“健脾益气生血法”对胃癌贫血患者细胞免疫功能的影响

Effect of “tonifying spleen to nourish Qi and to produce blood” on cell immune function of gastric cancer patients with anemia

[目的]观察"益气健脾生血法"代表方——归脾汤对胃癌贫血患者血红蛋白、红细胞计数、红细胞压积和外周血T细胞亚群变化的影响,并探究其临床意义。[方法]采用随机、对照、前瞻性临床研究方法,收集60例确诊为胃癌伴轻中度贫血的患者,分为试验组(基础营养支持联合归脾汤、力蜚能胶囊和叶酸片治疗)和对照组(基础营养支持联合力蜚能胶囊、叶酸片治疗)。28 d为1个疗程,治疗前后使用血液分析仪和流式细胞仪检测血红蛋白、红细胞计数、红细胞压积和外周血T细胞亚群水平变化,并进行2组间比较。[结果]与治疗前比较,2组胃癌贫血患者治疗后的血红蛋白、红细胞计数和红细胞压积均明显升高(P<0.05),且试验组升高水平较对照组更明显(P<0.05)。与治疗前比较,试验组治疗后的CD8 T细胞水平明显降低(P<0.05),CD3、CD4 T细胞水平、CD4/CD8比值、Th1、Tc1细胞水平以及Th1/Th2、Tc1/Tc2比值均明显升高(P<0.05),而对照组上述细胞水平变化均不大(P>0.05)。[结论]胃癌贫血患者细胞免疫功能低下,应用归脾汤辅助西医治疗可有效地纠正贫血,改善机体细胞免疫抑制状态,从而对胃癌综合治疗措施的实施产生积极作用。

[Objective]To observe the representative prescription of'onifying spleen to nourish Qi and to produce blood'—Guipi soup’s effect on the changes of hemoglobin,erythrocyte count,hematocrit and peripheral blood T cell subsets in patients with anemia of gastric cancer,and to discuss its clinical significance.[Methods]Using randomized,controlled and prospective clinical research method,60 cases that diagnosised as gastric cancer with mild or moderate anemia were selected and then divided randomly into two groups:Experimental group(which was treated with Guipi soup and conventional therapy)and Control group(which was treated with conventional therapy).28 days as a course of treatment,hemoglobin,red blood cell count,hematocrit and peripheral blood T cell were detected by hematology analyzer and flow cytometry before and after treatment,and the results were compared between the two groups.[Results]Compared with which before treatment,the level of hemoglobin,red blood cell count and hematocrit in two groups were all elevated greatly(P<0.05),while such index in Experimental group were more higher than Control group(P<0.05).Compared with which before treatment,the level of CD8 T cell in Experimental group reduced markedly(P<0.05),the levels of CD3,CD4,Th1,Tc1,and the ratios of CD4/CD8,Th1/Th2,Tc1/Tc2 rase significantly(P<0.05),while such index in Control group had no obvious change(P>0.05).[Conclusion]The cellular immune function of anemia patients with gastric cancer is low,application of guipi soup at the base of western medicine treatment can effectively rectify anemia,improve the cellular immunosuppression state,therefore to have a positive effect on the implementation of comprehensive treatment measures for gastric cancer.