摘要
目的观察黄芪桃红汤辅助TP化疗方案治疗晚期宫颈癌(CC)的临床疗效及对程序性死亡分子1(PD-1)/程序性死亡分子1配体(PD-L1)通路、肿瘤标志物、Th细胞因子的影响。方法将115例晚期CC患者按照随机数字表法分为2组,对照组57例予TP化疗方案治疗,21 d为1个周期,连续治疗4个周期;治疗组58例在对照组治疗基础上应用黄芪桃红汤,4周为1个疗程,共治疗3个疗程。比较2组疗效;比较2组治疗前后CD4^+T细胞表面PD-1、CD8^+T细胞表面PD-1、CD14^+单核细胞PD-L1变化;比较2组治疗前后肿瘤标志物癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCC-A)变化;比较2组治疗前后Th1细胞因子γ干扰素(INF-γ)、白细胞介素2(IL-2)及Th2细胞因子IL-4、IL-6水平变化;比较2组治疗前后生活质量评分变化;比较2组不良反应发生率。结果治疗组疾病控制率(DCR) 74.14%(43/58),对照组DCR63.16%(36/57),2组疗效比较差异无统计学意义(P>0.05)。治疗组治疗后CD4^+T细胞表面PD-1、CD8^+T细胞表面PD-1、CD14^+单核细胞PD-L1均较本组治疗前降低(P<0.05),且低于对照组治疗后(P<0.05)。对照组治疗前后CD4^+T细胞表面PD-1、CD8^+T细胞表面PD-1、CD14^+单核细胞PD-L1比较差异均无统计学意义(P>0.05)。2组治疗后血清CEA、CA199、CA125、SCC-A水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后INF-γ、IL-2、IL-4、IL-6水平均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。治疗组治疗后宫颈癌生活质量评估量表(FACT-Cx)生理状况、社会/家庭状况、情感状况、功能状况、CC特异模块评分及总评分均高于本组治疗前及对照组治疗后(P<0.05);对照组治疗前后FACT-Cx生理状况、社会/家庭状况、情感状况、功能状况、CC特异模块评分及总评分比较差异无统计学意义(P>0.05)。2组不良反应发生率比较差异有统计学意义(P<0.05),
Objective To observe the clinical efficacy of Huangqi Taohong Decoction combined with TP Chemotherapy on advanced cervical cancer( CC) and its effect on programmed death molecule1/programmed death molecule-1 ligand pathway,tumor markers,Th Cytokines. Methods A total of 115 patients with advanced CC were randomly divided into two groups,57 patients in the control group were treated with TP Chemotherapy,21 days as a course,and the treatment lasted for 4 courses. 58 cases in the treatment group were given Huangqi Taohong Decoction more On the basis of the control group,4 weeks as a course,and the treatment lasted for 3 courses. The curative effects of the two groups were compared. The changes of PD-1 on CD4^+T cells,PD-L1 on CD14^+monocytes were compared before and after treatment. The changes of tumor markers [carcinoembryonic antigen( CEA),sugar chain antigen( CA199),carbohydrate antigen( CA125),squamous cell carcinoma antibody( SCC-A) ],the levels of Th1 cytokines [γ-interferon( INF-γ),interleukin-2( IL-2)〗,Th2 cytokine [interleukin-4( IL-4),interleukin-6( IL-6) ],quality of life score and the incidence of adverse reactions were compared between the two groups before and after treatment. Results The disease control rate( DCR) was 74. 14%( 43/58) in the treatment group and 63. 16%( 36/57) in the control group,and there was no significant difference between the two groups( P > 0. 05). After treatment,PD-1 on CD4^+T cells,PD-1 on CD8^+T cells and PD-L1 on CD14^+monocytes in the treatment group were lower than those before treatment( P< 0. 05),and lower than those in the control group( P < 0. 05). There was no significant difference in PD-1 on CD4^+T cells,PD-1 on CD8^+T cells and PD-L1 on CD14^+monocytes before and after treatment in the control group( P > 0. 05). After treatment,the levels of serum CEA,CA199,CA125 and SCC-A in the two groups were lower than those before treatment( P < 0. 05),and the decrease in the treatment group was more significant( P < 0.05). After treatment,the serum INF-γ,IL-2,IL-4 and I
作者
李洁
张波
郭雁冰
田乃佳
王光涛
杨戈
陈雪
刘甲寒
LI Jie;ZHANG Bo;GUO Yanbing(Department of TCM,Characteristic Medical Center of the Chinese People's Liberation Army Strategic Support Forces,Beijing 100101)
出处
《河北中医》
2020年第11期1670-1675,共6页
Hebei Journal of Traditional Chinese Medicine
关键词
宫颈肿瘤
中西医结合疗法
Cervical cancer
Integrated traditional Chinese and Western medicine therapy
