华蟾素联合治疗对气阴两虚型晚期非鳞非小细胞肺癌患者血清炎性因子及疼痛递质的影响

doi:10.3969/j.issn.1004-583X.2024.12.007

摘要/Abstract

摘要：

目的探讨华蟾素联合治疗对气阴两虚型晚期非鳞非小细胞肺癌(NSCLC)癌性疼痛的控制效果及可能作用机制。方法选择2020年5月-2022年10月收治的气阴两虚型晚期非鳞NSCLC患者76例,采用随机数字表法分为治疗组、对照组各38例,对照组给予常规化疗与镇痛治疗,治疗组联合应用口服华蟾素胶囊。治疗2个月,比较两组癌性疼痛控制效果、血清炎性因子[白细胞介素6(Interleukin-6, IL-6)、白细胞介素10(Interleukin-10, IL-10)、肿瘤坏死因子α(tumor necrosis factor-α, TNF-α)、干扰素γ(Interferon-γ, INF-γ)]、疼痛递质[5-羟色胺(5-hydroxy tryptamine, 5-HT)、P物质(substance P, SP)、神经肽Y(neuropeptide Y, NPY)、β-内啡肽(β-endorphin, β-EP)]等。结果 ①试验过程中,治疗组脱落剔除1例,对照组脱落剔除2例,最终完成试验73例,治疗组37例,对照组36例。②治疗组数字疼痛评分(NRS)低于对照组(P<0.05),疼痛有效率94.59%高于对照组77.78%(χ²=4.365, P<0.05)。③治疗组血清IL-6、TNF-α、INF-γ含量低于对照组,IL-10高于对照组(P<0.05)。④治疗组血清5-HT、SP、NPY低于对照组,β-EP高于对照组(P<0.05)。结论华蟾素联合治疗有助于缓解气阴两虚型晚期NSCLS癌性疼痛程度,提高控制效果,可能与拮抗炎症反应、调节疼痛神经递质等因素有关。

关键词: 癌, 非小细胞肺, 华蟾素, 癌性疼痛, 炎性因子, 疼痛递质

Abstract:

Objective To investigate the effect of cinobufotalin combined therapy on the control of cancer pain in advanced non-squamous non-small cell lung cancer (NSCLC) with Qi-yin deficiency and its underlying mechanism. Methods A total of 76 NSCLC patients with Qi-Yin deficiency treated from May 2020 to October 2022 were recruited. They were assigned into the treatment group ( $n$ =38) and control group( $n$ =38) by random number table method. All patients were given conventional chemotherapy and analgesia treatment, and those in the treatment group were additionally given oral cinobufotalin capsules. After two months of treatment, the effect of cancer pain control, serum inflammatory factors (interleukin-6 [IL-6], interleukin-10 [IL-10], tumor necrosis factor-α [TNF-α], interferon-γ [INF-γ]), pain transmitters (5-hydroxytryptamine [5-HT), substance P [SP], neuropeptide Y [NPY], and β-endorphin [β-EP]) were compared between the two groups. Results During the experiment, 1 case dropped out the treatment group and 2 cases dropped out the control group. Finally, 73 cases were enrolled, involving 37 cases in the treatment group and 36 cases in the control group. The Numerical Rating Scale (NRS) score of the treatment group was significantly lower than that of the control group (P<0.05), and the effective rate was significantly higher (94.59% vs 77.78%, χ²=4.365, P<0.05). Serum IL-6, TNF-α and INF-γ contents in the treatment group were significantly lower than those of the control group, and IL-10 level was significantly higher (P<0.05). Serum 5-HT, SP and NPY in the treatment group were significantly lower than those of the control group, but β-EP was significantly higher (P<0.05). Conclusion Cinobufotalin combined therapy can alleviate cancer pain of advanced NSCLS with Qi-yin deficiency and improve the pain control effect via the antagonistic inflammatory response and regulation of pain neurotransmitters.

Key words: carcinoma, non-small-cell lung, cinobufotalin, cancerous pain, inflammatory factors, pain transmitter

中图分类号:

R730.26

柳云飞, 陈涛利, 王延朋, 随俊召, 王启船. 华蟾素联合治疗对气阴两虚型晚期非鳞非小细胞肺癌患者血清炎性因子及疼痛递质的影响[J]. 临床荟萃, 2024, 39(12): 1101-1105.

Liu Yunfei, Chen Taoli, Wang Yanpeng, Sui Junzhao, Wang Qichuan. Effect of cinobufotalin combined therapy on cancer pain in patients with advanced non-squamous non-small cell lung cancer with Qi-Yin deficiency[J]. Clinical Focus, 2024, 39(12): 1101-1105.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.12.007

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I12/1101

图/表 4

表1 两组一般资料比较

Tab.1 Baseline data between the two groups

组别	例数	性别[例(%)]		年龄 (岁)	病程 (月)	TNM分期[例(%)]
组别	例数	男	女	年龄 (岁)	病程 (月)	Ⅲ期	Ⅳ期
治疗组	37	21(56.76)	16(43.24)	57.63±7.12	14.05±2.12	22(59.46)	15(40.54)
对照组	36	24(66.67)	12(33.33)	55.78±7.35	13.46±2.25	25(69.44)	11(30.56)
统计值		χ²=0.758		$t$ =1.092	$t$ =1.153	χ²=0.793
P值		0.384		0.278	0.253	0.373

表1 两组一般资料比较

Tab.1 Baseline data between the two groups

组别	例数	性别[例(%)]		年龄 (岁)	病程 (月)	TNM分期[例(%)]
组别	例数	男	女	年龄 (岁)	病程 (月)	Ⅲ期	Ⅳ期
治疗组	37	21(56.76)	16(43.24)	57.63±7.12	14.05±2.12	22(59.46)	15(40.54)
对照组	36	24(66.67)	12(33.33)	55.78±7.35	13.46±2.25	25(69.44)	11(30.56)
统计值		χ²=0.758		$t$ =1.092	$t$ =1.153	χ²=0.793
P值		0.384		0.278	0.253	0.373

表2 两组镇痛效果比较 [$\bar{x} \pm s$, n(%)]

Tab.2 Analgesic effect between the two groups

组别	例数	NRS评分		镇痛效果
组别	例数	治疗前	治疗后	显效	有效	无效	有效率
治疗组	37	7.02±1.23	2.05±0.53^*	24(64.86)	11(29.73)	2(5.41)	35(94.59)
对照组	36	6.78±1.14	2.86±0.57^*	16(44.44)	12(33.33)	8(22.22)	28(77.78)
统计值		$t$ =0.864	$t$ =6.290	$Z$ =5.231		χ²=4.365
P值		0.391	0.000	0.073		0.037

表2 两组镇痛效果比较 [$\bar{x} \pm s$, n(%)]

Tab.2 Analgesic effect between the two groups

组别	例数	NRS评分		镇痛效果
组别	例数	治疗前	治疗后	显效	有效	无效	有效率
治疗组	37	7.02±1.23	2.05±0.53^*	24(64.86)	11(29.73)	2(5.41)	35(94.59)
对照组	36	6.78±1.14	2.86±0.57^*	16(44.44)	12(33.33)	8(22.22)	28(77.78)
统计值		$t$ =0.864	$t$ =6.290	$Z$ =5.231		χ²=4.365
P值		0.391	0.000	0.073		0.037

表3 两组治疗前后血清炎性因子含量比较 ($\bar{x} \pm s$)

Tab.3 Serum inflammatory factor levels of the two groups before and after treatment

组别	例数	IL-6(ng/L)		IL-10(ng/L)		TNF-α(μg/L)		INF-γ(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	36.23±5.44	23.15±4.12^*	105.34±20.24	197.45±12.15^*	7.06±1.01	2.85±0.64^*	58.45±6.12	36.38±5.43^*
对照组	36	35.08±5.56	28.23±4.52^*	105.36±13.12	134.24±22.45^*	6.84±1.23	3.41±0.68^*	57.12±6.45	43.24±7.12^*
$t$ 值		0.893	5.021	0.005	15.017	0.836	3.624	0.904	4.637
P值		0.375	0.000	0.996	0.000	0.406	0.001	0.369	0.000

表3 两组治疗前后血清炎性因子含量比较 ($\bar{x} \pm s$)

Tab.3 Serum inflammatory factor levels of the two groups before and after treatment

组别	例数	IL-6(ng/L)		IL-10(ng/L)		TNF-α(μg/L)		INF-γ(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	36.23±5.44	23.15±4.12^*	105.34±20.24	197.45±12.15^*	7.06±1.01	2.85±0.64^*	58.45±6.12	36.38±5.43^*
对照组	36	35.08±5.56	28.23±4.52^*	105.36±13.12	134.24±22.45^*	6.84±1.23	3.41±0.68^*	57.12±6.45	43.24±7.12^*
$t$ 值		0.893	5.021	0.005	15.017	0.836	3.624	0.904	4.637
P值		0.375	0.000	0.996	0.000	0.406	0.001	0.369	0.000

表4 两组治疗前后血清疼痛递质含量比较($\bar{x} \pm s$)

Tab.4 Serum pain transmitter content of the two groups before and after treatment

组别	例数	5-HT(ng/L)		SP(μg/mL)		NPY(μg/L)		β-EP(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	208.42±30.1	124.36±15.24^*	545.36±67.25	254.45±42.36^*	224.12±30.15	136.24±20.36^*	108.25±15.12	232.41±35.24^*
对照组	36	201.35±32.32	162.14±18.21^*	528.42±62.16	314.25±45.34^*	213.56±31.45	162.14±22.15^*	112.45±16.12	186.24±33.54^*
$t$ 值		0.967	9.623	1.117	5.285	1.465	5.204	1.149	5.731
P值		0.337	0.000	0.268	0.000	0.147	0.000	0.255	0.000

表4 两组治疗前后血清疼痛递质含量比较($\bar{x} \pm s$)

Tab.4 Serum pain transmitter content of the two groups before and after treatment

组别	例数	5-HT(ng/L)		SP(μg/mL)		NPY(μg/L)		β-EP(ng/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
治疗组	37	208.42±30.1	124.36±15.24^*	545.36±67.25	254.45±42.36^*	224.12±30.15	136.24±20.36^*	108.25±15.12	232.41±35.24^*
对照组	36	201.35±32.32	162.14±18.21^*	528.42±62.16	314.25±45.34^*	213.56±31.45	162.14±22.15^*	112.45±16.12	186.24±33.54^*
$t$ 值		0.967	9.623	1.117	5.285	1.465	5.204	1.149	5.731
P值		0.337	0.000	0.268	0.000	0.147	0.000	0.255	0.000

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