Clinical observation of treatment and immune tolerance reversion in esophageal squamous carcinoma patients with XiaoChaiHu decoction combined chemotherapy
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摘要: [目的]观察小柴胡汤联合紫杉醇加顺铂(TP)方案对晚期食管癌患者的疗效以及对免疫功能的影响并探讨其相关机制。[方法]晚期食管癌患者150例,随机分为对照组(75例)和观察组(75例),对照组仅予TP方案静脉化疗,观察组在化疗基础上口服小柴胡汤,21 d为1周期,2周期后评估疗效及不良反应事件。采用流式细胞术检测患者化疗前后免疫功能评估免疫激活及免疫耐受状态。[结果]与对照组相比,观察组的有效率和控制率都有显著提高(P<0.05)。主要不良反应为中性粒细胞减少及消化道反应,观察组发生率明显减少(均P<0.05)。与化疗前相比,2组的免疫功能均有所恢复,观察组联合化疗后T细胞总数及亚群的逆转幅度更为明显,且差异有统计学意义(P<0.05)。[结论]小柴胡汤联合TP方案可提高化疗有效率、减少不良反应发生,其机制很可能是小柴胡汤通过逆转外周血中免疫耐受,激活免疫应答发挥的作用。Abstract: [Objective] To observe the effect of XiaoChaiHu Decoction combined TP(paclitaxel + cisplatin) chemotherapy regime in advanced esophageal squamous carcinoma patients, and investigate its mechanism of Immune function.[Methods] 150 advanced esophageal squamous carcinoma patients were randomly divided into two groups, the control group (75 cases) which were treated with TP chemotherapy; and treatment groups (75 cases) which were treated with XiaoChaiHu Decoction combined the same chemotherapy.Both are 3 weeks for a course.After 2 courses, effectiveness and adverse effects were evaluated.Immune function was detected by Flow cytometer to assess immune response and tolerance.[Results] Effective rate and improvement of treatment group were higher than control group(P<0.05).Adverse events of granulocytopenia and gastrointestinal reaction were fewer in treatment group(P<0.05 respectively).After treatment, immune function was improved in both groups.The increase of total T cell and subgroup in treatment group were more obvious(P<0.05).[Conclusion] The regime of XiaoChaiHu Decoction combined TP chemotherapy can improve efficacy, reduce adverse reaction that may be result from reversing immune tolerance and stimulating immune response.
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