国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (2): 305-309.DOI: 10.3760/cma.j.issn.1007-1245.2024.02.026

• 临床研究 • 上一篇    下一篇

补中益气汤在驱动基因阴性NSCLC免疫治疗中的应用价值

姜军选1  方圆2   

  1. 1通许县中医院肿瘤科,许昌 475400;2商丘市第一人民医院肿瘤科,商丘 467000

  • 收稿日期:2023-07-27 出版日期:2024-01-15 发布日期:2024-02-02
  • 通讯作者: 姜军选,Email:jiangjunyuan123@yeah.net
  • 基金资助:

    河南省医学科技攻关项目(LHGJ2021001341)

Application value of Buzhong Yiqi decoction in immunotherapy of NSCLC with negative driver gene

Jiang Junxuan1, Fang Yuan2   

  1. 1 Department of Oncology, Tongxu County Hospital of Traditional Chinese Medicine, Xuchang 475400, China; 2 Department of Oncology, Shangqiu First People's Hospital, Shangqiu 467000, China

  • Received:2023-07-27 Online:2024-01-15 Published:2024-02-02
  • Contact: Jiang Junxuan, Email: jiangjunyuan123@yeah.net
  • Supported by:

    Medical Science and Technology Research Project of Henan Province (LHGJ2021001341)

摘要:

目的 观察补中益气汤在驱动基因阴性非小细胞肺癌(NSCLC)免疫治疗中的应用价值。方法 本文为前瞻性研究,病例纳入通许县中医院2020年3月至2022年5月收治的85例驱动基因阴性NSCLC患者,采用随机数字表法对入组患者进行分组,分别列为联合组(43例)和常规组(42例)。联合组中男30例,女13例,年龄45~65(55.25±5.18)岁;常规组中男32例,女10例,年龄47~63(56.14±5.22)岁。常规组实施常规免疫治疗,联合组采用补中益气汤配合治疗,治疗3个周期后比较两组患者的近期疗效,随访1年比较两组预后情况。采用χ2检验、t检验。结果 在不同治疗方案下,联合组的客观缓解率(ORR)为83.72%(36/43),疾病控制率(DCR)为93.02%(40/43),均高于常规组[61.90%(26/42)、69.05%(29/42)],差异均有统计学意义(均P<0.05)。治疗前,两组患者的免疫功能差异均无统计学意义(均P>0.05);治疗后,联合组的CD4/CD8高于常规组,白细胞介素-10(IL-10)、干扰素-γ(INF-γ)均低于常规组,差异均有统计学意义(均P<0.05)。治疗前,两组患者的多重耐药相关蛋白表达差异均无统计学意义(均P>0.05);治疗后,联合组的MRP1相对表达量为(12.25±3.41),ERCC1相对表达量为(102.45±20.61),均低于常规组[(14.39±3.18)、(115.62±20.33)],差异均有统计学意义(均P<0.05)。在不同治疗方案下,联合组的毒副反应发生率23.26%(10/43)低于常规组38.10%(16/42),差异有统计学意义(P<0.05)。联合组的无进展生存期(PFS)为(8.22±2.41)个月,总生存期(OS)为(11.26±2.31)个月,均高于常规组[(6.81±2.12)个月、(9.44±2.06)个月],差异均有统计学意义(均P<0.05)。结论 补中益气汤辅助免疫治疗可一定程度上提升驱动基因阴性NSCLC患者近期疗效,对增强患者免疫力、化疗耐受性,降低毒副反应发生风险并延长生存周期均有积极意义。

关键词:

非小细胞肺癌, 驱动基因阴性, 补中益气汤, 免疫治疗, 近期疗效, 预后

Abstract:

Objective To observe the application value of Buzhong Yiqi decoction in immunotherapy for driver gene negative non-small cell lung cancer (NSCLC). Methods This was a prospective study. A total of 85 patients with driver gene negative NSCLC admitted to Tongxu County Hospital of Traditional Chinese Medicine from March 2020 to May 2022 were included. The enrolled patients were divided into a combined group (43 cases) and a conventional group (42 cases) using the random number table method. In the combined group, there were 30 males and 13 females, aged 45-65 (55.25±5.18) years. In the conventional group, there were 32 males and 10 females, aged 47-63 (56.14±5.22) years. The conventional group received routine immunotherapy, while the combined group received Buzhong Yiqi decoction on the basis. The short-term efficacy of the two groups was compared after 3 cycles of treatment, and the prognosis of the two groups was compared after 1 year of follow-up. χ2 test and t test were used. Results Under different treatment regiments, the objective response rate (ORR) and disease control rate (DCR) of the combined group were 83.72% (36/43) and 93.02% (40/43), which were higher than those of the conventional group [61.90% (26/42) and 69.05% (29/42)], with statistically significant differences (both P<0.05). Before treatment, there were no statistically significant differences in the immune function between the two groups (all P>0.05). After treatment, the CD4/CD8 in the combined group was higher than that in the conventional group, but the levels of interleukin-10 (IL-10) and interferon-γ (INF-γ) were lower than those in the conventional group, with statistically significant differences (all P<0.05). Before treatment, there were no statistically significant differences in the expressions of multidrug-resistance-related proteins between the two groups (both P>0.05). After treatment, the relative expressions of MRP1 and ERCC1 in the combined group was (12.25±3.41) and (102.45±20.61), which were both lower than those in the conventional group [(14.39±3.18) and (115.62±20.33)], with statistically significant differences (both P<0.05). Under different treatment regimens, the incidence of toxic and side effects in the combined group was 23.26% (10/43), which was lower than that in the conventional group [38.10% (16/42)], with a statistically significant difference (P<0.05). The progression-free survival (PFS) and overall survival (OS) of the combined group were (8.22±2.41) months and (11.26±2.31) months, which were higher than those of the conventional group [(6.81±2.12) months and (9.44±2.06) months], with statistically significant differences (both P<0.05). Conclusion Buzhong Yiqi decoction assisted immunotherapy can improve the short-term efficacy of NSCLC patients with negative driver genes to a certain extent, and has positive significance in enhancing the patients' immunity and chemotherapy tolerance, reducing the risk of toxic and side effects, and prolonging the survival cycle.

Key words:

Non-small cell lung cancer, Driving gene negative, Buzhong Yiqi decoction, Immunotherapy, Short-term efficacy, Prognosis