健脾补肾方对脾肾两虚型晚期恶性肿瘤患者免疫功能的影响
发布时间：2018-08-29 10:45
【摘要】：目的:本研究旨在通过收集分析2015年1月~2015年10月在河北医科大学附属石家庄平安医院肿瘤科住院,并符合入组标准的脾肾两虚型晚期恶性肿瘤患者90例。初步评价健脾补肾方对脾肾两虚型晚期恶性肿瘤患者免疫功能的影响。方法:采用随机非盲平行对照的研究方法,共纳入符合标准的脾肾两虚型晚期恶性肿瘤患者90例,分别纳入治疗组、空白组、对照组,各组患者均30例,治疗组、空白组和对照组均给予常规营养支持及对症处理,治疗组给予健脾补肾方(人参、白术、甘草、菟丝子、淫羊藿、巴戟天、女贞子、柴胡、鸡内金),由我院药剂科采用自动煎药机制备,每袋150ml,每次1袋,每日2次,口服,连续服用4周。对照组给予静脉滴注葡萄糖250ml、胸腺五肽1mg,一日一次,连续治疗4周。空白组单纯应用常规营养支持及对症处理,连续4周。记录三组治疗前后的临床症状及体征、外周血T淋巴细胞亚群相关数值(CD3+、CD4+、CD8+、CD4+/CD8+、NK)、免疫球蛋白、中医症候积分、生活质量评分等疗效指标以及血尿常规、大便常规、肝肾功能、心电图等安全性指标,并进行统计学分析,以评价健脾补肾方对脾肾两虚型晚期恶性肿瘤患者免疫功能的影响。结果:通过临床观察进行了90例脾肾两虚型晚期恶性肿瘤患者免疫功能、中医症候积分及生活质量评分的对照研究。我们对治疗前三组患者的年龄、性别、病情差异、临床分期等资料进行比较,差异均无统计学意义(P0.05),具有可比性。我们对三组患者治疗前淋巴细胞亚群、免疫球蛋白、中医症候积分及生活质量评分等指标进行了比较,结果发现治疗前三组间各指标无显著差异,无统计学意义(P0.05),具有可比性。1治疗后三组与各自治疗前的细胞免疫功能指标进行对比(1)治疗组:CD3+、CD4+、CD4+/CD8+、NK细胞水平较治疗前明显提高,CD8+细胞水平较治疗前明显下降,P0.01。(2)对照组:CD3+、CD4+细胞水平较治疗前提高,P0.05;CD8+细胞水平较治疗前明显下降,P0.01;CD4+/CD8+值、NK细胞水平较治疗前无显著变化,P0.05。(3)空白组:CD3+细胞水平较治疗前明显下降,P0.05;CD4+、CD8+、CD4+/CD8+、NK细胞水平无明显改善,P0.05。2治疗后三组间细胞免疫功能指标比较:治疗组CD3+、CD4+、CD8+、CD4+/CD8+以及NK细胞各指标改善情况均优于对照组和空白组,差异存在统计学意义(P0.05)。3治疗后三组间免疫球蛋白改善情况对比,治疗组、对照组及空白组无显著差异,统计学无意义(P0.05)。4治疗后三组间中医症候积分对比,治疗组较对照组、空白组有显著优势,P0.01。治疗组与对照组比较,P=0.00350.01;治疗组与空白组比较,P=0.00160.01;对照组与空白组比较,P=0.79520.05。5治疗后三组生活质量评分对比,治疗组较对照组、空白组有明显优势,P0.01。治疗组与对照组比较,P=0.00230.01;治疗组与空白组比较,P=0.00100.01;对照组与空白组比较,P=0.79340.05。6治疗后三组间不良反应对比,治疗组、对照组、空白组不良反应发生率无显著差异,P0.05。结论:通过临床观察研究,我们发现健脾补肾方能够有效改善脾肾两虚型晚期肿瘤患者的细胞免疫功能,CD3+、CD4+、CD8+、CD4+/CD8+值以及NK细胞水平均有显著改善,明显优于胸腺五肽对照组及空白组。对照组胸腺五肽对晚期肿瘤患者的免疫功能亦有一定改善作用,可以使CD3+、CD4+细胞水平提高,CD8+细胞水平下降,但对于CD4+/CD8+值以及NK细胞水平改善不明显,总疗效劣于健脾补肾方。空白组患者经过营养支持对症治疗免疫功能无改善,甚至免疫功能出现下降,研究发现空白组患者CD3+细胞水平下降显著,说明如果不给予脾肾两虚型肿瘤患者相关提高免疫力的治疗,随着肿瘤病情发展,患者免疫功能会逐渐下降。另外,健脾补肾方能够有效减轻脾肾两虚型晚期恶性肿瘤患者临床症状,降低中医症候积分,提高患者生活质量评分,效果显著。健脾补肾方对于脾肾两虚型晚期恶性肿瘤患者体液免疫功能的改善作用不明显,与对照组、空白组相比,无明显优势。
[Abstract]:Objective: To collect and analyze 90 cases of advanced malignant tumor of deficiency of both spleen and kidney type hospitalized in the Department of Oncology of Shijiazhuang Ping'an Hospital Affiliated to Hebei Medical University from January 2015 to October 2015. Ninety patients with advanced malignant tumor of deficiency of both spleen and kidney were included in the treatment group, blank group, control group, 30 cases in each group. The treatment group, blank group and control group were given routine nutritional support and symptomatic treatment. The treatment group was given Jianpi Bushen Recipe (Ginseng, Baizhu, Gansu). Herba Cuscutae, Herba Epimedii, Morinda officinalis, Fructus Ligustrum, Radix Bupleuri and Radix Chicken Neijin were prepared by the pharmacy department of our hospital with automatic Decoction mechanism, 150 ml per bag, 1 bag per day, 2 times a day, oral administration for 4 weeks. The clinical symptoms and signs, peripheral blood T lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 + / CD8 +, NK), immunoglobulin, TCM syndrome score, quality of life score and other therapeutic indicators were recorded before and after treatment, and the safety indicators such as routine hematuria, routine stool, liver and kidney function, electrocardiogram were statistically analyzed. To evaluate the effect of Jianpi Bushen Recipe on immune function of patients with advanced malignant tumor of deficiency of both spleen and kidney.Results:90 cases of advanced malignant tumor of deficiency of both spleen and kidney were studied by clinical observation. We compared the lymphocyte subsets, immunoglobulin, TCM symptom score and quality of life score of the three groups before treatment, and found that there was no significant difference between the three groups before treatment, there was no statistical significance (P 0.05). Comparability. 1 After treatment, the levels of CD3 +, CD4 +, CD4 + / CD8 +, NK cells and CD8 + cells in the treatment group were significantly higher than those before treatment, and the levels of CD8 + cells were significantly lower than those before treatment, P 0.01. (2) The levels of CD3 +, CD4 + cells in the control group were significantly higher than those before treatment, P 0.05; CD4 + / CD8 +, NK cell level had no significant change, P 0.05. (3) blank group: CD3 + cell level was significantly lower than before treatment, P 0.05; CD4 +, CD8 +, CD4 + / CD8 +, NK cell level was not significantly improved, P 0.05. The improvement was better than the control group and the blank group, the difference was statistically significant (P 0.05). 3 After treatment, there was no significant difference in the improvement of immunoglobulin among the three groups, the treatment group, the control group and the blank group, there was no statistical significance (P 0.05). 1. Comparing the treatment group with the control group, P = 0.00350.01; Comparing the treatment group with the blank group, P = 0.00160.01; Comparing the control group with the blank group, P = 0.79520.05.5 after treatment, the quality of life scores of the three groups were compared, the treatment group was superior to the control group, the blank group was superior, P = 0.00230.01; Comparing the treatment group with the blank group, P = 0.00100.0. 1. Comparing the control group with the blank group, P = 0.79340.05.6 after treatment, there was no significant difference in the incidence of adverse reactions between the treatment group, the control group and the blank group, P 0.05. Conclusion: Through clinical observation and study, we found that Jianpi Bushen Recipe can effectively improve the cellular immune function of patients with advanced tumor of deficiency of both spleen and kidney, CD3 +, CD4 +, CD8 +. The levels of CD4 +/CD8 + and NK cells were significantly improved in the control group, but not in the CD4 +/CD8 + and NK cells. The study found that the level of CD3 + cells in the blank group decreased significantly, indicating that if the patients with spleen and kidney deficiency were not given the treatment of related immunity improvement, with the development of the tumor, the patients were exempted. In addition, Jianpi Bushen Recipe can effectively alleviate the clinical symptoms of patients with advanced malignant tumors of deficiency of both spleen and kidney, reduce the score of TCM symptoms, and improve the quality of life of patients, the effect is significant. Jianpi Bushen Recipe has no obvious effect on the improvement of humoral immune function of patients with advanced malignant tumors of deficiency of both spleen and kidney, compared with the control group. Compared with blank group, there was no obvious advantage.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R730.5
本文编号：2210961
[Abstract]:Objective: To collect and analyze 90 cases of advanced malignant tumor of deficiency of both spleen and kidney type hospitalized in the Department of Oncology of Shijiazhuang Ping'an Hospital Affiliated to Hebei Medical University from January 2015 to October 2015. Ninety patients with advanced malignant tumor of deficiency of both spleen and kidney were included in the treatment group, blank group, control group, 30 cases in each group. The treatment group, blank group and control group were given routine nutritional support and symptomatic treatment. The treatment group was given Jianpi Bushen Recipe (Ginseng, Baizhu, Gansu). Herba Cuscutae, Herba Epimedii, Morinda officinalis, Fructus Ligustrum, Radix Bupleuri and Radix Chicken Neijin were prepared by the pharmacy department of our hospital with automatic Decoction mechanism, 150 ml per bag, 1 bag per day, 2 times a day, oral administration for 4 weeks. The clinical symptoms and signs, peripheral blood T lymphocyte subsets (CD3 +, CD4 +, CD8 +, CD4 + / CD8 +, NK), immunoglobulin, TCM syndrome score, quality of life score and other therapeutic indicators were recorded before and after treatment, and the safety indicators such as routine hematuria, routine stool, liver and kidney function, electrocardiogram were statistically analyzed. To evaluate the effect of Jianpi Bushen Recipe on immune function of patients with advanced malignant tumor of deficiency of both spleen and kidney.Results:90 cases of advanced malignant tumor of deficiency of both spleen and kidney were studied by clinical observation. We compared the lymphocyte subsets, immunoglobulin, TCM symptom score and quality of life score of the three groups before treatment, and found that there was no significant difference between the three groups before treatment, there was no statistical significance (P 0.05). Comparability. 1 After treatment, the levels of CD3 +, CD4 +, CD4 + / CD8 +, NK cells and CD8 + cells in the treatment group were significantly higher than those before treatment, and the levels of CD8 + cells were significantly lower than those before treatment, P 0.01. (2) The levels of CD3 +, CD4 + cells in the control group were significantly higher than those before treatment, P 0.05; CD4 + / CD8 +, NK cell level had no significant change, P 0.05. (3) blank group: CD3 + cell level was significantly lower than before treatment, P 0.05; CD4 +, CD8 +, CD4 + / CD8 +, NK cell level was not significantly improved, P 0.05. The improvement was better than the control group and the blank group, the difference was statistically significant (P 0.05). 3 After treatment, there was no significant difference in the improvement of immunoglobulin among the three groups, the treatment group, the control group and the blank group, there was no statistical significance (P 0.05). 1. Comparing the treatment group with the control group, P = 0.00350.01; Comparing the treatment group with the blank group, P = 0.00160.01; Comparing the control group with the blank group, P = 0.79520.05.5 after treatment, the quality of life scores of the three groups were compared, the treatment group was superior to the control group, the blank group was superior, P = 0.00230.01; Comparing the treatment group with the blank group, P = 0.00100.0. 1. Comparing the control group with the blank group, P = 0.79340.05.6 after treatment, there was no significant difference in the incidence of adverse reactions between the treatment group, the control group and the blank group, P 0.05. Conclusion: Through clinical observation and study, we found that Jianpi Bushen Recipe can effectively improve the cellular immune function of patients with advanced tumor of deficiency of both spleen and kidney, CD3 +, CD4 +, CD8 +. The levels of CD4 +/CD8 + and NK cells were significantly improved in the control group, but not in the CD4 +/CD8 + and NK cells. The study found that the level of CD3 + cells in the blank group decreased significantly, indicating that if the patients with spleen and kidney deficiency were not given the treatment of related immunity improvement, with the development of the tumor, the patients were exempted. In addition, Jianpi Bushen Recipe can effectively alleviate the clinical symptoms of patients with advanced malignant tumors of deficiency of both spleen and kidney, reduce the score of TCM symptoms, and improve the quality of life of patients, the effect is significant. Jianpi Bushen Recipe has no obvious effect on the improvement of humoral immune function of patients with advanced malignant tumors of deficiency of both spleen and kidney, compared with the control group. Compared with blank group, there was no obvious advantage.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R730.5
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