麦粒灸治疗恶性肿瘤高凝状态的疗效分析与机制探讨

发布时间：2018-04-25 17:18

本文选题：麦粒灸 + 恶性肿瘤　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察麦粒灸疗法对恶性肿瘤患者凝血相关指标及血清白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)的影响,以及其对Lewis肺癌裸鼠一般情况、瘤体大小、生存率及IL-1β、核转录因子-kB(NF-kB)表达等的影响,探讨麦粒灸对恶性肿瘤高凝状态的治疗作用。方法:(1)将55例确诊为恶性实体肿瘤患者随机分两组:治疗组(27例)和对照组(28例)。两组均接受扶正抗肿瘤药物治疗,治疗组在药物治疗基础上,加用麦粒灸足三里治疗,1次/天,10天为1个周期,两个周期后观察患者凝血相关指标及血清IL-1β、T NF-α表达水平。(2)将30只雄性BALB/c裸鼠随机分为三组:模型组、治疗组和对照组,每组10只。其中对照组为空白对照,模型组裸鼠予皮下注射Lewis肺腺癌细胞悬液建立模型,治疗组在此基础上加用麦粒灸后三里(双侧)治疗,每个穴位灸3壮,1次/天,共治疗10天。三组裸鼠每天同时固定在鼠板上,模型组和对照组不予麦粒灸干预。观察各组裸鼠的一般情况、瘤体大小和生存率;采用酶联免疫吸附法(ELISA)方法测定血清IL-1β、采用免疫印迹法(Western Blot)方法测定瘤体中NF-kB表达水平。结果:1、临床试验结果显示:(1)治疗前患者血清IL-1β与凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)成负相关,与纤维蛋白原量(FIB)、D-二聚体(D-D)成正相关,差异具有统计学意义(P0.05);血清TNF-α与APTT、PT成负相关,与FIB、血小板计数(PLT)及D-D成正相关,差异具有统计学意义(P0.05)。(2)两组APTT、PT较前升高,FIB、PLT较前降低,差异具有统计学意义(P0.05),且在升高PT,降低PLT、FIB等方面,治疗组明显优于对照组,差异具有统计学意义(P0.05)。同时治疗组D-D也较前降低,差异具有统计学意义(P0.05)。(3)治疗组血清IL-1β、TNF-α均较前明显降低,对照组血清TNF-α较前明显升高,差异具有统计学意义(P0.05);同时在降低血清IL-1β、TNF-α方面,治疗组明显优于对照组,差异具有统计学意义(P0.05)。2、动物实验结果显示:在体重和生存率方面,治疗组与模型组相比,差异无统计学意义(P0.05);在瘤体大小方面,治疗组在成瘤第8天以后明显小于模型组,差异具有统计学意义(P0.05);在血清IL-1β和组织NF-kB表达水平方面,治疗组和模型组与对照组相比明显升高,并且治疗组明显低于模型组,差异具有统计学意义(P0.05)。结论:麦粒灸可通过下调肿瘤患者IL-1β、TNF-α的表达,调节机体炎症微环境,改善异常凝血功能,进而改善肿瘤高凝状态。麦粒灸能改善Lewis肺癌裸鼠瘤体一般情况、抑制肿瘤生长、降低死亡率,其机制可能与麦粒灸通过降低血清IL-1β水平,进一步下调NF-κB在瘤体中的表达,改善血液高凝状态,延缓肿瘤的生长、转移。这为麦粒灸在肿瘤高凝状态治疗中的临床运用完善了实验依据。
[Abstract]:Objective: to observe the effect of grain moxibustion therapy on blood coagulation related indexes and serum interleukin-1 尾 -1 尾, tumor necrosis factor- 伪 TNF- 伪 in patients with malignant tumor, as well as the general situation and tumor size of nude mice with Lewis lung cancer. The survival rate and the expression of IL-1 尾 and nuclear transcription factor NF-kB were studied in order to explore the therapeutic effect of grain moxibustion on hypercoagulable state of malignant tumor. Methods 55 patients with malignant solid tumor were randomly divided into two groups: treatment group (n = 27) and control group (n = 28). Both groups were treated with Fuzheng antitumor drugs. On the basis of drug therapy, the treatment group was treated with moxibustion of wheat grain Zusanli once a day for 10 days as one cycle. After two cycles, 30 male BALB/c nude mice were randomly divided into three groups: model group, treatment group and control group, 10 rats in each group. The model group was established by subcutaneously injection of Lewis lung adenocarcinoma cell suspension, and the treatment group was treated with wheat grain moxibustion for 3 li (bilateral). Each acupoint moxibustion was treated once a day for 10 days. The three groups of nude mice were fixed on the mouse board at the same time every day, while the model group and the control group were not treated with moxibustion. The general condition, tumor size and survival rate of nude mice in each group were observed. Serum IL-1 尾 was determined by Elisa and the expression of NF-kB was detected by Western blotting. Results the clinical trial results showed that the serum IL-1 尾 was negatively correlated with prothrombin time and activated partial thromboplastin time (APTT) before treatment, and positively correlated with fibrinogen content and D-dimer. Serum TNF- 伪 had a negative correlation with APTTT PT, and a positive correlation with FIBT, platelet count (PLT) and D-D. The difference was statistically significant (P < 0.05). The difference was statistically significant (P 0.05), and the treatment group was better than the control group in increasing PTT and decreasing PLT FIB, and the difference was statistically significant (P 0.05). At the same time, the D-D of the treatment group was also lower than that of the former, the difference was statistically significant (P 0.05). The serum IL-1 尾 -TNF- 伪 of the treatment group was significantly lower than that of the previous treatment group, and the serum TNF- 伪 level of the control group was significantly higher than that of the former group, and the difference was statistically significant (P 0.05), at the same time, the serum IL-1 尾 -TNF- 伪 was decreased. The results of animal experiments showed that there was no significant difference in body weight and survival rate between the treatment group and the model group, and there was no significant difference in the size of the tumor in the treatment group compared with the model group. The level of serum IL-1 尾 and tissue NF-kB in the treatment group was significantly higher than that in the control group, and it was significantly lower in the treatment group than in the model group, and the difference was statistically significant between the treatment group and the model group after the 8th day after tumorigenesis, and the expression of serum IL-1 尾 and tissue NF-kB in the treatment group was significantly lower than that in the model group. The difference was statistically significant (P 0.05). Conclusion: grain moxibustion can regulate the inflammatory microenvironment, improve abnormal coagulation function and improve tumor hypercoagulability by down-regulating the expression of IL-1 尾 -TNF- 伪 in tumor patients. Grain moxibustion can improve the general condition of Lewis lung cancer in nude mice, inhibit tumor growth and reduce mortality. The mechanism may be that grain moxibustion can further down-regulate the expression of NF- 魏 B in the tumor and improve the hypercoagulability by reducing the serum IL-1 尾 level. To delay the growth and metastasis of the tumor. This provides an experimental basis for the clinical application of granulated moxibustion in the treatment of tumor hypercoagulability.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.5

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