四君子汤加味联合免疫化疗治疗晚期肺癌对患者疗效及相关细胞因子的影响

靖景艳; 吴阿敏; 薛亚楠; 徐艳霞; 褚磊

doi:10.16766/j.cnki.issn.1674-4152.003784

四君子汤加味联合免疫化疗治疗晚期肺癌对患者疗效及相关细胞因子的影响

doi: 10.16766/j.cnki.issn.1674-4152.003784

1.
康复大学青岛中心医院(青岛市中心医院)中西医科，山东青岛 266000
2.
康复大学青岛中心医院(青岛市中心医院)医务部

基金项目:

山东省中医药科技重点项目 Z-2022009

详细信息

通讯作者:
褚磊，E-mail：dyjc9105@126.com

中图分类号: R734.2 R289.51
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- 文章访问数: 21
- HTML全文浏览量: 13
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2024-04-05
- 网络出版日期: 2025-01-20

Effectiveness of Sijunzi Decoction combined with immunochemotherapy in patients with advanced lung cancer and its influence on related cytokines

1.
Department of Chinese and Western Medicine, University of Health and Rehabilitation Sciences (Qingdao Central Hospital), Qingdao, Shandong 266000, China

摘要

摘要: 目的在免疫化疗治疗晚期肺癌的前提下,加用四君子汤加味治疗,探究其对晚期肺癌患者疗效、生存质量、T细胞亚群、外周血象、生存情况等的影响，为临床改善晚期肺癌的疗效，改善患者生存质量提供依据。方法纳入2022年8月—2023年8月青岛市中心医院收治的100例晚期肺癌患者，采用随机数表法分为观察组(四君子汤加味联合免疫化疗治疗)和对照组(免疫化疗治疗)各50例，比较2组临床疗效及治疗前后生存质量[美国肺癌生存质量量表(FACT-L4.0)]、T淋巴细胞亚群(CD3⁺、CD3⁺/CD4⁺、CD3⁺/CD8⁺)、外周血象[白细胞(WBC)、白蛋白(ALB)、血红蛋白(Hb)、血小板(PLT)]，比较2组生存情况[无进展生存期(PFS)、中位总生存期(OS)]、不良反应发生率。结果治疗12周，2组总有效率比较差异无统计学意义[52%(26/50) vs. 44%(22/50)，P>0.05]；2组治疗12周后生理状况、功能状况、CD4⁺/CD8⁺均高于治疗前，WBC、ALB、PLT均低于治疗前，观察组CD4⁺水平高于治疗前，CD8⁺低于治疗前，对照组Hb低于治疗前(P<0.01)，治疗12周后观察组CD4⁺、CD4⁺/CD8⁺、WBC、ALB、Hb、PLT高于对照组，CD8⁺低于对照组(F=6.047、18.539、10.934、2.218、7.415、6.260、5.895，P<0.05)；2组PFS、OS、3~4级不良反应发生率比较差异均无统计学意义(P>0.05)。结论四君子汤加味联合免疫化疗治疗晚期肺癌能够显著提升患者免疫功能，减少毒副反应，提升生存质量。
- 肺癌 /
- 四君子汤 /
- 化疗 /
- T淋巴细胞 /
- 生活质量
Abstract: Objective Under the premise of immunochemotherapy treatment of advanced lung cancer, Sijunzi Decoction was added to explore the effect of advanced lung cancer on patients, quality of life, T cell subsets, peripheral blood image, health. To provide a basis for clinical improvement of the efficacy of advanced lung cancer, improve the quality of life of patients. Methods A total of 100 patients with advanced lung cancer admitted to Qingdao Central Hospital from August 2022 to August 2023 were included and divided into the observation group (n=50, Sijunzi Decoction combined with immunochemotherapy) and the control group (n=50, immunochemotherapy) by random number table method. The clinical efficacy, quality of life [using function assessment of cancer therapy-lung cancer (FACT-L4.0)], T lymphocyte subsets (CD3⁺, CD3⁺/CD4⁺, CD3⁺/CD8⁺), and peripheral blood parameters [white blood cells (WBC), albumin (ALB), hemoglobin (Hb), platelets (PLT)] were compared before and after treatment. Survival status, such as progression-free survival (PFS), overall survival (OS), and adverse reaction rate were analyzed. Results The two groups had no significant difference in overall effective rate after 12 weeks of treatment [52% (26/50) vs. 44% (22/50)， P>0.05]. After 12 weeks of treatment, physiological status, functional status, CD4⁺/CD8⁺, WBC, ALB, PLT were all higher in 2 groups than before treatment. The level of CD4⁺ in observation group was higher than before treatment, CD8⁺ in observation group was lower than before treatment, and Hb in control group below pre-treatment (P<0.01). After 12 weeks of treatment, the observation group had higher levels of CD4⁺, CD4⁺/CD8⁺, WBC, ALB, Hb, and PLT, but lower CD8⁺ compared to the control group (F=6.047, 18.539, 10.934, 2.218, 7.415, 6.260, 5.895, P<0.05). In terms of PFS, OS or grade 3-4 adverse reactions, the two groups had no significant differences (P>0.05). Conclusion Sijunzi Decoction combined with immunochemotherapy significantly improves the immune function of patients with advanced lung cancer, reduces toxic and side effects, and improves the quality of life in patients with advanced lung cancer.
- Lung cancer /
- Sijunzi Decoction /
- Chemotherapy /
- T lymphocytes /
- Quality of life

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表 1 2组晚期肺癌患者临床疗效比较[例(%)]

Table 1. Comparison of clinical efficacy between the two groups of patients with advanced lung cancer [cases (%)]

组别	例数	临床疗效				总有效
组别	例数	完全缓解	部分缓解	疾病稳定	疾病进展	总有效
观察组	50	0	26(52.00)	18(36.00)	6(12.00)	26(52.00)
对照组	50	0	22(44.00)	20(40.00)	8(16.00)	22(44.00)
统计量		0.843^a				0.641^b
P值		0.399				0.423
注：^a为Z值，^b为χ²值。

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表 2 2组晚期肺癌患者FACT-L4.0各维度得分比较(x±s，分)

Table 2. Comparison of FACT-L4.0 scores between the two groups of patients with advanced lung cancer (x±s, points)

组别	例数	生理状况		t值	P值	社会家庭		t值	P值	情感状况		t值	P值
组别	例数	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值
观察组	50	19.93±2.92	23.61±3.42	8.209	< 0.001	21.07±4.01	21.71±3.39	1.223	0.226	17.99±3.46	18.65±3.43	1.355	0.181
对照组	50	20.01±2.69	23.47±3.55	7.842	< 0.001	21.13±4.44	21.26±3.85	0.222	0.825	17.50±3.69	18.52±3.25	1.992	0.051
统计量		0.142^a	0.157^b			0.071^a	0.477^b			0.685^a	0.125^b
P值		0.887	0.876			0.944	0.635			0.495	0.901

组别	例数	功能状况				t值	P值	附加关注				t值	P值
组别	例数	治疗前		治疗12周后		t值	P值	治疗前		治疗12周后		t值	P值
观察组	50	14.56±3.44		18.01±4.53		6.122	< 0.001	22.53±4.53		23.51±4.74		1.495	0.140
对照组	50	14.81±3.59		18.24±4.12		6.292	< 0.001	22.41±3.96		23.19±4.67		1.278	0.206
统计量		0.356^a		0.164^b				0.141^a		0.229^b
P值		0.723		0.870				0.888		0.820
注：^a为t值，^b为F值。

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表 3 2组晚期肺癌患者CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺水平比较(x ±s)

Table 3. Comparison of CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺ levels between the two groups of patients with advanced lung cancer (x ±s)

组别	例数	CD3⁺(%)		t值	P值	CD4⁺(%)		t值	P值	CD8⁺(%)		t值	P值	CD4⁺/CD8⁺		t值	P值
组别	例数	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值
观察组	50	64.06±3.54	64.90±4.19	1.537	0.130	34.51±4.55	42.07±5.59	10.544	< 0.001	31.48±3.58	26.05±3.24	11.260	< 0.001	1.10±0.10	1.61±0.13	31.359	< 0.001
对照组	50	63.33±3.67	64.56±4.41	1.803	0.077	34.37±4.90	35.61±5.08	1.757	0.084	31.03±3.20	30.10±3.62	1.928	0.059	1.11±0.09	1.18±0.10	5.210	< 0.001
统计量		1.012^a	0.236^b			0.148^a	5.113^b			0.663^a	4.775^b			0.526^a	15.083^b
P值		0.314	0.814			0.883	< 0.001			0.509	< 0.001			0.600	< 0.001
注：^a为t值，^b为F值。

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表 4 2组晚期肺癌患者WBC、ALB、Hb、PLT水平比较(x ±s)

Table 4. Comparison of WBC, ALB, Hb and PLT levels between the two groups of patients with advanced lung cancer (x ±s)

组别	例数	WBC(×10⁹/L)		t值	P值	ALB(g/L)		t值	P值	Hb(g/L)		t值	P值	PLT(×10⁹/L)		t值	P值
组别	例数	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值	治疗前	治疗12周后	t值	P值
观察组	50	6.78±0.26	6.25±0.55	9.253	< 0.001	38.97±4.67	34.23±4.16	7.592	< 0.001	131.23±12.08	129.14±13.47	1.157	0.252	205.26±21.53	178.22±20.71	9.053	< 0.001
对照组	50	6.80±0.30	4.98±0.61	28.284	< 0.001	39.25±4.38	32.40±4.09	11.437	< 0.001	132.50±13.16	110.43±11.70	12.555	< 0.001	202.47±22.93	151.88±21.36	16.154	< 0.001
统计量		0.356^a	8.565^b			0.309^a	2.077^b			0.503^a	5.949^b			0.627^a	5.011^b
P值		0.722	< 0.001			0.758	0.042			0.616	< 0.001			0.532	< 0.001
注：^a为t值，^b为F值。

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表 5 2组晚期肺癌患者生存情况及不良反应比较

Table 5. Comparison of survival and adverse reactions between the two groups of patients with advanced lung cancer

组别	例数	PFS [M(P₂₅, P₇₅)，月]	OS [M(P₂₅, P₇₅)，月]	3~4级不良反应[例(%)]
观察组	50	4.20(3.21，5.12)	12.56(11.07，14.02)	7(14.00)
对照组	50	4.08(2.90，5.05)	12.17(10.98，13.89)	9(18.00)
统计量		0.856^a	0.394^a	0.298^b
P值		0.392	0.693	0.585
注：^a为Z值，^b为χ²值。

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