晚期肺癌恶病质中医辨证分型及细胞因子变化

目的探讨晚期肺癌恶病质血清细胞因子变化与不同中医证型之间的关系。方法对38例晚期肺癌恶病质患者进行中医辨证分型,并检测血清肿瘤坏死因子α（tunor necrosis factor-α,TNF-α）、白细胞介素-1（interleukin-1,IL-1）、白细胞介素-6（interleukin-6,IL-6）水平。结果 38例肺癌恶病质患者中,10例（占26.3%）为气虚痰湿型,5例（占13.2%）为阴虚内热型,3例（占7.9%）为气滞血瘀型,20例（占52.6%）为气阴两虚型。与健康对照组比较,气阴两虚型和阴虚内热型TNF-α显著增高（P〈0.05）,气虚痰湿型和气滞血瘀型TNF-α显著减低;气阴两虚型、阴虚内热型、气虚痰湿型IL-1I、L-6水平均显著增高。结论肺癌恶病质中医辨证分型以气阴两虚型为主,TNF-αI、L-1I、L-6是肺癌恶病质相关因子,TNF-αI、L-1与恶病质的阴虚证有关,IL-6水平可能是反映气虚的一个指标。

The Relationship between Cytokines and Syndrome Differentiation of Traditional Chinese Medicine in Lung Cancer Induced Cachexia

Objective To study the relationship between cytokines and syndrome differentiation of traditional Chinese medicine in lung cancer induced cachexia.Methods Thirty-eight patients of lung cancer induced cachexia were differentiated into syndrome types,and their serum levels of tumor necrosis factor-α(TNF-α),interleukin-1(IL-1) and interleukin-6(IL-6) were assayed.Results Of 38 patients with lung cancer induced cachexia,10(accounting for 26.3%) were diagnosed as type of qi deficiency and phlegm-damp,5(accounting for 13.2%) as type of yin deficiency and internal heat,3(accounting for 7.9%) as type of qi stagnation and blood stasis,and 20(accounting for 52.6%) as type of both qi and yin deficiency.Compared with those in healthy controls,the levels of TNF-α were significantly increased in the type of both qi and yin deficiency,and the type of yin deficiency and internal heat,while they were significantly decreased in the type of qi deficiency and phlegm-damp,and the type of qi stagnation and blood stasis.The levels of IL-1 and IL-6 were all significantly increased in types of both qi and yin deficiency,yin deficiency and internal heart,and qi deficiency and phlegm-damp.Conclusion The most common type in lung cancer induced cachexia was both qi and yin deficiency.TNF-α,IL-1,and IL-6 are the cytokines related with lung cancer induced cachexia.TNF-α and IL-1 are related with the type of yin deficiency,and IL-6 is maybe an indicator of qi deficiency.