肺积方对肺癌免疫逃逸干预作用的临床研究

目的观察肺积方对肺癌免疫逃逸的干预作用。方法采用前瞻性随机对照研究方法,将60例气阴两虚型中晚期非小细胞肺癌患者随机分为治疗组（30例）和对照组（30例）,观察治疗前后外周血CD4^＋CD2^＋5Tr、IL-10、VEGF、sCD44v6及TGF-β1表达水平,并从肺癌患者瘤体变化、Karnofsky（KPS）评分、中医证候临床方面评价肺积方临床疗效。结果（1）与对照组比较,治疗组可降低外周血CD4^＋CD2^＋5Tr、VEGF、sCD44v6、TGF-β1、IL-10水平;（2）治疗组瘤灶稳定率（78.26%）优于对照组（50.00%,P〈0.05）;（3）治疗组KPS评分增加稳定率76.67%,对照组为43.33%;治疗组KPS改善情况优于对照组（P〈0.01）。（4）治疗组气阴两虚证候改善明显优于对照组。结论（1）肺积方可稳定瘤体,改善气阴两虚型中晚期非小细胞肺癌患者的临床症状,提高生存质量。（2）肺积方可以通过多途径干预肺癌免疫逃逸,恢复机体的免疫监视作用,提高临床疗效。

Intervention Effect of Feiji Recipe on Immune Escape of Lung Cancer

OBJECTIVE: To evaluate the intervention effect of Feiji Recipe (FJR) on tumor immune escape. METHODS: In the prospective randomized control study, 60 cases of middle stage and advanced non-small cell lung cancer (NSCLC) with qi-yin deficiency syndrome were randomly assigned to the treatment group and the control group, 30 in each group. The levels of CD+ CD25+ Tr, interleukin-10 (IL-10), vascular endothelial growth factor (VEGF), sCD44v6 and transforming growth factor-beta1 (TGF-beta1) of peripheral blood were observed before and after treatment, and the clinical efficacy of FJR was evaluated depending upon the changes in tumor size, Karnofsky Performance scoring (KPS) and TCM syndrome. RESULTS: (1) The levels of CD4+ CD2+Tr, VEGF, sCD44v6, TGF-beta1, and IL-10 decreased, in the treatment group as compared with those in the control group, respectively. (2) The stabilization rate of tumor in the treatment group was superior to that in the control group (78.26% vs 50.00%, P < 0.05). (3) The stabilization rate of KPS increasing in the treatment group and the control group was 76.67% and 43.33% respectively, suggesting the improvement of KPS in the treatment group was superior to that in the control group (P < 0.01). (4) Improvement in TCM qi-yin deficiency syndrome was more significant in the treatment group than that in the control group. CONCLUSION: FJR can stabilize the tumor body, improve the clinical symptoms of middle stage and advanced NSCLC with qi-yin deficiency syndrome, promote patients' quality of life, and is effective in recovering immuno-surveillance and intervening immune escape of lung cancer through multi-pathway to enhance the clinical therapeutic efficacy.