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纸质出版日期:2018
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陈皎皎, 胡陵静, 张国铎, 等. 四君子汤加味对肺癌化疗骨髓抑制的作用机制[J]. 中国实验方剂学杂志, 2018,24(2):180-185.
CHEN Jiao-jiao, HU Ling-jing, ZHANG Guo-duo, et al. Effect of Sijunzi Tang on Bone Marrow Suppression of Lung Cancer in Chemotherapy[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(2): 180-185.
陈皎皎, 胡陵静, 张国铎, 等. 四君子汤加味对肺癌化疗骨髓抑制的作用机制[J]. 中国实验方剂学杂志, 2018,24(2):180-185. DOI: 10.13422/j.cnki.syfjx.2018020180.
CHEN Jiao-jiao, HU Ling-jing, ZHANG Guo-duo, et al. Effect of Sijunzi Tang on Bone Marrow Suppression of Lung Cancer in Chemotherapy[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(2): 180-185. DOI: 10.13422/j.cnki.syfjx.2018020180.
目的:探讨四君子汤加味对肺癌化疗骨髓抑制气阴两虚证的疗效及对血清中粒-巨噬细胞集落刺激因子(GM-CSF)和粒细胞集落刺激因子(G-CSF)水平的影响。方法:将中晚期肺癌患者104例患者,参照数字表法随机分为对照组和观察组各52例。对照组采用化疗方案(TP)。观察组在对照组治疗的基础上给予四君子汤加味,化疗第1天开始内服,2次/d,化疗后继续服用1周。比较两组骨髓抑制程度、白细胞减少、中医症状积分及近期临床疗效。测定两组患者外周血T细胞亚群CD3+,CD4+及CD8+水平变化。记录两组患者重组人粒细胞刺激因子注射液(rhG-CSF)使用量;检测两组患者血清中GM-CSF和G-CSF水平。结果:治疗后1周,观察组中性粒细胞、血红蛋白、血小板及白细胞数量均显著高于对照组(P<0.01)。观察组的中性粒细胞和白细胞减少发生率均明显低于对照组(P<0.05);治疗后1周,观察组白细胞减少、中医症状积分均明显低于对照组(P<0.01);观察组的近期总有效率为86.27%,显著高于对照组66%(P<0.05)。观察组患者治疗后1周CD3+,CD4+均显著高于对照组,CD8+低于对照组(P<0.01)。观察组rhG-CSF使用量明显少于对照组。观察组治疗后1周血清中GM-CSF和G-CSF水平均明显高于对照组(P<0.01)。结论:四君子汤加味辅助用于中晚期肺癌化疗气阴两虚证患者,能改善骨髓抑制程度,降低骨髓抑制发生率,提高临床疗效,提高免疫功能和血清中GM-CSF和G-CSF水平可能是其疗效途径之一。
Objective:To investigate the efficacy of Sijunzi Tang on bone marrow suppression of lung cancer in chemotherapy with syndrome of deficiency of both Qi and Yin
and tpexplore its effect on serum granulocyte-macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF). Method:One hundred and four cases of patients with advanced pulmonary carcinomas were randomly divided into observation group (52 cases) and control group (52 cases). The patients in control group were treated with chemotherapy regimen (TP). Based on the treatment in control group
the patients in observation group additionally received Sijunzi Tang from the first day of chemotherapy
bid
until 1 week after chemotherapy. Degree of bone marrow suppression
symptom score of traditional Chinese medicine (TCM)
leukopenia
and recent clinical efficacy were compared in two between groups. Peripheral blood T-cell subsets CD3+
CD4+ and CD8+ changes were detected in both groups. Application amount of Recombinant Human Granulocyte Colony-stimulating Factor Injection (rhG-CSF) was recorded in both groups
and the levels of GM-CSF and G-CSF in serum were also detected in both groups. Result:One week after treatment
the counts of neutrophils
hemoglobin
platelets
and white blood cells in observation group were obviously higher than those in control group (P<0.01). The incidence of neutropenia and leukopenia was evidently lower than that in the control gorup (P<0.05). One week after treatment
TCM symptom scores and leukopenia scores were remarkably lower than those in control group (P<0.01). Recent efficacy rate was 86.27% in observation group
superior to 66% in control group (P<0.05). Observation group CD3+ and CD4+ in were obviously higher
while CD8+ was lower than those of control group one week after treatment(P<0.01). Application amount of rhG-CSF in observation group was obviously less than that in control group (P<0.01)
and the levels of GM-CSF and G-CSF in serum of observation group were evidently higher than those of control group one week after treatment(P<0.01). Conclusion:Adjuvant therapy of Sijunzi Tang in patients with chemotherapy for late lung cancer with syndrome of deficiency of both Qi and Yin can improve bone marrow suppression degree
reduce occurrence rate of bone marrow suppression
and increase efficacy. Improvement of immunity and up-regulation of GM-CSF and G-CSF levels in serum may be one of its curative pathways.
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