论文部分内容阅读
目的探讨含毒性中药材苦参碱对非化疗晚期非小细胞癌患者的抗肿瘤及免疫调节作用。方法选择2013年1月—2014年10月收治的100例已经失去手术、介入、放射治疗机会的晚期非小细胞癌患者作为研究对象,随机分为对照组和观察组各50例。对照组采用TP化疗方案治疗,观察组采用含毒性中药材苦参碱治疗,50 g/d,水煎分两次服;两组均治疗21 d。观察两组治疗前后症状评分、癌胚抗原(carcino-embryonic antigen,CEA)、IFN-γ、IL-2、IL-4、IL-5等细胞因子的变化情况及不良反应发生情况。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组治疗后症状积分为(3.1±1.8)分,优于治疗前的(5.6±3.1)分及对照组的(5.1±2.9)分,差异均有统计学意义(均P<0.05)。观察组与对照组治疗后CEA分别为(40.89±12.88)、(49.44±15.78)ng/ml,均低于治疗前的(56.75±14.96)、(55.23±12.56)ng/ml,差异均有统计学意义(均P<0.05)。且两组治疗后CEA水平比较差异有统计学意义(P<0.05)。治疗后,观察组与对照组IFN-γ、IL-2、IL-4、IL-5水平分别为(10.25±2.11)、(12.69±3.21)、(36.54±4.12)、(38.74±7.56)、(19.65±3.14)、(15.16±3.85)、(48.63±6.99)、(43.69±8.33)pg/ml,与治疗前的(22.05±2.65)、(17.89±3.21)、(68.46±7.85)、(83.47±6.89)、(22.45±2.63)、(17.39±2.85)、(67.21±8.46)、(82.76±6.54)pg/ml比较差异均有统计学意义(均P<0.05)。且两组治疗后各免疫因子水平比较差异均有统计学意义(均P<0.05)。对照组血红蛋白降低、白细胞降低、血小板降低、谷草转氨酶升高、肌酐升高、恶心呕吐、腹泻发生率分别为70%、68%、52%、76%、22%、70%、56%,观察组分别为2%、0、0、0、0、0、0,两组各不良反应发生率比较差异均有统计学意义(均P<0.05)。结论含毒性中药材苦参碱具有抗肿瘤,改善晚期患者生存质量,调节免疫力等作用且不良反应发生率低,值得临床推广应用。
Objective To investigate the anti-tumor and immunoregulatory effects of matrine, a toxic traditional Chinese medicine, on patients with advanced non-small cell lung cancer. Methods From January 2013 to October 2014, 100 patients with advanced non-small cell lung cancer who had lost the chance of surgery, intervention and radiotherapy were randomly divided into control group and observation group of 50 cases each. The control group was treated with TP chemotherapy. The observation group was treated with toxic Chinese herbal medicine matrine, 50 g / d, and decocted twice. Both groups were treated for 21 days. The changes of symptom scores, carcinoembryonic antigen (CEA), IFN-γ, IL-2, IL-4, IL-5 and other cytokines were observed before and after treatment in both groups and the occurrence of adverse reactions. Measurement data were compared between groups using t test, the group was compared using paired t test, count data using χ2 test, P <0.05 for the difference was statistically significant. Results The score of symptom in observation group after treatment was (3.1 ± 1.8) points, which was significantly higher than that before treatment (5.6 ± 3.1) and control group (5.1 ± 2.9) (all P <0.05). The CEA of observation group and control group after treatment were (40.89 ± 12.88) and (49.44 ± 15.78) ng / ml respectively, which were lower than those before treatment (56.75 ± 14.96 and 55.23 ± 12.56) ng / ml Significance (both P <0.05). The CEA levels of the two groups after treatment were significantly different (P <0.05). After treatment, the levels of IFN-γ, IL-2, IL-4 and IL-5 in observation group and control group were (10.25 ± 2.11), (12.69 ± 3.21), (36.54 ± 4.12) and (38.74 ± 7.56) (19.65 ± 3.14), (15.16 ± 3.85), (48.63 ± 6.99) and (43.69 ± 8.33) pg / ml respectively, which were significantly higher than those before treatment (22.05 ± 2.65, 17.89 ± 3.21, 68.46 ± 7.85, 83.47 ± 6.89), (22.45 ± 2.63), (17.39 ± 2.85), (67.21 ± 8.46) and (82.76 ± 6.54) pg / ml respectively (all P <0.05). There were significant differences in the levels of immune factors between the two groups (all P <0.05). In the control group, hemoglobin, leukopenia, thrombocytopenia, elevated aspartate aminotransferase, elevated creatinine, nausea and vomiting, and diarrhea were 70%, 68%, 52%, 76%, 22%, 70% and 56% Group 2%, 0,0,0,0,0,0, respectively, the incidence of adverse reactions in both groups were significantly different (P <0.05). Conclusions Matrine, a toxic traditional Chinese medicine, has anti-tumor effects, improves the quality of life in advanced patients, regulates immunity, and has a low incidence of adverse reactions. It is worthy of clinical application.