世界中医药

目的：探讨参芪解毒汤联合GP方案对晚期非小细胞肺癌（Nonsmall-cell Lung Cancer,NSCLC）患者血清巨噬细胞抑制因子-1（MIC-1）、基质金属蛋白酶-9（MMP-9）及免疫功能的影响。方法：选取2019年3月至2019年12月深圳市宝安纯中医治疗医院收治的晚期NSCLC患者84例作为研究对象，采用随机数字表法分为对照组和观察组，每组42例。对照组予以GP方案化疗，在此基础上观察组予以参芪解毒汤治疗。比较2组临床疗效、治疗期间不良反应发生情况及治疗前后中医证候积分、血清MIC-1和MMP-9水平、免疫功能指标（CD3+、CD4+、CD8+、CD4+/CD8+）。结果：观察组有效率（47.62%）和疾病控制率（83.33%）显著高于对照组（26.19%、64.29%）（P<0.05）。治疗后观察组中医证候积分（11.38±2.76）显著低于对照组（14.71±2.48）（P<0.05）。治疗后观察组血清MIC-1（584.28±82.16）pg/mL和MMP-9（170.63±115.27）ng/L水平均显著低于对照组［(832.13±90.84)pg/mL，（228.59±121.38)ng/L］（P<0.05）。治疗后观察组CD3+（64.72±6.83）%、CD4+（35.76±4.23）%及CD4+/CD8+（1.62±0.41）%均显著高于对照组［(50.35±3.46）%，（29.28±3.41）%，1.02±0.11)%］，CD8+（22.17±3.26）％显著低于对照组（28.23±2.16）％（P<0.05）。观察组白细胞计数减少、血小板计数减少、贫血及胃肠道反应的发生率（16.67%、4.76%、9.52%、19.05%）显著低于对照组（35.71%、19.05%、26.19%、40.48%）（P<0.05）。结论：参芪解毒汤联合GP方案能够降低晚期NSCLC患者MMP-9、MIC-1表达水平，较单一使用GP方案而言能够提高治疗效果，降低中医证候积分，改善患者免疫功能，降低不良反应发生率。且疗效高于单纯的化疗，值得临床推广应用。

English Summary:

To investigate the effects of Shenqi Jiedu Decoction with GP regimen on serum macrophage inhibitory factor 1(mic-1)，matrix metalloproteinase-9(mmp9)and immune function in patients with advanced non-small cell lung cancer(NSCLS).Methods:A total of 84 patients with advanced NSCLC admitted to Bao'an Authentic Traditional Chinese Medicine Therapy Hospital from March 2019 to December 2019 were selected as research objects and were divided into a control group and an observation group by random digital table method，with 42 cases in each group.The control group received GP regimen chemotherapy.On this basis，the observation group was treated with Shenqi Jiedu Decoction.The clinical efficacy and adverse reactions/ side effects during treatment were compared between 2 groups.Traditional Chinese medicine(TCM)syndrome score，the level of serum MIC-1 and MMP-9，immune function index(CD3+，CD4+，CD8+，CD4+/ CD8+)were also compared between the 2 groups before and after treatment.Results:The effective rate(47.62%)and disease control rate(83.33%)in the observation group were significantly higher than those in the control group(26.19%，64.29%)(P<0.05).The TCM syndrome score(11.38±2.76)in the post-treatment observation group was significantly lower than that in the control group(14.71±2.48)(P<0.05).After treatment，the level of serum MIC-1(584.28±82.16)pg/mL and MMP-9(170.63±115.27)ng/Lin the observation group were significantly lower than those in the control group［(832.13±90.84)pg/mL，（228.59±121.38)ng/L］(P<0.05).After treatment，CD3+(64.72±6.83）%，CD4+(35.76±4.23）%and CD4+/CD8+(1.62±0.41）%in the observation group were significantly higher than those in the control group［(50.35±3.46）%，（29.28±3.41）%，1.02±0.11)%］while CD8+(22.17±3.26)％was significantly lower than the control group(28.23±2.16)％(P<0.05).The incidence of leukopenia，thrombocytopenia，anemia and gastrointestinal reactions in the observation group(16.67%，4.76%，9.52%，19.05%)was significantly lower than that in the control group(35.71%，19.05%，26.19%，40.48%)(P<0.05).Conclusion:Shenqi Jiedu Decoction combined with GP regimen can reduce the expression of mmp-9 and mic-1 in advanced NSCLC patients.Compared with the single use of GP regimen，it can improve the curative effect，reduce the score of TCM syndrome，improve the immune function of patients，and reduce the incidence of adverse reactions.Plus the higher effect than that of chemotherapy alone，this therapy is worthy of clinical application.

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