益气养血汤减轻胃癌患者癌症疲劳疗效及其相关细胞免疫学机制

Effect of Yiqi Yangxue decoction on cancer fatigue in patients with gastric cancer and related cellular immunological mechanism

关键词:  癌症疲劳  胃癌  细胞免疫学  益气养血汤

Key words:  cancer fatigue  gastric cancer  cytoimmunology  Yiqi Yangxue decoction

摘要:

[目的]观察益气养血汤减轻胃癌患者癌症疲劳的疗效及相关的细胞免疫学机制。[方法]将75例胃癌患者按疲劳程度和病情分期随机分为对照组和治疗组。两组患者均接受基础对症支持治疗，并给予消癌平和痰热清注射液静脉滴注。除上述治疗外，治疗组每日还口服益气养血汤。采用多维度疲乏量表（MFI）、医院焦虑抑郁量表（HADS）、癌症治疗功能评估疲乏量表（FACT-F）评价患者治疗前后疲劳程度、焦虑抑郁程度及生活质量；取外周血，检测血常规；采用流式细胞仪检测外周血T细胞亚群、B细胞、NK细胞的分布比率，酶联免疫吸附（ELISA）法检测C反应蛋白、白介素（IL）-1β、IL-6水平。[结果]对照组总有效率为42.1%，治疗组总有效率为68.4%，组间比较差异有统计学意义（P<0.05）。治疗前，两组患者MFI、HADS和FACT-F各项评分及总分间比较无统计学差异（P>0.05）。两种治疗方法均可降低患者的MFI和HADS评分，提高FACT-F评分（P<0.05），且治疗组的改善效果优于对照组（P<0.05）。治疗前，两组患者各淋巴细胞数量、炎症因子水平比较无统计学差异（P>0.05）。治疗后，治疗组可提高CD3⁺和CD3⁺/CD4⁺T细胞、CD3^-CD16⁺CD56⁺NK细胞的分布比例，提高CD4⁺/CD8⁺比值（P<0.05），且效果优于对照组（P<0.05）。两种治疗方法均可降低患者的炎症因子水平（P<0.05），且治疗组的效果优于对照组（P<0.05）。[结论]益气养血汤能有效降低胃癌患者疲劳程度、提高患者生活质量，其作用机制与改善患者免疫功能、降低炎性因子水平有关。

Abstract:

[Objective] In this study, the effect and mechanism of Yiqi Yangxue decoction on cancer-related fatigue in gastric cancer patients were detected.[Methods] Altogether 75 patients with gastric cancer were randomly divided into the control and treatment groups according to fatigue degree and disease stage. The patients in the control group were given Xiaoaiping and Tanreqing injection by an intravenous infusion. Besides the above treatment, the patients in the treatment group were given Yiqi Yangxue decoction orally once daily. The fatigue degree, anxiety and depression, and the quality of daily life of patients in the two groups at pre-and post-treatment were evaluated using the Multidimensional Fatigue Inventory (MFI), Hospital Anxiety and Depression Scale (HADS) and Functional Assessment of Cancer Therapy-Fatigue scale(FACT-F). After treatment, blood tests were performed and the distribution ratio of T cell subsets, B and NK cells in peripheral blood were determined by flow cytometry. The levels of C-reactive protein, IL-1β and IL-6 were detected by ELISA.[Results] The total effective rate were 42.1% and 68.4% for the control and treatment groups respectively with significant between-group differences (P<0.05). There were no significant differences in the pre-treatment scores of MFI, HADS and FACT-F between two groups (P>0.05). The post-treatment scores of MFI and HADS in the two groups decreased obviously when compared with pre-treatment scores (P<0.05), and the improvement effect of the treatment group was better than that of the control group (P<0.05). The post-treatment FACT-F score in the two groups increased significantly when compared with pre-treatment score (P<0.05), and a better improvement effect was found in the treatment group (P<0.05). There were no significant differences in the pre-treatment distribution ratio of T cell subsets, B and NK cells and the levels of inflammatory factors in peripheral blood between the two groups (P>0.05). After treatment, increased distribution ratio of CD3⁺, CD3⁺CD4⁺T cells, CD3^-CD16⁺CD56⁺NK cells and CD4⁺/CD8⁺ were found in the treatment group (P<0.05), and the effect was better than that of the control group (P<0.05). The levels of inflammatory cytokines were reduced (P<0.05), and a better effect was detected in the treatment group (P<0.05).[Conclusion] Yiqi Yangxue Decoction could effectively relieve cancer-related fatigue and improve the quality of life in patients with gastric cancer by reducing the level of inflammatory cytokines.