青蒿鳖甲汤对肺癌骨转移患者细胞因子的影响

王红兵 蒲志忠 邓彬 雷霄

摘要 目的：观察青蒿鳖甲汤对提高肺癌骨转移患者的临床疗效和安全性，并探索其对细胞因子的影响。方法：选取2015年2月至2017年8月重庆市开州区人民医收治的肺癌并发骨转移的患者90例，随机分成对照组和观察组，每组45例。2组患者均予紫杉醇与顺铂化疗，观察组在此基础上加用青蒿鳖甲汤，比较2组治疗的临床疗效、各细胞因子水平、临床受益情况等。结果：1）治疗后观察组有效率86.22%，对照组有效率68.12%，差异有统计学意义（P<0.05），观察组优于对照组;2）2组患者治疗前各免疫功能差异无统计学意义（P>0.05），治疗后观察组均较治疗前明显提高，差异有統计学意义（P<0.05）;3）观察组在KPS方面的改变及其体重稳定率的例数比对照组优（P<0.05）;4）治疗前的血浆IL-2、IL-6、IL-10及TNF-α浓度，2组差异无统计学意义（P>0.05），治疗后指标均降低，观察组降低显著。结论：青蒿鳖甲汤可明显改善肺癌并骨转移患者的免疫力和抗炎水平，同时可提高其临床疗效，值得推广。

关键词 青蒿鳖甲汤;肺癌;骨转移;细胞因子

Effects of Qinghao Biejia Decoction on Cytokines in Patients with Bone Metastasis of Lung Cancer

Wang Hongbing， Pu Zhizhong， Deng Bin， Lei Xiao

（Department of General Surgery， People′s Hospital of Kaizhou District， Chongqing 405400， China）

Abstract Objective：To observe the clinical efficacy and safety of Qinghao Biejia decoction in improving the bone metastasis of lung cancer and to explore its effects on cytokines. Methods：Ninety patients with lung cancer complicated with bone metastasis admitted in our hospital from February 2015 to August 2017 were randomly divided into control group and observation group， with 45 cases in each group. Two groups of patients were treated with paclitaxel and cisplatin chemotherapy. The observation group was added Qinghao Biejia Decoction. The clinical efficacy， the level of cytokines， and clinical benefit of two groups were compared. Results：1） The effective rate was .86.22% in the observation group and 6.8.12% in the control group. The difference was statistically significant （P<0.05）， and the observation group was better than the control group. 2） There was no difference in immune function of the two groups of patients before treatment （P<0.05）. The observation group was significantly improved after treatment， and the difference was statistically significant （P<0.05）. 3） The stability and improvement of KPS and body weight in the observation group were significantly higher than those in the control group （P<0.05）， and the difference was statistically significant （P<0.05）. 4） There was no significant difference in the levels of IL-2， IL-6， IL-10 and TNF-α between the two groups before treatment （P>0.05）. After treatment， the above indicators were lower than before treatment， but the observation group decreased more significantly. Conclusion：Qinghao Biejia decoction can significantly improve the immunity and anti-inflammatory level of patients with lung cancer and bone metastasis， and can improve its clinical curative effect.

Key Words Qinghao Biejia soup; Lung cancer; Bone metastasis; Cytokines

中图分类号：R273文献标识码：Adoi：10.3969/j.issn.1673-7202.2018.03.030

肺癌是我国最常见的恶性肿瘤，随着目前工业发展迅速所随之而来的日益厉害的环境污染，吸烟风气的日盛，我国肺癌的发病率逐年上升。据研究统计，我国肺癌目前以每年8万人的死亡速度增长，其发病率高达23%[1]。肺癌又称为原发性支气管肺癌，不仅是呼吸系统疾病中，发病率最高的恶性疾病之一，同时，也是我国发病率最高的肿瘤。該病早期可无临床表现，或者仅有不明显、不特异的临床症状，比如咳嗽（多为干咳）、咳白黏痰，早期较少有胸痛或者咯血，当出现胸痛或咯血，甚至是胸腔积液时，提示疾病已经到了晚期[2]。肺癌中晚期患者常有癌细胞的转移，其转移途径多为血性转移和淋巴转移，其中，以肺癌的骨转移最为多见[3]。……