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目的探讨四君子汤加减结合细胞因子诱导的杀伤(CIK)细胞对消化道恶性肿瘤患者免疫机制的影响。方法选取2014年1月至2015年1月间陕西省肿瘤医院收治的100例晚期消化道恶性肿瘤患者,按照随机数字表法随机分为观察组和对照组,每组50例。观察组患者给予CIK细胞联合中药四君子汤加减治疗,对照组患者仅给予CIK治疗。两组患者治疗时间均为1个月,比较两组患者卡氏体力状态(KPS)评分、体质量、中医症候评分、外周血T细胞CD_3~+、CD_4~+、CD_8~+和自然杀伤(NK)细胞的变化。结果治疗前,两组患者的KPS评分和体质量间比较,差异无统计学意义(P>0.05)。治疗后,观察组患者KPS评分显著提高,差异有统计学意义(P<0.05)。治疗后对照组患者的中医证候评分无明显改善,观察组患者的气短、神疲、乏力和少言症状评分显著提高,差异有统计学意义(P<0.05)。治疗前后对照组患者的各T细胞亚群水平改变比较,差异无统计学意义(P>0.05)。治疗后,观察组患者CD_3~+和CD_4~+水平显著提高,CD_8~+水平降低,与治疗前比较,差异有统计学意义(P<0.05)。结论四君子汤加减结合CIK细胞治疗消化道恶性肿瘤,能有效改善患者的生活质量和症候评分,提高机体的免疫机能,值得临床推广应用。
Objective To investigate the effect of Si Junzi Decoction combined with cytokine-induced killer (CIK) cells on immune mechanism in patients with gastrointestinal cancer. Methods One hundred patients with advanced gastrointestinal cancer admitted to Shaanxi Cancer Hospital from January 2014 to January 2015 were randomly divided into observation group and control group according to the random number table method, with 50 cases in each group. Patients in the observation group were treated with CIK cells combined with Sijunzi Decoction, while those in the control group were treated with CIK only. The treatment time of the two groups was one month. The scores of Karnosis Fitness (KPS), body weight, symptom score of Chinese medicine, peripheral blood CD_3 ~ +, CD_4 ~ +, CD_8 ~ + and natural killer NK) cells. Results Before treatment, there was no significant difference in KPS score and body weight between the two groups (P> 0.05). After treatment, KPS scores in observation group were significantly increased, the difference was statistically significant (P <0.05). After treatment, the TCM syndrome score of the control group patients showed no significant improvement. The shortness of breath, fatigue, fatigue and symptoms of symptoms in the observation group were significantly improved (P <0.05). Before and after treatment in the control group of patients with changes in T cell subsets levels, the difference was not statistically significant (P> 0.05). After treatment, the levels of CD_3 ~ + and CD_4 ~ + in the observation group were significantly increased, while the levels of CD_8 ~ + were decreased in the observation group. The difference was statistically significant (P <0.05). Conclusion Sijunzi Decoction combined with CIK cells in the treatment of gastrointestinal cancer can effectively improve the quality of life and symptom scores of patients and improve the immune function of the body, worthy of clinical application.