摘要目的 观察复方苦参注射液对直肠癌患者的辅助性T细胞17(T helper cell,Th17)和IL-17的影响,并分析其生存率.方法 将符合入选标准的直肠癌患者128例采用随机数字法法分为2组,每组64例.对照组采用FOLFOX4化疗方案治疗,观察组在对照组基础上加用复方苦参注射液.28 d为1个疗程,2组均连续治疗4个疗程.分别于治疗前后采用流式细胞仪检测Th17细胞,采用ELISA法检测IL-17,评价临床疗效.结果 治疗后,观察组Th17细胞[(11.28±2.42)%比(13.12±3.15)%,t=2.376]和IL-17[(16.58±3.26)ng/ml比(21.84±4.12)ng/ml,t=2.391]均低于对照组(P<0.05).观察组有效率为60.9%(39/64)、对照组为43.8%(28/64),2组比较差异有统计学意义(χ2=2.384,P=0.041);观察组控制率为92.2%(59/64)、对照组为81.3%(52/64),2组比较差异有统计学意义(χ2=2.371,P=0.047).观察组白细胞减少[37.5%(24/64)比60.9%(39/64),χ2=2.417)]、贫血[35.9%(23/64)比59.3%(38/64),χ2=2.421]、血小板减少[34.4%(22/64)比62.5%(40/64),χ2=2.432]、神经系统毒性[15.6%(10/64)比37.5%(24/64),χ2=2.458]、胃肠道反应[21.9%(14/64)比43.8%(28/64),χ2=2.453]、口腔黏膜炎[28.1%(18/64)比57.8%(37/64),χ2=2.451]发生率低于对照组(P<0.05).观察组1年生存率为79.7%(51/64)、对照组为60.9%(39/64),2组比较差异有统计学意义(χ2=2.414,P<0.05).结论 复方苦参注射液联合FOLFOX4方案可降低直肠癌患者Th17细胞比例和IL-17表达,提高患者生存率,减轻化疗药物的毒副作用.

abstractsObjective To observe the effect of complex sophorae injection combined with FOLFOX4 on Th17 cells, IL-17 and survival rate in patients with rectal cancer.Methods A total of 128 patients with rectal cancer were sellected in this study. The patients were divided into the control group (n=64) and observation group (n=64). The control group received the treatment of FOLFOX4 regimen, and the observation group received the treatment of FOLFOX4 regimen and sophorae injection. The Th17 cells were detected by flow cytometry, and IL-17 by ELISA assay.Results After treatment, the Th17 cells (11.28% ± 2.42%vs. 13.12% ± 3.15%,t=2.376) and IL-17 (16.58 ± 3.26 ng/mlvs. 21.84 ± 4.12 ng/ml,t=2.391) in observation group was lower than those in control group (P<0.05). After treatment, the effective rate (60.9%vs. 43.8%,χ2=2.384) and control rate (92.2%vs. 81.3%,χ2=2.371) in observation group was higher than that in control group (P<0.05). The different levels of white blood cells (37.5%vs. 60.9%,χ2=2.417), anemia (35.9%vs. 59.3%,χ2=2.421), thrombocytopenia (34.4%vs. 62.5%,χ2=2.432), nervous system toxicity (15.6%vs. 37.5%,χ2=2.458), gastrointestinal tract reaction (21.9%vs. 43.8%,χ2=2.453), oral mucositis incidence (28.1%vs. 57.8%,χ2=2.451) in observation group were lower than those in control group (P<0.05). The 1 year survival rate was 79.7% (51/64) in observation group,, which was higher than that of 60.9% (39/64) in control group (χ2=2.414,P<0.05).Conclusions The complex sophorae injection combined with FOLFOX4 regimen can reduce Th17 cells and IL-17 in patients with rectal cancer, improve survival rate, and reduce the clinical toxicity of chemotherapy drugs.