散纤颗粒对亚厘米肺结节的临床疗效及免疫炎症影响

Clinical efficacy and influence of immunity and inflammation of Sanxian Granules on subcentimeter pulmonary nodules

目的探讨散纤颗粒治疗肺脾两虚夹痰瘀型亚厘米肺结节的临床疗效及对患者免疫炎症水平的影响。方法选取2022年3月—2023年3月在本院全科医学科门诊确诊的60例中医辨证为肺脾气虚兼痰瘀证的肺亚厘米结节患者,分为治疗组和对照组,每组30例。治疗组口服散纤颗粒治疗3个月,对照组定期随访,对比治疗前后影像学肺结节最大直径、肺结节危险程度分级、中医证候评分及血清炎症因子、免疫指标水平的变化。结果治疗后治疗组咯痰、胸闷、气短、乏力、纳差等多个中医症状评分降低、肺结节最大直径缩小,结节数量减少且低危结节比例增加,IL-6、TNF-α、CD4+T淋巴细胞水平降低,IgG及IgA水平上升(均P<0.05);IL-2、IL-8、IgM、CD3+T细胞、CD8+T及CD4+/CD8+水平变化差异无统计学意义(P>0.05);对照组肺结节最大径较试验前增大,差异有统计学意义(P<0.05),其余数据差异均无统计学意义(P>0.05);治疗组观察指标变化均优于对照组(均P<0.05)。结论散纤颗粒能在一定程度上改善亚厘米肺结节患者的症状、缩小肺结节并降低危险程度,并可能对机体的免疫调节产生一定影响,但仍需大样本研究及相关机制研究以获取此免疫调节作用与其临床疗效关系的更多证据。

Objective Evaluate the clinical efficacy of Sanxian granules in the treatment of subcentimeter pulmonary nodules and its impact on immune response and inflammation levels in patients.Methods A total of 60 patients were randomly assigned to two groups.The treatment group received Sanxian Granules for a duration of 3 months,while the control group underwent regular follow-up.Changes in maximum diameter of pulmonary nodules on imaging,risk grade classification,TCM syndrome score,serum inflammatory factor levels,and humoral immunity index levels before and after treatment were compared between the two groups.Results In treatment group,the scores of multiple TCM symptoms such as expectoration,chest tightness,shortness of breath,fatigue,and poor appetite were decreased,the maximum diameter and the number of lung nodules was reduced,as well as the proportion of low-risk nodules was increased.Additionally,the levels of IL-6,TNF-αand CD4+T lymphocytes were decreased while the levels of IgG and IgA were increased.However,the levels of IL-2,IL-8,IgM,CD3+T cells,CD8+T cells and CD4+/CD8+did not change significantly.Most changes in data from the control group did not show statistical significance.Observation indexes showed more favorable changes in the treatment group compared to the control group.Conclusion As for patients with subcentimeter lung nodules,treatment for taking Sanxian granules can relieve symptoms,reduce nodule diameter as well as risk level.Besides,Sanxian granules may have an effect on immune regulation,but large sample studies and related mechanism studies are still needed to obtain more evidence on the relationship between its immunomodulatory effect and clinical efficacy.