清热解毒方剂联合~(125)I粒子植入治疗局限中晚期NSCLC疗效及对T细胞亚群和血清CEA等因子的影响
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摘要
目的:观察清热解毒方剂联合~(125)I粒子植入治疗局限中晚期非小细胞肺癌(non-small cell lung carcinoma,NSCLC)的疗效及对T细胞亚群和血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)、NK细胞、Karnofsky(KPS)评分的影响。方法:将100例晚期NSCLC患者随机分为2组,对照组50例给予~(125)I粒子植入治疗,研究组50例给予清热解毒方剂联合~(125)I粒子植入治疗。比较两组治疗后临床疗效,统计两组治疗前后T细胞亚群、血清CEA、CYFRA21-1、NK细胞、KPS评分变化情况。结果:研究组治疗后临床总有效率为62.00%,显著优于对照组40.00%(P<0.05);研究组和对照组治疗后CD3~+、CD4~+和CD4~+/CD8~+水平、NK细胞活性以及KPS评分均较治疗前显著上升(P<0.05),且研究组均较对照组升高幅度更明显(P<0.05);研究组和对照组治疗后CD8~+和血清CEA、CYFRA21-1水平均较治疗前显著下降(P<0.05),且研究组均较对照组降低幅度更明显(P<0.05)。结论:清热解毒方剂联合~(125)I粒子植入治疗局限中晚期NSCLC,疗效显著,同时能明显改善T细胞亚群水平和NK细胞活性,降低血清CEA、CYFRA21-1含量。
Objective:To observe the effect of Qingrejiedu decoction combined with ~(125)I particle implantation in the treatment of localized advanced non-small cell lung carcinoma(NSCLC) and the influences on T cell subgroups and serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),NK cells,and Karnofsky(KPS) scores.Methods:A total of 100 cases of NSCLC were randomly divided into two groups.The control group was treated with ~(125)I particle implantation,and the study group was given Qingrejiedu decoction combined with ~(125)I particle implantation.The clinical efficacy of the two groups after treatment was compared.The changes of T cell subgroups,serum CEA,CYFRA21-1,NK cells and KPS scores were counted between the two groups before and after treatment.Results:The total effective rate of the study group after treatment was 62.00%,which was significantly better than 40.00% of the control group(P<0.05).The levels of CD3~+,CD4~+ and CD4~+/CD8~+,NK cell activity and KPS scores in the study group and the control group after treatment were significantly higher than those before treatment(P<0.05),and the study group was significantly higher than the control group(P<0.05).The CD8~+,serum CEA and CYFRA21-1 levels in the study group and the control group after treatment were significantly lower than those before treatment(P<0.05),and the study group was significantly lower than the control group(P<0.05).Conclusion:Qingrejiedu decoction combined with ~(125)I particle implantation in the treatment of advanced NSCLC has significant effect,at the same time,it can obviously improve the T cell subgroup level and NK cell activity,and reduce the contents of serum CEA and CYFRA21-1.
Objective:To observe the effect of Qingrejiedu decoction combined with ~(125)I particle implantation in the treatment of localized advanced non-small cell lung carcinoma(NSCLC) and the influences on T cell subgroups and serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),NK cells,and Karnofsky(KPS) scores.Methods:A total of 100 cases of NSCLC were randomly divided into two groups.The control group was treated with ~(125)I particle implantation,and the study group was given Qingrejiedu decoction combined with ~(125)I particle implantation.The clinical efficacy of the two groups after treatment was compared.The changes of T cell subgroups,serum CEA,CYFRA21-1,NK cells and KPS scores were counted between the two groups before and after treatment.Results:The total effective rate of the study group after treatment was 62.00%,which was significantly better than 40.00% of the control group(P<0.05).The levels of CD3~+,CD4~+ and CD4~+/CD8~+,NK cell activity and KPS scores in the study group and the control group after treatment were significantly higher than those before treatment(P<0.05),and the study group was significantly higher than the control group(P<0.05).The CD8~+,serum CEA and CYFRA21-1 levels in the study group and the control group after treatment were significantly lower than those before treatment(P<0.05),and the study group was significantly lower than the control group(P<0.05).Conclusion:Qingrejiedu decoction combined with ~(125)I particle implantation in the treatment of advanced NSCLC has significant effect,at the same time,it can obviously improve the T cell subgroup level and NK cell activity,and reduce the contents of serum CEA and CYFRA21-1.
引文
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[16] Liu Zongkun,Zhang Huainan,Zhang Zhengqiang,et al.Advances in chemical constituents and pharmacological actions of Sabina chinensis [J].Imaging Research and Medical Applications,2017,1(8):241-243.[刘宗昆,张怀楠,张争强,等.石上柏的化学成分及药理作用的研究进展[J].影像研究与医学应用,2017,1(8):241-243.]
[2] Zhang Hui,Zhang Shucai.Progress in targeted therapy of EGFR gene in non-small cell lung cancer [J].Chinese Journal of Lung Cancer,2017,20(1):61-65.[张卉,张树才.非小细胞肺癌EGFR基因靶向治疗研究进展[J].中国肺癌杂志,2017,20(1):61-65.]
[3] Cheng Yating,Tian Chengwang,Ren Tao,et al.Research on the clinical application and mechanism of traditional Chinese medicine in the treatment of non small cell lung cancer[J].Drug Evaluation,2016,39(2):289-295.[成娅婷,田成旺,任涛,等.中药治疗非小细胞肺癌的临床应用及作用机制研究进展[J].药物评价研究,2016,39(2):289-295.]
[4] Chinese Cancer Association.New standard for diagnosis and treatment of malignant tumors [M].Beijing:Peking Union Medical College Press,1999:51-58.[中国抗癌协会.新编常见恶性肿瘤诊治规范[M].北京:中国协和医科大学出版社,1999:51-58.]
[5] Zheng Xiaoyu.Guiding principle of clinical research on new Chinese medicine [M].Beijing:China Medical Science and Technology Press,2002:216-221.[郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:216-221.]
[6] Bogaerts J,Ford R,Sargent D,et al.Individual patient data analysis to assess modifications to the RECIST criteria[J].Eur J Cancer,2009,45(2):248-260.
[7] Usó M,Jantuslewintre E,Bremnes RM,et al.Analysis of the immune microenvironment in resected non-small cell lung cancer:The prognostic value of different T lymphocyte markers[J].Oncotarget,2016,7(33):52849-52861.
[8] Chen Xufang,Liang Li,Gong Weiwei,et al.Clinical observation of combined detection of serum CEA,CA125 and Cyfra21-1 in patients with advanced non-small cell lung cancer[J].Clinical Observation of the Chinese Journal of Coal Industrial Medicine,2016,19 (6):826-830.[陈旭芳,梁莉,宫薇薇,等.晚期非小细胞肺癌血清CEA、CA125与Cyfra21-1联合检测临床观察[J].中国煤炭工业医学杂志,2016,19(6):826-830.]
[9] Polders DL,Steggerda M,Van HM,et al.Establishing implantation uncertainties for focal brachytherapy with I-125 seeds for the treatment of localized prostate cancer[J].Acta Oncol,2015,54(6):839-846.
[10] Zhang Dawei,He Jin,Wu Huijing,et al.Dose studies of radioactive 125I seeds for treatment of advanced liver cancer[J].Modern Oncology,2016,24(12):1937-1939.[张大为,何津,吴会静,等.放射性125I粒子治疗中晚期肝癌的剂量学分析[J].现代肿瘤医学,2016,24(12):1937-1939.]
[11] Du Peng,Lu Wei,Xiao Yueyong,et al.The safety and effectiveness of modified 125I particle implantation in the treatment of lung function incomplete lung cancer [J].Chinese Radiology,2016,50 (1):32-36.[杜鹏,卢伟,肖越勇,等.改良125I粒子植入技术治疗肺功能不全肺癌的安全性和有效性[J].中华放射学杂志,2016,50(1):32-36.]
[12] Chen Hongzhou,Lin Xufang.Clinical effect analysis of TCM syndrome differentiation and treatment combined with GP regimen on advanced non-small cell lung cancer[J].Chinese Journal of Traditional Chinese Medicine,2016,34(2):487-489.[陈红宙,林旭芳.中医辨证治疗联合GP方案对中晚期非小细胞肺癌临床疗效分析[J].中华中医药学刊,2016,34(2):487-489.]
[13] Dan Mengjun,Zhang Liyuan,You Jie.A randomized controlled study on the combination of TCM syndrome differentiation therapy and chemotherapy in the treatment of advanced non-small cell lung cancer in the elderly[J].Chinese Journal of Integrated Chinese and Western Medicine,2018,38(2):163-167.[单孟俊,张丽媛,游捷.中医辨证疗法联合化疗治疗老年晚期非小细胞肺癌患者随机对照研究[J].中国中西医结合杂志,2018,38(2):163-167.]
[14] Chen Li,Li Hong,Qiu Ting,et al.Effect of Supplementing Qi and nourishing yin method combined with gemcitabine on the quality of life of elderly non-small cell lung cancer [J].Journal of Nanjing University of Chinese Medicine,2016,32(4):330-333.[陈黎,李红,邱婷,等.益气养阴法联合吉西他滨对老年晚期非小细胞肺癌生活质量的影响[J].南京中医药大学学报,2016,32(4):330-333.]
[15] Fan Haizhou.Pharmacology of arrowhead [J].Hubei Journal of Traditional Chinese Medicine,2015,37(2):74-75.[范海洲.山慈菇药理研究[J].湖北中医杂志,2015,37(2):74-75.]
[16] Liu Zongkun,Zhang Huainan,Zhang Zhengqiang,et al.Advances in chemical constituents and pharmacological actions of Sabina chinensis [J].Imaging Research and Medical Applications,2017,1(8):241-243.[刘宗昆,张怀楠,张争强,等.石上柏的化学成分及药理作用的研究进展[J].影像研究与医学应用,2017,1(8):241-243.]