参苓白术散对肿瘤恶病质患者TNF-α、TWEAK、Fn14表达的影响

Effect of Shenlingbaizhu powder on the expression of TNF-α,TWEAK and Fn14 in patients with tumor cachexia

目的:观察参苓白术散对肿瘤恶病质患者血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、肿瘤坏死因子弱凋亡诱导剂(tumor necrosis factor-like weak inducer of apoptosis,TWEAK)、成纤维细胞生长诱导因子-14(fibroblast growth factor-inducible 14,Fn14)表达的影响。方法:将64例诊断符合肿瘤恶病质,辨证属于脾气虚证患者,随机分为2组。对照组32例,予以复方氨基酸等营养支持治疗;治疗组32例,在营养支持治疗基础上加用参苓白术散汤剂,水煎服,每日1剂,分3次温服,共用4周。观察治疗前后中医临床证候、生存质量评定(Kanrofsky score,KPS)、TNF-α、TWEAK及其受体早期反应蛋白Fn14。结果:治疗组和对照组脾气虚证患者治疗后比较,中医证候总有效率分别为40.62%和15.62%,治疗组明显优于对照组(P<0.05)。在KPS评分改善率方面,治疗组优于对照组(P<0.05)。2组治疗后TNF-α、TWEAK、Fn14均降低,治疗组治疗前后差异有统计学意义(P<0.05),2组间比较,治疗后治疗组TNF-α、TWEAK、Fn14降低更为显著,差异均有统计学意义(P<0.05)。结论:参苓白术散与营养支持相联合,可改善肿瘤恶病质患者中医证候,提高患者体力状况,降低患者体内TNF-α、TWEAK、Fn14表达,提示参苓白术散可能通过该途径起到控制肿瘤恶病质发生的作用。

Objective:To observe the expression of TNF-α,TWEAK,Fn14 on the treat of tumor cachexia with Shenlingbaizhu powder.Methods:Sixty-four tumor cachexia patients were randomized into treatment group and control group,with thirty-two in each.The control group was given nutritional support and the treatment group was given Shenlingbaizhu powder in addition.The effect was evaluated after 4 weeks.The clinical symptoms,kanrofsky score(KPS),tumor necrosis factor-α(TNF-α),tumor necrosis factor-like weak inducer of apoptosis(TWEAK)and fibroblast growth factor-inducible 14(Fn14)were observed.Results:After treatment,the total effective rates of the Chinese medicine symptom in treatment group and control group were 40.62%and 15.62%respectively,with significant differences between groups(P<0.05).After treatment,the KPS improvement rate was improved significantly in treatment group(P<0.05).After treatment,the TNF-α,TWEAK and Fn14 were reduced significally in treatment group(P<0.05).Conclusion:Shenlingbaizhu powder combined with nutritional support can improve life quality and KPS,decrease TNF-α,TWEAK,Fn14 expression of the tumor cachexia patient.Shenlingbaizhu powder control cancer cachexia maybe due to its regulation of these cytokines.