2024 年第 4 期 第 0 卷

复方万年青胶囊联合化疗对中晚期非小细胞肺癌患者辅助性T细胞17/调节性T细胞失衡和血清凋亡因子的影响

Effect of compound Wannianqing capsule combine with chemotherapy on T helper cell 17/regulatory T cell imbalance and serum apoptotic factors in patients with advanced non-small cell lung cancer

作者：刁鑫1潘双1邸丽改1李亚明1樊伟军2

英文作者：Diao Xin1 Pan Shuang1 Di Ligai1 Li Yaming1 Fan Weijun2

单位：1西安医学院第一附属医院呼吸与危重症医学科，西安710077；2西安医学院第二附属医院肿瘤内科，西安710038

英文单位：1Department of Respiratory and Critical Care Medicine the First Affiliated Hospital of Xi′an Medical University Xi′an 710077 China; 2Department of Medical Oncology the Second Affiliated Hospital of Xi′an Medical University Xi′an 710038 China

关键词：非小细胞肺癌；复方万年青胶囊；辅助性T细胞17；调节性T细胞；凋亡因子

英文关键词：Non-smallcelllungcancer;CompoundWannianqingcapsules;Thelpercell17;RegulatoryTcells;Apoptoticfactor

• 摘要：

• 目的 探讨复方万年青胶囊联合吉西他滨+顺铂（GP）化疗方案对中晚期非小细胞肺癌（NSCLC）患者辅助性T细胞17（Th17）/调节性T细胞（Treg）失衡和血清凋亡因子的影响。方法 选择2018年3月至2021年2月西安医学院第一附属医院收治的98例中晚期NSCLC患者。按照随机数字表法将患者分为对照组和观察组，各49例。对照组接受GP化疗方案治疗；观察组在对照组基础上联合复方万年青胶囊口服治疗。以21 d为1个疗程，完成4个疗程的化疗。比较2组临床疗效以及治疗前后血清Th17、Treg、Th17/Treg比值、肿瘤标志物水平、凋亡因子水平。观察2组治疗期间不良反应发生情况。所有患者随访2年，记录无进展生存期（PFS）和总生存期。结果 治疗后，观察组客观缓解率和疾病控制率均高于对照组（均P＜0.05）。治疗后，2组Treg均低于治疗前、且观察组低于对照组［（2.9±0.5）%比（4.8±0.8）%］，2组Th17、Th17/Treg比值均高于治疗前、且观察组均高于对照组［（1.42±0.13）%比（1.25±0.11）%、（0.49±0.10）比（0.26±0.08）］（均P<0.05）；2组癌胚抗原、细胞角蛋白19片段、糖类抗原125、B淋巴细胞瘤基因2（Bcl-2）水平均低于治疗前、且观察组均低于对照组，2组Bcl-2相关X蛋白水平均高于治疗前、且观察组高于对照组（均P<0.05）。2组治疗期间不良反应发生率比较差异无统计学意义（P＞0.05）。观察组中位PFS、中位总生存期均长于对照组（均P＜0.01）。结论 复方万年青胶囊联合GP化疗方案治疗中晚期NSCLC患者，可有效控制疾病进展，延长生存期，调节血清肿瘤标志物和血清凋亡因子水平，改善免疫功能。

• Objective To investigate the effect of compound Wannianqing capsule combine with gemcitabine+cisplatin (GP) chemotherapy on the T helper cell 17 (Th17)/regulatory T cell (Treg) imbalance and serum apoptotic factors in patients with advanced non-small cell lung cancer (NSCLC). Methods Totally 98 patients with advanced NSCLC admitted to the First Affiliated Hospital of Xi′an Medical University from March 2018 to February 2021 were enrolled. According to the random number table method, patients were divided into control group and observation group, with 49 cases in each group. The control group were treated with GP chemotherapy, and the observation group was treated with compound Wannianqing capsule orally based on the control group. Both groups were treated for 4 courses, with 21 d as a course. The clinical efficacy, and Th17, Treg, Th17/Treg ratio, serum tumor marker levels, apoptotic factor levels before and after treatment were compared between the two groups. The occurrence of adverse reactions during treatment in the two groups was observed. All patients were followed-up for 2 years, and progression-free survival (PFS) and overall survival (OS) were recorded. Results After treatment, objective remission rate and disease control rate in the observation group were higher than those in the control group (both P<0.05). After treatment, Treg levels in both groups were lower than those before treatment, and the observation group was lower than the control group ［（2.9±0.5）% vs （4.8±0.8）%］; Th17 and Th17/Treg ratio were higher than those before treatment, and the observation group was higher than the control group ［（1.42±0.13）% vs （1.25±0.11）%,（0.49±0.10） vs （0.26±0.08）］(all P<0.05). Levels of carcinoembryonic antigen, cytokeratin fragment 19, carbohydrate antigen 125, and B cell lymphoma gene-2 (Bcl-2) in both groups after treatment were lower than those before treatment, and the observation group was lower than the control group, Bcl-2 related X protein levels in both groups were higher than those before treatment, and the observation group was higher than the control group (all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during treatment (P>0.05). The medium PFS and OS in the observation group were longer than those in the control group (both P<0.01). Conclusion Compound Wannianqing capsule combined with GP chemotherapy in the treatment of patients with advanced NSCLC can effectively control the disease progression and prolong the survival period, regulate serum tumor markers and serum apoptosis factors, and improve immune function.