注射用香菇多糖对胃癌免疫调节作用的临床观察

目的观察注射用香菇多糖联合DCF（多西紫杉醇＋顺铂＋氟尿嘧啶）方案治疗胃癌的免疫调节作用及毒副反应。方法将经病理学及影像学确诊为胃癌的患者44例作为研究对象,其中术后20例,复发转移24例,随机分为注射用香菇多糖联合DCF方案组（联合治疗组）22例及单纯DCF方案组（对照组）22例。每例患者每治疗2个周期,进行疗效评价。结果联合治疗组可评价疗效22例,治疗后T细胞总数（CD3＋）、T辅助细胞（CD4＋）的数量及CD4＋/CD8＋比值均较治疗前增加（P〈0.05）。而对照组治疗后T辅助细胞（CD4＋）的数量有所降低（P〈0.05）,T细胞总数及CD4＋/CD8＋比值无明显变化。联合治疗组白细胞减少的发生率为63.64%,恶心呕吐发生率为59.09%,显著低于对照组白细胞减少（90.91%）及恶心呕吐发生率（86.36%）,差异有统计学意义（P〈0.05）。黏膜损害、腹泻及肝肾功能损害等不良反应的发生两组差异无统计学意义。结论注射用香菇多糖能够增加胃癌患者的免疫功能,减少DCF方案化疗的毒副作用,增加患者化疗耐受性。

Effect of ientinan injection combined with chemotherapy on lymphocyte subsets in the treatment of gastric cancer.

Objective To observe the immune regulation efficacies and toxicities oflentinan injection com- bined with DCF regimen （docetaxel ＋ cisplatin ＋ fluorouracil） in the treatment of patients with gastric carcinoma. Methods Forty-four patients with gastric carcinoma diagnosed by histopathology, cytlogy and imaging, the postoper- ative of 20 cases, recurrence and metastasis of 24 cases, were divided into two groups. They were treated with DCF regimen alone （control group, n=22） or combination with lentinan injection （combination treatment group, n=22）, and every patient received at least 2 cycles of the treatment. Results Twenty-two cases could be evaluated in combina- tion treatment group and 22 cases could be evaluated in control group. The immunological function detection showed that CD3~, CD4＋, CD4~/CD~~ increased obviously post-therapy than pre-therapy in the combination treatment group （P〈0.05） and CDC decreased after treatment （P〈0.05）. CD4＋ decreased after treatment in the control group （P〈 0.05）, another immunological functions had no difference between post-therapy and pre-therapy in the control group. The incidence of lencopenia and gastrointestinal reactions in combination treatment group were 63.64% and 59.09%. These incidence rates were significantly lower than those in the control group （P〈 0.05）. Conclusion Lentinan injec- tion combined with DCF chemotherapy can improve the immunological function of the patients and obviously plays a supporting and synergistic effect in the treatment of gastric cancer, with fewer side effects.