论文部分内容阅读
目的观察复方苦参注射液联合同期放化疗治疗局部晚期鼻咽癌的疗效及其对患者免疫功能的影响。方法将2012年6月至2015年6月在西安交通大学第二附属医院肿瘤科门诊诊治的82例局部晚期鼻咽癌患者按照随机数法分为观察组42例和对照组40例,对照组采用顺铂3周化疗方案联合同期调强放射治疗(IMRT),观察组在对照组治疗的基础上加用复方苦参注射液20 m L静脉滴注,1次/d,连续14 d,停药7 d为一个周期,连续治疗3个周期。治疗前1 d及结束后1周观察并比较两组患者各项细胞免疫指标(CD3+、CD4+、CD8+及CD4+/CD8+)的变化情况;两组患者治疗过程中骨髓抑制最高等级反应程度;治疗结束后3个月时两组治疗的近期效果。结果所有的患者均完成放疗计划。观察组患者治疗后的CD4+水平较治疗前升高[(42.93±10.78)%vs(36.00±10.21)%],CD8+降低[(24.42±9.79)%vs(29.73±8.25)%),CD4+/CD8+比值升高(2.10±1.32 vs 1.38±0.83),观察组治疗后的细胞免疫功能水平优于其治疗前水平,差异均有统计学意义(P<0.05);观察组患者治疗后的CD4+、CD4+/CD8+增加量高于对照组[(6.65±1.34)%vs(-5.09±1.38)%、(0.56±0.15)vs(-0.57±0.16)],CD8+降低量高于对照组(-3.86±1.51)%vs(7.03±1.54)%,观察组治疗结束后细胞免疫功能水平优于对照组治疗后水平,差异均有统计学意义(P<0.05);观察组骨髓抑制程度低于对照组,差异有统计学意义(P<0.05);两组患者的近期疗效比较差异无统计学意义(P>0.05)。结论复方苦参注射液虽未能提高局部晚期鼻咽癌同期放化疗近期疗效,但能有效激活患者的细胞免疫功能,减轻局部晚期鼻咽癌同期放化疗对骨髓的损伤,值得临床推广应用。
Objective To observe the curative effect of Compound Kushen Injection combined with concurrent chemoradiotherapy on locally advanced nasopharyngeal carcinoma and its effect on immune function. Methods From June 2012 to June 2015, 82 patients with locally advanced nasopharyngeal carcinoma diagnosed and treated in the Department of Oncology, the Second Affiliated Hospital of Xi’an Jiaotong University from June 2012 to June 2015 were divided into observation group (n = 42) and control group (n = 40) Cisplatin combined with 3-week chemotherapy regimen combined with IMRT was used in the observation group. The observation group was given intravenous infusion of compound Kushen injection 20 m L once a day for 14 days, Medicine 7 d for a cycle, continuous treatment 3 cycles. The changes of various cellular immune indexes (CD3 +, CD4 +, CD8 + and CD4 + / CD8 +) of the two groups were observed and compared on the first day and one week after the end of treatment; the highest level of myelosuppression in the two groups was treated; Three months after the two groups when the treatment effect. Results All patients completed the radiotherapy program. The level of CD4 + in the observation group was significantly higher than that before treatment [(42.93 ± 10.78)% vs (36.00 ± 10.21)%], CD8 + [24.42 ± 9.79% vs 29.73 ± 8.25%], CD4 + / CD8 + (2.10 ± 1.32 vs 1.38 ± 0.83). The level of cellular immunity after treatment in observation group was better than that before treatment (P <0.05). After treatment, the CD4 + and CD4 + / CD8 + was significantly higher than that of the control group [(6.65 ± 1.34)% vs (-5.09 ± 1.38)%, (0.56 ± 0.15) vs (-0.57 ± 0.16) )% vs (7.03 ± 1.54)%. The level of cellular immunity in the observation group was better than that in the control group after treatment (P <0.05), and the degree of myelosuppression in the observation group was lower than that in the control group (P <0.05). There was no significant difference in short-term curative effect between the two groups (P> 0.05). Conclusion Compound Kushen injection failed to improve the curative effect of concurrent chemoradiotherapy in locally advanced nasopharyngeal carcinoma patients. However, it could effectively activate the cellular immune function and reduce the damage to the bone marrow of patients with locally advanced nasopharyngeal carcinoma, which is worthy of clinical application.