补肺消积饮配合化疗对肺癌免疫逃逸的干预作用

【摘要】目的探讨补肺消积饮配合化疗对气阴两虚型中晚期非小细胞肺癌免疫逃逸的干预作用。方法将50例气阴两虚型中晚期非小细胞肺癌患者随机分为治疗组（补肺消积汤+化疗）25例和对照组（单纯化疗）25例，对照组中2例未完成规定疗程，不计入疗效分析。对照组均采用长春瑞滨+顺铂（NP）化疗方案，治疗组在对照组基础上从第1天开始加服补肺消积饮。每4周为1个疗程，2个疗程后观察临床疗效及免疫抑制性细胞（血管内皮生长因子、转化生长因子-β1、可溶性CD44v6以及CD4+CD25+调节性T细胞）情况，治疗结束后随访观察远期疗效。结果治疗组症状缓解率为80%，优于对照组的43.5%（U=167.50，P=0.005）；治疗组免疫抑制性细胞治疗后较治疗前降低（P＜0.05）。对照组治疗后免疫抑制性细胞较治疗前对比升高（P＜0.05）。治疗组较对照组治疗后免疫抑制性细胞下降明显。治疗组1年累计生存率为44.0%（11/25），与对照组的30.4%（7/23）比较差异无统计学意义（χ2=0.941，P＞0.05），2组生存期差异亦无统计学意义（χ2=3.221，P＞0.05），2组疾病进展时间比较，差异无统计学意义（χ2=2.524，P＞0.05）。结论补肺消积汤配合化疗能抑制免疫抑制性细胞的分泌，有效干预肿瘤免疫逃逸，在临床症状改善、延长患者生存期及无疾病进展期方面均优于单纯化疗。

Intervention Effect on Tumor Immune Escape by BuFeiXiaoJiYin combined Chemotherapy on Non-small Cell Lung Cancer

To investigate the intervention effect on Tumor Immune Escape by BuFeiXiaoJiYin combined Chemotherapy on middle and advanced stage of non-small cell lung cancer(NSCLC) with the Yin and Qin deficiency type. Methods: 48 cases of middle and advanced stage of non-small cell lung cancer with the Yin and Qin deficiency type were randomly divided into the treatment group (BuFeiXiaoJiYin + chemotherapy) and the control group (chemotherapy alone), every 4 weeks for a cycle, clinical symptoms, immune suppression cell and follow-up forward curative effect were observed after the two cycles. Results: The clinical symptoms of the two groups were alleviated due to treatment (P < 0.01), and the treatment group showed better than the control group（P<0.05）. The immune suppression cells of the treatment group dropped after the two cycles（P<0.01）, however, the cells grew up at the control group（P<0.05）.The immune suppression cells in the treatment group dropped obviously , compared with the control group after treatment , and there was significant difference between the two groups(P < 0.01). The median survival and the disease progressing time of the two groups was 310 d and 226, 139 d and 100 d respectively by the follow-up, 1 year accumulative total survival rates were 44% and 30.4%, the data of the treatment group are all better than the control group, while there was not statistical differences (P﹥0.05).Conclusion: BuFeiXiaoJiYin combined chemotherapy could suppress the immune suppression cell secretion and intervene tumor immune escape, Integrating modern and traditional medicine was superior to chemotherapy alone at alleviating symptoms and prolonging survival period and disease free time .