肺抑瘤膏对lewis肺癌小鼠的干预及肺癌中医证型与病理类型相关性的研究

发布时间：2018-08-20 20:27

【摘要】：目的:(1)动物实验研究肺抑瘤膏对lewis肺癌小鼠移植瘤的干预机制,为肺抑瘤膏治疗晚期肺腺癌提供一定的理论依据。(2)临床研究74例原发性支气管肺癌患者中医证型与病理类型的相关性,为中医辨证分型提供客观化依据。方法:(1)动物实验建立lewis肺癌小鼠模型,随机分为六组,分别为模型对照组(M组)、肺抑瘤膏低剂量组(ZD组)、肺抑瘤膏中剂量组(ZZ组)、肺抑瘤膏高剂量组(ZG组)、顺铂组(S组)及肺抑瘤膏加顺铂组(SZ组),造模第5天,对不同组分别予以相应的药物处理,给药21天结束后脱颈椎处死小鼠取移植瘤,测量瘤重,并通过流式细胞术Annexin V-FITC/PI法检测细胞凋亡率。(2)临床研究将74例不同病理类型的肺癌患者辨证分型为气滞血瘀型、气虚血瘀型、气阴两虚型、阴虚内热型、脾虚痰湿型、热毒炽盛型,对中医证型与病理类型进行统计学分析。结果:(1)瘤重、抑瘤率:各实验组瘤重较M组平均瘤重低,差别具有统计学意义(p0.05)。中药组除ZZ组与ZG组间P0.05,其余中药组组间比较有统计学意义,中药剂量越高,瘤重越小;SZ组对肿瘤的抑制作用最佳,其次为S组。(2)细胞凋亡率:各实验组凋亡率均高于M组,具有统计学意义(P0.05);组间两两进行对比,除ZZ组与ZG组比较P0.05外,其余各组组间比较P值均小于0.05,具有统计学意义。(3)临床研究发现腺癌与鳞癌的中医证型分布存在差异(P0.05)。腺癌患者中气阴两虚占33.3%,阴虚内热型占30.8%;鳞癌患者中气滞血瘀型占38.1%,气虚血瘀型,占28.6%。小细胞癌、大细胞癌、及其他类型的肺癌因样本数量少,在不同中医证型患者中的分布情况无统计学意义。结论:(1)肺抑瘤膏对lewis肺癌移植瘤生长有抑制作用,肺抑瘤膏中剂量与肺抑瘤膏高剂较低剂量的抑瘤作用明显。(2)肺抑瘤膏能够通过促肿瘤细胞凋亡抑制肿瘤的生长。(3)肺抑瘤膏对顺铂抑制肿瘤生长有协同增效作用。(4)肺腺癌以虚证(气阴两虚型、阴虚内热型)为主,鳞癌以实证(气滞血瘀型、气虚血瘀型)为主,可作为微观辨证的一个指标。因小细胞肺癌、大细胞癌及其他类型的肺癌样本数量少,在不同中医证型中的分布无统计学意义,有待于进一步增加样本量,以探讨其中医证型的分布情况。
[Abstract]:Objective: (1) to study the interventional mechanism of Fei Yi Liu Gao (FYO) on transplanted tumor of lewis lung cancer mice. To provide a theoretical basis for the treatment of advanced lung adenocarcinoma. (2) Clinical study of 74 cases of primary bronchial lung cancer patients with traditional Chinese medicine syndrome type and pathological type of correlation, for TCM syndrome differentiation to provide an objective basis. Methods: (1) lewis lung cancer mice were randomly divided into six groups. Model control group (M group), low dose group (ZD group), middle dose group (ZZ group), high dose group (ZG group), cisplatin group (S group) and lung tumor ointment plus cisplatin group (SZ group). After 21 days of administration, the mice with cervical vertebrae were killed to take the transplanted tumor, and the tumor weight was measured. The apoptosis rate was detected by flow cytometry (Annexin V-FITC/PI). (2) 74 cases of lung cancer with different pathological types were classified as qi stagnation and blood stasis type, qi deficiency and blood stasis type, qi and yin deficiency type, yin deficiency internal heat type, spleen deficiency phlegm damp type. The syndrome type and pathological type of TCM were analyzed statistically. Results: (1) tumor weight and tumor inhibition rate: the average tumor weight of each experimental group was lower than that of M group (p0.05). In Chinese medicine group, there was significant difference between ZZ group and ZG group (P0.05). The higher the dosage of traditional Chinese medicine, the smaller the tumor weight, SZ group had the best inhibitory effect on tumor, followed by S group. (2) apoptosis rate: the apoptosis rate of each experimental group was higher than that of M group. There was statistical significance (P0.05); two groups were compared except ZZ group and ZG group P value was less than 0.05 (P < 0.05). (3) Clinical study found that there were differences in the distribution of TCM syndromes between adenocarcinoma and squamous cell carcinoma (P0.05). In adenocarcinoma patients, the deficiency of both qi and yin was 33.33.3, the type of internal heat due to yin deficiency was 30.8; in the patients with squamous cell carcinoma, Qi stagnation and blood stasis accounted for 38.1, and qi deficiency and blood stasis accounted for 28.6. The distribution of small cell carcinoma, large cell carcinoma and other types of lung cancer in different TCM syndromes was not statistically significant because of the small number of samples. Conclusion: (1) FYO can inhibit the growth of transplanted tumor of lewis lung cancer. The middle dose of Feiyao tumour ointment and the low dose of Feiyi tumour ointment had obvious antitumor effect. (2) FYO could inhibit the growth of tumor by promoting apoptosis of tumor cells, (3) FYO had synergistic effect on the inhibition of tumor growth by cisplatin; (4) FYO had a synergistic effect on the inhibition of tumor growth by Cisplatin. Lung adenocarcinoma is characterized by deficiency (deficiency of Qi and Yin). Yin deficiency and internal heat are the main types of squamous cell carcinoma (qi stagnation and blood stasis type, qi deficiency and blood stasis type), which can be used as an index of micro syndrome differentiation. Because of the small number of small cell lung cancer, large cell carcinoma and other types of lung cancer samples, there is no statistical significance in the distribution of different TCM syndromes, so it is necessary to further increase the sample size in order to explore the distribution of TCM syndromes.
【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R273

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