance and angiogenic factors.