养阴抗瘤饮与化疗联合治疗中晚期肺癌的临床研究

Clinical study on the combination of Yangyin Kangliu Yin and chemotherapy in the treatment of middle and advanced lung cancer

摘要

目的 本研究旨在从免疫调节角度探讨养阴抗瘤饮联合化疗治疗中晚期肺癌的临床价值，分析该方案对患者免疫功能的影响，以期为中西医结合治疗中晚期肺癌提供免疫学参考。方法 选取2020年9月至2025年1月于贵州中医药大学第二附属医院肿瘤科收治的60例中晚期肺癌患者作为研究对象，依据随机数字表法将其分为对照组（30例，接受单纯化疗）与干预组（30例，在化疗基础上联合养阴抗瘤饮治疗）。两组患者均完成2个治疗周期。观察并比较两组患者的客观缓解率（ORR）与疾病控制率（DCR），同时检测治疗前后的中医证候积分、肿瘤标志物水平（CEA、ProGRP）及免疫细胞（CD3⁺T、CD4⁺T、NK）计数，同时评估体能状态（KPS、ECOG评分）、化疗相关不良反应及临床症状改善情况。结果 （1）干预组ORR（46.7%）、DCR（93.3%）略高于对照组（36.7%、80.0%），但差异无统计学意义（P＞0.05）；干预组治疗后中医证候总积分（8.28±0.39）低于对照组（11.32±0.36），差异有统计学意义（P＜0.05）。（2）治疗后干预组血清CEA（17.59±5.85）ng/mL和ProGRP（481.33±196.33）pg/mL水平低于对照组（42.70±21.05和579.33±270.47）pg/mL，差异有统计学意义（P＜0.05）。（3）治疗后干预组外周血CD3⁺T细胞（945.24±112.96）个/μL、CD4⁺T细胞（636.01±56.50）个/μL、NK细胞（328.99±35.17）个/μL数量均高于对照组，分别为（579.43±96.62、354.29±85.04、189.70±32.18）个/μL，差异有统计学意义（P＜0.05）。（4）干预组0度消化道反应（46.7%）和0度骨髓抑制（53.3%）的发生率高于对照组（16.7%、20.0%），差异有统计学意义（P＜0.05）。（5）干预组在咳嗽、咳痰、气短、乏力症状上达到无症状状态的患者比例（分别为36.7%、50.0%、73.3%、60.0%）高于对照组（20.0%、20.0%、46.7%、23.3%），差异有统计学意义（P＜0.05）。结论 养阴抗瘤饮联合化疗可通过上调中晚期肺癌患者外周血CD3⁺T、CD4⁺T及NK细胞水平，增强免疫功能，减少肿瘤负荷，减轻化疗相关毒副反应，改善临床症状，为中晚期肺癌患者免疫调节治疗提供有效方案。

Abstract

Objective This study investigated the clinical value of combining the Yin-nourishing and Tumor-inhibiting Decoction with chemotherapy for the treatment of advanced lung cancer from an immunomodulatory perspective. Methods A total of 60 patients with locally advanced or metastatic lung cancer admitted to the Department of Oncology at the Second Affiliated Hospital of Guizhou University of Chinese Medicine between September 2020 and January 2025 were enrolled. They were divided into control (n=30, receiving chemotherapy alone) and intervention (n=30, receiving chemotherapy plus Yangyin Kangliu Yin) groups. Both groups completed two treatment cycles. The objective response rate (ORR) and disease control rate (DCR) were compared. Pre- and post-treatment measurements were evaluated. Results (1) The ORR (46.7%) and DCR (93.3%) in the intervention group were slightly higher than those in the control group (36.7% and 80.0%), but the differences were not significant; The total TCM syndrome score in the intervention group after treatment (8.28±0.39) was lower than control group (11.32±0.36, P＜0.05). (2) Post-treatment, serum CEA (17.59±5.85) ng/ml and ProGRP (481.33±196.33) pg/ml levels in the intervention group were lower than those in the control group (42.70±21.05 and 579.33±270.47) pg/ml (P＜0.05). (3) After treatment, the intervention group had higher levels of peripheral blood CD3⁺ T cells (945.24±112.96), CD4⁺ T cells (636.01±56.50) and NK cells (328.99±35.17) were higher than those in the control group (579.43±96.62, 354.29±85.04, and 189.70±32.18 cells/μl, P＜0.05). (4) The incidence of Grade 0 gastrointestinal reactions (46.7%) and Grade 0 bone marrow suppression (53.3%) in the intervention group was higher than that in the control group (16.7% and 20.0%, P＜0.05). (5) The proportion of patients in the intervention group who achieved asymptomatic state for cough, sputum, shortness of breath, and fatigue (36.7%, 50.0%, 73.3%, and 60.0%) was higher than that in the control group (20.0%, 20.0%, 46.7%, and 23.3%, P＜0.05). Conclusion Yin-nourishing and tumor-inhibiting decoction combined with chemotherapy can enhance immune function by upregulating peripheral blood CD3⁺ T, CD4⁺ T, and NK cells in patients with advanced lung cancer. This approach reduces tumor burden, alleviates chemotherapy-related adverse reactions, and improves clinical symptoms, providing an effective immunomodulatory treatment strategy for patients with advanced lung cancer.

关键词

养阴抗瘤饮 / 中晚期肺癌 / 免疫功能 / CD3⁺T细胞 / CD4⁺T细胞 / 自然杀伤细胞 / 化疗减毒增效

Key words

Yangyin Kangliu Yin / middle-advanced lung cancer / immune function / CD3⁺ T cells / CD4⁺ T cells / NK cells / chemotherapy attenuation and synergy

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基金资助

贵州省卫生健康委科学技术基金资助项目(gzwkj2024-288)

贵州省中医药管理局、民族医药科学技术研究课题(QZYY-2015-019)

贵州省科学技术基金资助项目(黔科合J字(2015)2018)