健脾補腎方對脾腎兩虛型晚期惡性腫瘤患者免疫功能的影響
發(fā)布時間：2018-08-29 10:45
【摘要】：目的:本研究旨在通過收集分析2015年1月~2015年10月在河北醫(yī)科大學附屬石家莊平安醫(yī)院腫瘤科住院,并符合入組標準的脾腎兩虛型晚期惡性腫瘤患者90例。初步評價健脾補腎方對脾腎兩虛型晚期惡性腫瘤患者免疫功能的影響。方法:采用隨機非盲平行對照的研究方法,共納入符合標準的脾腎兩虛型晚期惡性腫瘤患者90例,分別納入治療組、空白組、對照組,各組患者均30例,治療組、空白組和對照組均給予常規(guī)營養(yǎng)支持及對癥處理,治療組給予健脾補腎方(人參、白術、甘草、菟絲子、淫羊藿、巴戟天、女貞子、柴胡、雞內(nèi)金),由我院藥劑科采用自動煎藥機制備,每袋150ml,每次1袋,每日2次,口服,連續(xù)服用4周。對照組給予靜脈滴注葡萄糖250ml、胸腺五肽1mg,一日一次,連續(xù)治療4周�？瞻捉M單純應用常規(guī)營養(yǎng)支持及對癥處理,連續(xù)4周。記錄三組治療前后的臨床癥狀及體征、外周血T淋巴細胞亞群相關數(shù)值(CD3+、CD4+、CD8+、CD4+/CD8+、NK)、免疫球蛋白、中醫(yī)癥候積分、生活質(zhì)量評分等療效指標以及血尿常規(guī)、大便常規(guī)、肝腎功能、心電圖等安全性指標,并進行統(tǒng)計學分析,以評價健脾補腎方對脾腎兩虛型晚期惡性腫瘤患者免疫功能的影響。結(jié)果:通過臨床觀察進行了90例脾腎兩虛型晚期惡性腫瘤患者免疫功能、中醫(yī)癥候積分及生活質(zhì)量評分的對照研究。我們對治療前三組患者的年齡、性別、病情差異、臨床分期等資料進行比較,差異均無統(tǒng)計學意義(P0.05),具有可比性。我們對三組患者治療前淋巴細胞亞群、免疫球蛋白、中醫(yī)癥候積分及生活質(zhì)量評分等指標進行了比較,結(jié)果發(fā)現(xiàn)治療前三組間各指標無顯著差異,無統(tǒng)計學意義(P0.05),具有可比性。1治療后三組與各自治療前的細胞免疫功能指標進行對比(1)治療組:CD3+、CD4+、CD4+/CD8+、NK細胞水平較治療前明顯提高,CD8+細胞水平較治療前明顯下降,P0.01。(2)對照組:CD3+、CD4+細胞水平較治療前提高,P0.05;CD8+細胞水平較治療前明顯下降,P0.01;CD4+/CD8+值、NK細胞水平較治療前無顯著變化,P0.05。(3)空白組:CD3+細胞水平較治療前明顯下降,P0.05;CD4+、CD8+、CD4+/CD8+、NK細胞水平無明顯改善,P0.05。2治療后三組間細胞免疫功能指標比較:治療組CD3+、CD4+、CD8+、CD4+/CD8+以及NK細胞各指標改善情況均優(yōu)于對照組和空白組,差異存在統(tǒng)計學意義(P0.05)。3治療后三組間免疫球蛋白改善情況對比,治療組、對照組及空白組無顯著差異,統(tǒng)計學無意義(P0.05)。4治療后三組間中醫(yī)癥候積分對比,治療組較對照組、空白組有顯著優(yōu)勢,P0.01。治療組與對照組比較,P=0.00350.01;治療組與空白組比較,P=0.00160.01;對照組與空白組比較,P=0.79520.05。5治療后三組生活質(zhì)量評分對比,治療組較對照組、空白組有明顯優(yōu)勢,P0.01。治療組與對照組比較,P=0.00230.01;治療組與空白組比較,P=0.00100.01;對照組與空白組比較,P=0.79340.05。6治療后三組間不良反應對比,治療組、對照組、空白組不良反應發(fā)生率無顯著差異,P0.05。結(jié)論:通過臨床觀察研究,我們發(fā)現(xiàn)健脾補腎方能夠有效改善脾腎兩虛型晚期腫瘤患者的細胞免疫功能,CD3+、CD4+、CD8+、CD4+/CD8+值以及NK細胞水平均有顯著改善,明顯優(yōu)于胸腺五肽對照組及空白組。對照組胸腺五肽對晚期腫瘤患者的免疫功能亦有一定改善作用,可以使CD3+、CD4+細胞水平提高,CD8+細胞水平下降,但對于CD4+/CD8+值以及NK細胞水平改善不明顯,總療效劣于健脾補腎方�？瞻捉M患者經(jīng)過營養(yǎng)支持對癥治療免疫功能無改善,甚至免疫功能出現(xiàn)下降,研究發(fā)現(xiàn)空白組患者CD3+細胞水平下降顯著,說明如果不給予脾腎兩虛型腫瘤患者相關提高免疫力的治療,隨著腫瘤病情發(fā)展,患者免疫功能會逐漸下降。另外,健脾補腎方能夠有效減輕脾腎兩虛型晚期惡性腫瘤患者臨床癥狀,降低中醫(yī)癥候積分,提高患者生活質(zhì)量評分,效果顯著。健脾補腎方對于脾腎兩虛型晚期惡性腫瘤患者體液免疫功能的改善作用不明顯,與對照組、空白組相比,無明顯優(yōu)勢。
[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.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R730.5
本文編號：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.
【學位授予單位】：河北醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R730.5
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