摘要:目的运用中西医结合治疗化疗敏感的小细胞肺癌患者,观察辨证与辨病治疗化疗敏感的小细胞肺癌的临床疗效。方法本研究采用探索性的队列研究模式,纳入2013年10月—2015年12月期间就诊于中国中医科学院广安门医院及中国医学科学院肿瘤医院的初治的门诊小细胞肺癌患者。根据是否接受中医药治疗为暴露因素,分为中西医结合队列和西医队列。4~6周期化疗后进入随访阶段。研究的主要指标包括OS、PFS等;次要指标包括实体瘤疗效评价、中医症状评分改善情况等。结果中西医结合队列与西医队列比较:MST分别为24个月和20个月,mPFS分别为19个月和14个月;局限期中西医结合队列与西医队列比较:MST分别为25个月和22个月,mPFS分别为19个月和15个月;广泛期中西医结合队列与西医队列比较:MST分别为21个月和16个月,mPFS分别为11个月和7个月,差异均无统计学意义。疗后84、126 d,2组DCR差异具有统计学意义(P<0.05)。疗后42、84、126 d KPS评分变化情况,中西医队列优于西医队列(P<0.05)。2队列治疗前后临床症状疗效相比较,其中神疲乏力、气短、食欲不振、自汗盗汗、口干咽燥、胸闷、咳嗽、咯痰、便秘等9个症状,中西医队列优于西医队列(P<0.05)。在血液系统中性粒细胞及血红蛋白减少不良反应以及泌尿系统不良反应,肌酐不良反应等方面,中西医结合队列优于西医队列(P<0.05)。结论花宝金教授运用系列方药中西医结合治疗化疗敏感的小细胞肺癌,可以改善患者体力状况,缓解临床症状以及减轻血液系统和泌尿系统的不良反应,且在延长OS、PFS方面有一定作用,但仍需扩大样本量以验证。
摘要:Objective To verify the inhibitory effect of Xiaoshui Formula(XSF)on malignant pleural effusion(MPE)in animal level and explore its mechanism. Methods After MPE mice model was established,the volume of MPE,survival time,pleural metastasis,pleural permeability and angiogenesis,vascular endothelial growth factor(VEGF)expression were assessed using bioluminescence imaging,Luminex and immunohistochemistry. Results The MPE volume of mice in XSF group was significantly reduced and the survival time was prolonged. There was no significant difference between the XSF group and the control group in pleural metastases. The Evans’ blue ratio of MPE to peripheral serum,the level of VEGF in MPE,and the expression of CD31 and CD34 in pleural tumors were much lowered in XSF group than that of the control group all with statistically significant difference. Conclusion Xiaoshui Formula can inhibit the production of MPE in mice,and its mechanism may be related to reducing pleural permeability and inhibiting angiogenesis.
摘要:Objective To observe the effect of Feiliuping Ointment on immune function of Lewis lung cancer bearing mice. Methods Flow cytometry was used to determine the number of DC,macrophage and phenotype in spleen of lung cancer bearing mice of different groups(blank group,Feiliuping Ointment group,model group). Results There was no significant change in the number of DC in the blank group; the number of DC in the model group was decreased from 4.26% to 2.59%; the number of DC in the Lung Ointment group was decreased from 5.39%,4.83% and 4.15% at 14 d,21 d and 28 d,respectively. And at 28 d,there was significant difference compared with the model group(P<0.05). Macrophages: in the model group,the number of M1 macrophages was increased gradually from 8.59% to 25.98%,meanwhile the number of M2 cells increased gradually from 0.92% to 5.42%,and the ratio of M1/M2 decreased from 9.34 to 4.79. In Feiliuping Ointment group,the number of M1 and M2 macrophages was increased more that of the model group at 14 d and 21 d,and at 21 d,they were 23.16% and 2.77% respectively,which were much higher relatively,but at 14 d,21 d and 28 d,M1/M2 ratios were 7.86,8.36 and 9.62,respectively. At 28 d,the number of both kinds of macrophages were decreased,but the M1/M2 value were also kept increasing,indicating that Feiliuping Ointment could promote the transformation of macrophages to M1 macrophages. Conclusion Feiliuping Ointment can regulate the number and expression of dendritic cells and macrophages in the spleen of tumor-bearing mice to make them as stable as possible,and then regulate the immune function of tumor-bearing mice in a balanced state,which may be one of its anti-tumor mechanisms.