八珍汤对肺癌化疗致白细胞减少症临床疗效及部分机制研究

目的:探究八珍汤对肺癌化疗所致白细胞减少症的疗效及作用机制,有助于精准治疗并提高疗效。方法:选取2017年4月至2018年4月哈尔滨医科大学附属第一医院收治的肺癌化疗所致白细胞减少症患者66例作为研究对象,采用数字随机表法按就诊顺序号,分为对照组和观察组,每组33例。对照组予利血生20 mg口服,3次/d;鲨肝醇100 mg口服,3次/d,升白治疗,观察组在对照组基础上加用八珍汤化裁治疗,均治疗4周,观察不同方法治疗后在白细胞水平含量比较,比较治疗前、治疗末神疲乏力、心悸气短、头晕目眩、面色淡白、畏寒肢冷、纳呆食少中医症候积分和免疫功能指标CD4^+、CD8^+、CD4^+/CD8^+、NK细胞变化情况,治疗过程中收集不良反应情况,结束治疗后观察疗效情况。结果:1)2组治疗1周、2周、3周、4周后白细胞计数菌显著高于治疗前(P<0.05),观察组治疗1周、2周、3周、4周后显著优于对照组(P<0.05);2)2组患者治疗前神疲乏力、心悸气短、头晕目眩、面色淡白、畏寒肢冷、纳呆食少,比较差异无统计学意义(P>0.05),完成治疗方案后,2组患者以上指标较治疗前均显著下降(P<0.05)。治疗末观察组患者以上指标显著低于对照组(P<0.05)。3)2组患者治疗前CD4^+、CD8^+、CD4^+/CD8^+、NK细胞比较,差异无统计学意义(P>0.05),完成治疗方案后,2组患者CD8^+较治疗前均显著下降,CD4^+、CD4^+/CD8^+、NK细胞较治疗前显著升高(P<0.05),治疗末观察组患者以上指标显著优于对照组(P<0.05)。4)完成治疗后观察组患者显效率、总有效率明显高于对照组(P<0.05)。5)2组在不良反应发生率上比较,差异无统计学意义(P>0.05)。结论:八珍汤对肺癌化疗所致白细胞减少症能升高白细胞水平,提高疗效,改善症状。可能和该药能提高机体免疫力,促使骨髓造血功能有关。

Clinical Efficacy and Mechanism of Bazhen Decoction on Leukocyte Reduction Induced by Chemotherapy in Lung Cancer

Objective:To explore the curative effect of Bazhen Decoction on leukopenia caused by chemotherapy for lung cancer,and to explore its mechanism of action,so as to target treatment and improve the curative effect.Methods:A total of 66 patients with leukopenia caused by chemotherapy for lung cancer who were admitted to First Affiliated Hospital of Harbin Medical University from April 2017 to April 2018 were enrolled.The patients were divided into a control group(33 cases)and an observation group(33 cases)according to the order of treatment.The control group was given Lixuesheng 20 mg orally,3 times a day;batyl alcohol 100 mg orally,3 times a day for increasing white blood cell;on the basis of the control group,the observation group were added modified Bazhen Decoction.Both groups were treated for 4 weeks.After different methods of treatment,the white blood cell level comparison was observed.The mental fatigue,palpitations,short breath,dizziness,aversion to cold,cold limbs,poor appetite and less food intake,the changes of CD4^+,CD8^+,CD4^+/CD8^+,NK cells before and at the end of treatment were compared.Adverse reactions were collected during the treatment.The clinical efficacy was observed after treatment.Results:1)The white blood cell count bacteria of the 2 groups were significantly higher than before treatment after 1,2,3,and 4 weeks of treatment(P<0.05).The observation group was significantly better than the control group after 1,2,3,and 4 weeks of treatment(P<0.05).2)There were no statistical significant differences in the comparison of the mental fatigue,palpitations,short breath,dizziness,aversion to cold,cold limbs,poor appetite and less food intake between the 2 groups before treatment(P>0.05).After the treatment,the above indexes of the 2 groups were significantly decreased than those before treatment(P<0.05).At the end of treatment,the above indexes of the observation group were significantly lower than those of the control group(P<0.05).3)There was no significant difference in CD4^+,CD8^+,CD4^+/CD8^+,NK cells between the 2 groups before treatment(P>0.05).After the treatment,CD8^+ in the 2 groups decreased significantly.CD4^+,CD4^+/CD8^+,NK cells increased significantly(P<0.05),and the above indexes in the observation group were significantly better than those in the control group at the end of treatment(P<0.05).4)After treatment,the effective rate and total effective rate of the observation group were significantly higher than those of the control group(P<0.05).5)There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion:Bazhen Decoction can elevate the level of leukocyte,improve the curative effect and improve the symptoms of leukopenia caused by chemotherapy for lung cancer.It may be related to the enhancement of immunity and the hematopoietic function of bone marrow.