帕博利珠单抗治疗所致免疫相关不良反应与中医体质的相关性研究

Correlation between immune related adverse reactions in patients treated with pembrolizumab and Traditional Chinese Medicine constitution

目的探讨帕博利珠单抗治疗免疫相关不良反应与中医体质之间的相关性。方法选取初次确诊为非小细胞肺癌的患者共110例,在首次接受帕博利珠单抗免疫治疗时采用一般资料调查表、中医体质分类与判定量表及《免疫相关不良反应随访记录册》和患者记录的《自我感受日记》,对患者的中医证候和不良反应进行调查和分析。结果非小细胞肺癌患者中4种中医体质较多:平和质48例(43.64%),偏颇体质中,阳虚质30例(27.27%)、气虚质20例(18.18%)、阴虚质12例(10.91%)。气虚质和阳虚质更容易发生疲乏,阳虚质更易发生皮疹;气虚质和阴虚质更易发生瘙痒;阳虚质更易发生腹泻;平和质的非小细胞肺癌患者不易发生免疫相关不良反应。结论中医体质与irAEs相关,可从中医体质方面预测免疫相关不良反应的发生,早期干预不良反应。

Objective To explore the correlation between the immune related adverse(irAEs)reactions in patients treated with pembrolizumab and traditional Chinese Medicine(TCM)constitution.Methods A total of 110 patients diagnosed with nonsmall cell lung cancer for the first time were selected.When receiving pembrolizumab immunotherapy for the first time,a general information questionnaire,a TCM constitution classification and judgment scale,an immune related adverse reaction follow-up record book,and a patient's self-perception diary were used to investigate and analyze the TCM syndrome and adverse reactions of the patients.Results Among non-small cell lung cancer patients,there were more than four TCM constitutions,with 48 cases(43.64%)having a calm constitution,20 cases(18.18%)having a biased constitution,30 cases(27.27%)having a yang deficiency constitution,and 12 cases(10.91%)having a yin deficiency constitution.Qi deficiency and Yang deficiency were more prone to fatigue,while Yang deficiency was more prone to rash;Qi deficiency and Yin deficiency were more prone to itching;Yang deficiency was more prone to diarrhea;Non-small cell lung cancer patients with mild constitution were less prone to immune related adverse reactions.Conclusion TCM constitution is related to irAEs,which could predict the occurrence of immune related adverse reactions from the perspective of TCM constitution and intervene in adverse reactions early.