扶正培本方联合替莫唑胺对高级别胶质瘤患者外周血miRNA的影响

Effect of Fuzheng Peiben Recipe Combined with Temozolomide on Expression of miRNA in Peripheral Blood of Patients with High-grade Glioma

目的评价扶正培本方联合替莫唑胺对高级别胶质瘤外周血微小核糖核酸(microRNA,miRNA)的影响。方法选取2014年-2017年在我院神经外科就诊的80例高级别胶质瘤患者分为对照组(n=42例)和治疗组(n=38例)。对照组患者在术后服用替莫唑胺化疗;治疗组患者在对照组化疗的基础上加用中药方剂,14天为一疗程,一共7个疗程,随访2年。比较两组的肿瘤进展情况、血清miRNA水平及不良反应发生情况。结果到达研究终点时,治疗组因疾病进展比例为45.0%,对照组为70.27%,两组比较差异有统计学意义(P<0.05)。入组后7个月,治疗组miR-1193水平低于对照组,差异有统计学意义。完成治疗后,随访期间肿瘤进展的病人,两组病人治疗前与进展后的miR-1193水平相比无显著差异。2年内均无进展的病人,随访结束时两组病人miR-1193水平均显著低于治疗前,并且治疗组治疗后要显著低于对照组治疗后(P<0.05)。疾病进展时,对照组及治疗组miR-1193相比未进展病人都低,差异有统计学意义。结论扶正培本方剂辅助神经胶质瘤术后化疗是一种有效的治疗方法,能够改善患者的预后,其作用与miRNA-1193相关。

Objective To evaluate the effect of Fuzheng Peiben Recipe combined with timonidine on the expression of miRNA in peripheral blood of high-grade glioma patients.Methods Eighty patients with high-grade glioma admitted by Neurosurgery Department of the First Affiliated Hospital of Zhejiang Chinese Medical University from the year of 2014 to 2017 were divided into control group(n=42)and treatment group(n=38).The patients in the control group were treated with temozolamine chemotherapy after operation,while the patients in the treatment group were treated with Chinese medicine with the actions of supporting healthy Qi and strengthening body resistance on the basis of chemotherapy for the control group.Fourteen days constituted a course of treatment,and the two groups were treated by a total of 7 courses of treatment and were followed up by 2 years.The tumor progress,serum miRNA level and adverse reactions were compared between the two groups.Results At the end of the study,the rate of disease progression in the treatment group was 45.0%and that in the control group was 70.27%,and the difference between the two groups was statistically significant(P<0.05).The level of miR-1193 in the treatment group was lower than the control group 7 months after the enrollment,and there was a significant difference(P<0.05).There was no significant difference in the level of miR-1193 in patients with tumor progress during followup between the two groups(P>0.05).Patients with no progress within 2 years in the two groups had lower serum miR-1193 level at the end of follow-up than that before treatment(P<0.05),and the level in the treatment group was significantly lower than that in the control group(P<0.05).Patients in the two groups during the period of disease progress had lower miR-1193 level than those without disease progress(P<0.05).Conclusion Fuzheng Peiben Recipe combined with temozolomide is an effective treatment to improve the prognosis of patients with highgrade glioma after operation,and its therapeutic mechanism is related to the regulation of miRNA-1193 expression.