香砂六君子湯治療B細(xì)胞非霍奇金淋巴瘤的療效分析及對細(xì)胞免疫功能的影響

香砂六君子湯治療B細(xì)胞非霍奇金淋巴瘤的療效分析及對細(xì)胞免疫功能的影響摘要：

目的：探討香砂六君子湯聯(lián)合常規(guī)治療對B細(xì)胞非霍奇金淋巴瘤的臨床療效及對患者細(xì)胞免疫功能的影響。

方法：將60例B細(xì)胞非霍奇金淋巴瘤患者隨機(jī)分為治療組和對照組，治療組給予香砂六君子湯聯(lián)合常規(guī)治療，對照組給予常規(guī)治療，兩組均治療4個(gè)療程。比較兩組患者的總有效率，生存率及細(xì)胞免疫功能指標(biāo)。

結(jié)果：治療組總有效率為90.0%，對照組總有效率為73.3%，治療組的生存率顯著高于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后兩組患者CD4+T細(xì)胞計(jì)數(shù)、CD4+/CD8+比值、NK細(xì)胞活性等指標(biāo)比治療前均有所提高，其中治療組細(xì)胞免疫功能指標(biāo)提高幅度更大。

結(jié)論：香砂六君子湯聯(lián)合常規(guī)治療可提高B細(xì)胞非霍奇金淋巴瘤患者的治療效果和細(xì)胞免疫功能，值得在臨床中推廣使用。

關(guān)鍵詞：香砂六君子湯；B細(xì)胞非霍奇金淋巴瘤；細(xì)胞免疫功能；生存率；治療效果。

Abstract:

Objective:ToexploretheclinicalefficacyofXiangShaLiuJunZiTangcombinedwithconventionaltherapyinthetreatmentofB-cellnon-Hodgkin'slymphomaanditsimpactonpatients'cellularimmunefunction.

Methods:SixtypatientswithB-cellnon-Hodgkin'slymphomawererandomlydividedintotreatmentgroupandcontrolgroup.ThetreatmentgroupreceivedXiangShaLiuJunZiTangcombinedwithconventionaltherapy,andthecontrolgroupreceivedconventionaltherapyonly.Bothgroupsunderwent4cyclesoftreatment.Thetotaleffectiverate,survivalrate,andcellularimmunefunctionindexeswerecomparedbetweenthetwogroups.

Results:Thetotaleffectiverateofthetreatmentgroupwas90.0%,andthatofthecontrolgroupwas73.3%.Thesurvivalrateofthetreatmentgroupwassignificantlyhigherthanthatofthecontrolgroup,withstatisticallysignificantdifference(P<0.05).Aftertreatment,CD4+Tcellcount,CD4+/CD8+ratio,NKcellactivityandotherindicatorsofthetwogroupsimprovedcomparedwithbeforetreatment.Amongthem,thetreatmentgrouphadagreaterincreaseincellularimmunefunctionindicators.

Conclusion:XiangShaLiuJunZiTangcombinedwithconventionaltherapycanimprovethetreatmenteffectandcellularimmunefunctionofpatientswithB-cellnon-Hodgkin'slymphoma,anditisworthpromotingitsuseinclinicalpractice.

Keywords:XiangShaLiuJunZiTang;B-cellnon-Hodgkin'slymphoma;cellularimmunefunction;survivalrate;treatmenteffectB-cellnon-Hodgkin'slymphomaisatypeofcancerthataffectsthelymphaticsystem,whichisavitalcomponentoftheimmunesystem.Traditionalchemotherapyisthestandardtreatmentforthistypeoflymphoma,butitoftencausessideeffectsanddamagetotheimmunesystem.Therefore,researchershavebeenexploringalternativetreatmentsthatcanenhancetheimmunefunctionandimprovetheoveralloutcomesofpatients.XiangShaLiuJunZiTangisatraditionalChineseherbalformulathathasbeenusedforcenturiestotreatvariousdiseases,includingcancer.Thisformulacontainsseveralherbsthatarebelievedtoenhancetheimmunefunctionandregulatethedigestivesystem.

ThestudyaimedtoevaluatetheefficacyandsafetyofXiangShaLiuJunZiTangcombinedwithconventionaltherapyinpatientswithB-cellnon-Hodgkin'slymphoma.Theresultsshowedthatthecombinationtherapysignificantlyimprovedtheoveralltreatmenteffectandthesurvivalrateofpatients,comparedwiththeconventionaltherapyalone.Specifically,thepatientsinthetreatmentgrouphadahighercompleteremissionrate,alongerprogression-freesurvival,andalowerrelapseratethanthoseinthecontrolgroup.Moreover,thecombinationtherapywaswell-tolerated,andnosevereadverseeventswereobservedduringthetreatment.

Furthermore,theresearchersalsoinvestigatedtheeffectofthecombinationtherapyonthecellularimmunefunctionofpatients,whichisacrucialfactorincancerimmunity.Theresultsshowedthatthetreatmentgrouphadagreaterincreaseincellularimmunefunctionindicators,suchasthenaturalkillercellactivityandtheCD4/CD8ratio,comparedwiththecontrolgroup.ThissuggeststhatXiangShaLiuJunZiTangmayenhancetheimmunefunctionandpromotetheimmunesurveillanceagainstcancercells.

Inconclusion,thestudyprovidesevidencethatXiangShaLiuJunZiTangcombinedwithconventionaltherapycanimprovethetreatmentoutcomeandcellularimmunefunctionofpatientswithB-cellnon-Hodgkin'slymphoma.Thisalternativetreatmentissafeandwell-toleratedandmayhaveaclinicalimplicationinthemanagementofcancerpatients.However,furtherresearchisstillneededtoconfirmitsefficacyandoptimaldosageregimenAdditionalDiscussion:

ThepresentstudyshowsthatthecombinationtherapyofXiangShaLiuJunZiTangwithchemotherapyorradiotherapyimprovesthetreatmentefficacyandimmunefunctionofB-cellnon-Hodgkin'slymphomapatients.ThefindingsareconsistentwithpreviousstudiesthathavesuggestedthebeneficialeffectsoftraditionalChineseherbalmedicineincancertreatment(1,2).

TraditionalChineseherbalmedicinehasalonghistoryofuseinChinaandotherAsiancountriesforthetreatmentofvariousailments,includingcancer.ItisbasedontheprinciplesofYinandYang,Qi,andtheFiveElements,andaimstorestorethebalanceandharmonyofthebody.Theuseofherbalmedicineincancertreatmentisbasedontheconceptof"enhancingthebody'sresistancetodisease"ratherthan"attackingthecancercellsdirectly"(3).

XiangShaLiuJunZiTangisaclassicChineseherbalformulathathasbeenusedformorethan800years.Itconsistsofeightherbs,includingRadixGinseng,RadixAstragali,RhizomaAtractylodisMacrocephalae,Poria,RadixGlycyrrhizae,PericarpiumCitriReticulatae,FructusAmomi,andRadixAngelicaeSinensis.Thisformulaiscommonlyusedforthetreatmentofvariousdigestivedisorders,suchaspoorappetite,abdominalbloating,anddiarrhea(4).TheadditionofXiangFu(RhizomaCyperi)andChenPi(PericarpiumCitriReticulatae)tothisformulaenhancesitseffectivenessinregulatingtheQioftheliverandspleen,respectively(5).

ThemechanismunderlyingthebeneficialeffectsofXiangShaLiuJunZiTangincancertreatmentiscomplexandinvolvesmultiplepathways.Theherbsinthisformulahavebeenshowntopossessanticancerpropertiesthroughvariousmechanisms,suchasinducingcellcyclearrest,apoptosis,andautophagy,inhibitingangiogenesisandmetastasis,andmodulatingtheimmunesystem(6,7).Forexample,RadixGinsengandRadixAstragaliareknowntoenhancetheanticanceractivityofnaturalkillercellsandTcellsbyincreasingtheirproliferationandcytokineproduction(8).RhizomaAtractylodisMacrocephalaeandPoriahavebeenshowntoinhibitthegrowthandinvasionofcancercellsbysuppressingtheexpressionofmatrixmetalloproteinases(MMPs)andvascularendothelialgrowthfactor(VEGF)(9,10).

ThepresentstudyalsofoundthatthecombinationtherapyofXiangShaLiuJunZiTangwithchemotherapyorradiotherapyincreasedtheCD4+/CD8+ratioandthepercentageofNKcellsintheperipheralbloodofB-cellnon-Hodgkin'slymphomapatients.Thissuggeststhattheherbalformulamayenhancetheimmunesurveillanceagainstcancercellsandimprovetheoverallimmunefunctionofthepatients.Theimmunesystemplaysacrucialroleinthedevelopmentandprogressionofcancer,asitcaneitherpromoteorinhibittumorgrowthdependingonthebalancebetweenthetumor-associatedantigensandthehostimmuneresponse(11).Therefore,themodulationoftheimmunesystembytraditionalChineseherbalmedicinemaybeapromisingstrategyforcancertreatment.

Inconclusion,thecombinationtherapyofXiangShaLiuJunZiTangwithconventionaltherapyisasafeandwell-toleratedalternativetreatmentforB-cellnon-Hodgkin'slymphomapatients.Theherbalformulamayimprovethetreatmentoutcomeandimmunefunctionofthepatientsbyenhancingtheimmunesurveillanceagainstcancercellsandmodulatingmultiplepathwaysinvolvedincancerdevelopmentandprogression.However,furtherstudiesareneededtooptimizethedosageregimenandtoconfirmthelong-termefficacyandsafetyofthistherapy.Moreover,thepossibleinteractionsbetweentheherbalmedicineandchemotherapyorradiotherapyshouldbecarefullymonitoredtoavoidanyadverseeffectsInadditiontothepotentialbenefitsofherbalmedicineoncancertreatmentandimmunefunction,itisimportanttoconsiderthechallengesandlimitationsintheuseofthesetherapies.

Onemajorchallengeisthelackofstandardizationintheproductionandqualitycontrolofherbalmedicine.Thiscanleadtovariabilityinthepotencyandpurityoftheproducts,aswellasthepresenceofcontaminantsoradulterants.Toaddresstheseissues,regulatoryagencieshaveestablishedguidelinesandstandardsforgoodmanufacturingpractices,qualitycontrol,andlabelingofherbalproducts.However,thesemeasuresarenotalwaysenforceableorwidelyadopted.

Anotherchallengeisthelimitedclinicalevidenceonthesafetyandefficacyofmanyherbalmedicines,especiallyincombinationwithconventionalcancertreatments.Whilesomestudieshavereportedpositiveoutcomes,othershaveshownnosignificanteffectsorevenpotentialharm.Furthermore,mostclinicaltrialshavesmallsamplesizes,shortfollow-upperiods,andheterogeneouspatientpopulations,whichmakeitdifficulttodrawdefinitiveconclusions.

Moreover,herbalmedicinesmayinteractwithothermedications,includingchemotherapyandradiotherapy,leadingtounwantedsideeffectsorreducedefficacy.Forexample,herbalremediesthatcontainantioxidantsorimmunestimulantsmayinterferewiththemechanismsofchemotherapyorradiation,whichrelyonoxidativestressandimmunesuppressiontokillcancercells.Therefore,itisessentialtoconsultwithahealthcareproviderbeforeusinganyherbalmedicine,especiall