健脾生津中药辅助三维适形放疗治疗局部晚期鼻咽癌疗效及对T淋巴细胞亚群、血管内皮生长因子、骨性碱性磷酸酶水平的影响

摘要

目的 探讨健脾生津中药辅助三维适形放疗治疗局部晚期鼻咽癌疗效及对T淋巴细胞亚群、血管内皮生长因子(VEGF)、骨性碱性磷酸酶(B-ALP)水平的影响.方法 将150例鼻咽癌患者随机分为2组,对照组75例给予三维适形放疗治疗,观察组75例在此基础上加用健脾生津中药治疗,2组治疗时间均为6周.观察2组治疗前后中医证候积分、RTOG急性放射反应指标评分、QLQ-H&N35评分、T淋巴细胞亚群、VEGF及B-ALP水平变化情况,统计2组临床疗效.结果 2组治疗后鼻窒涕血、鼻咽肿块、头痛眩晕、神疲乏力、舌质红苔薄及脉细数积分均显著降低(P均<0.05),且观察组治疗后各项积分均显著低于对照组(P均<0.05);2组治疗后RTOG急性放射反应指标评分和QLQ-H&N35评分均显著提高(P均<0.05),VEGF和B-ALP水平均显著降低(P均<0.05),但观察组治疗后各项评分和VEGF、B-ALP水平均明显低于对照组(P均<0.05);观察组治疗后CD3 +、CD4 +及CD4 +/ CD8 +水平均显著提高(P均<0.05),CD8 +水平显著降低(P<0.05),且各指标改善均显著优于对照组(P均<0.05);观察组临床受益率显著高于对照组(P<0.05).结论 健脾生津中药辅助三维适形放疗治疗局部晚期鼻咽癌可有效缓解相关症状体征,延缓肿瘤侵袭进程,改善日常生活质量和免疫系统功能,且有助于下调VEGF和B-ALP水平.%Objective It is to investigate the curative effect of Chinese medicine for invigorating spleen and producing fluid assisted three dimensional conformal radiation therapy for the treatment of locally advanced nasopharyngeal carcinoma (NPC) and its influence on the levels of T lymphocyte subsets,vascular endothelial growth factor(VEGF) and bone alka-line phosphatase(B-ALP). Methods 150 patients with nasopharyngeal carcinoma were randomly divided into 2 groups. 75 cases in the control group were treated with three dimensional conformal radiation therapy. On the basis of this,75 cases in the observation group were treated with Chinese medicine for invigorating spleen and producing fluid. The two groups were treated for 6 weeks. The changes of TCM syndrome score,RTOG score,acute radiation reaction index score,QLQ-H&N35 score,and the levels of T lymphocyte subsets,VEGF and B-ALP in the 2 groups were observed before and after treatment, and the clinical curative effects of the 2 groups were statistically analyzed. Results The scores of nose stuffy and blood tears,nasopharyngeal mass,headache and vertigo, lassitude, lingual red and thin lingual fur, small and fast pulse were significantly decreased(all P<0.05),the scores of the observation group were significantly lower than those of the control group (P<0.05). The scores of RTOG acute radiation reaction index and QLQ-H&N35 were significantly improved in the 2 groups after treatment (all P<0.05). The levels of VEGF and B-ALP were significantly decreased(all P<0.05),the scores of the observation group and the level of VEGF and B-ALP were significantly lower than those in the control group(P<0.05). The levels of CD3 +,CD4 +and CD4 +/CD8 +in the observation group were significantly increased after treatment(all P<0.05),the level of CD8 +was significantly decreased(P<0.05),and the improvement of each index was signifi-cantly better than that of the control group (P<0.05). The clinical benefit rate of the observation group was significantly higher than that of the control group(P<0.05). Conclusion Chinese medicine for invigorating spleen and producing fluid assisted three dimensional conformal radiation therapy in the treatment of local advanced nasopharyngeal carcinoma can ef-fectively relieve the symptoms and signs of local advanced nasopharyngeal carcinoma,delay the progression of tumor inva-sion,improving the quality of daily life and the function of the immune system, and it helps to reduce the level of VEGF and B-ALP.