世界中医药

目的：观察加味金水六君煎在改善肺癌围手术期患者免疫力方面的临床疗效，并借此探讨其对各炎性反应因子及免疫因子的影响和机制。方法：选取2015年6月至2016年4月收住我院的非小细胞肺癌（NSCLC）并且有手术指征的患者患者60例，随机分成对照组和观察组，各30例。对照组采用生理盐水250 mL静脉推注，2次/d，持续15 d。观察组予加味金水六君煎分2次/d热水冲服服用，同样治疗15 d后观察2组治疗的临床疗效、各免疫因子评分、药物不良反应、临床受益情况分析及血浆IL-2、IL-6、IL-10及TNF-α水平变化等情况。结果：1）治疗后观察组有效率86.67％，对照组有效率68.89％，2组有效率比较差异有统计学意义（P<0.05）；2）2组患者治疗前各免疫功能比较，差异无统计学意义(P>0.05)，治疗15 d后，观察组各免疫动能均较治疗前稍提高，差异有统计学意义(P<0.05)，但对照组较治疗前无变化，差异无统计学意义(P>0.05)；3）2组患者治疗过程中均出现不同程度的不良反应，比如可表现为腹痛、腹泻、恶心、呕吐、白细胞、血小板、血红蛋白减少等，对照组出现1例(2.22％)，观察组2例(4.44％)，观察组不良反应与对照组比，差异无统计学意义，该药不会增加患者用药不良反应(P>0.05)。观察组KPS和体重变化的稳定率和改善例数明显高于对照组（P<0.05）；4）2组患者治疗前血浆IL-2、IL-6、IL-10及TNF-α水平比较差异无统计学意义(P>0.05)。治疗15 d后，上述指标均较治疗前下降，但观察组下降更明显。结论：加味金水六君煎在改善肺癌围手术期患者免疫力方面有显著的临床效果，且不良反应并不升高，并可以增强癌症围手术期患者免疫力，值得推广。

English Summary:

To observe the effect of the Supplemented Jinshuiliujun Decoction in the treatment of perioperative lung cancer，and to discuss its regulation of immunity.Methods:A total of 90 perioperative lung cancer who were admitted to our department from August 2015-January 2016 was randomly divided into control group and observation group with 45 cases each.The control group received normal saline of 250 mL intravenous injection，2 times a day for 15 days.Observation group were given J Supplemented Jinshuiliujun Decoction twice a day.After 15 days of treatment，the clinical efficacy，all immune factors score，adverse drug reactions，clinical benefits and serum IL-2，IL-6，IL-10 and TNF-α level changes were detected.Results:After treatment，the effective rate of observation group was 86.67%，the control group 68.89%，the difference was statistically significant(P<0.05).Before the treatment，there were no significant differences of patients’ immune function(P>0.05)，after 15 days of treatment，immunized kinetic energy of the observation group slightly improved than before，but control group didn’t show that，the difference was statistically significant(P<0.05).During the treatment，patients of the two groups have different adverse reactions，such as abdominal pain，diarrhea，nausea，vomiting，reduced white blood cells，platelets，hemoglobin after the treatment.the control group had 1 case(2.22%),but observation group had 2 patients(4.44%)，the difference was not statistically significant.The drug does not increase in patients with medication side effects(P>0.05).The observation group had higher stability rate than another group in KPS and body weight change(P<0.05)； Before treatment，there were no significant differences between the patients in plasma IL-2，IL-6，IL-10 and TNF-α level(P>0.05).But after 15 days of treatment，the index decreased than before treatment，but the observation group decreased more significantly.Conclusion:Supplemented Jinshuiliujun Decoction has its effect on improving immunity in cancer during surgery in patients with significant clinical results and less adverse reactions and side effects of drugs does not rise，and can enhance the immune system of cancer patients around the patients，which is worth of clinical promotion.

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