茶多酚抑制晚期非小细胞肺癌新生血管生成的临床研究

【作者】 侯丽； 富琦； 张雅月； 孙韬； 刘伟； 陆鸿飞；

【机构】 北京中医药大学东直门医院血液肿瘤科； 首都医科大学附属北京中医医院肿瘤科； 北京中医药大学东方医院肿瘤科； 北京中医药大学；

【摘要】 目的明确茶多酚胶囊配合化疗治疗晚期非小细胞肺癌的疗效,探讨茶多酚抑制肺癌新生血管生成机制。方法以116例非小细胞肺癌Ⅲb、Ⅳ期患者为研究对象,以茶多酚胶囊为观察药物,与参一胶囊、恩度、空白(单纯化疗)组进行对照观察,观测指标为临床有效率、临床获益率、中医症状、免疫指标以及肿瘤新生血管相关因子表达水平。结果四组有效率和临床获益率比较均无显著性差异(P>0.05);症状改善方面,茶多酚联合化疗组和参一联合化疗组治疗后症状积分下降,与治疗前比较,有统计学差异(P<0.01),组间比较显示茶多酚联合化疗组及参一联合化疗组对症状改善作用明显优于单纯化疗组及恩度联合化疗组(P<0.01),这两组间比较没有统计学差异(P>0.05);茶多酚联合化疗组及参一联合化疗组治疗后CD4+/CD8+升高,与治疗前相比,有统计学差异(P<0.05),单纯化疗组比值下降,与治疗前相比,有统计学差异(P<0.01),恩度联合化疗组比值有下降趋势,但无统计学差异(P>0.05),组间比较茶多酚联合化疗组及参一联合化疗组对CD4+/CD8+改善作用明显优于单纯化疗组及恩度联合化疗组(P<0.05),这两组比较没有统计学差异(P>0.05);茶多酚联合化疗组及参一联合化疗组治疗后FOXP3下降,与治疗前相比有统计学差异(P<0.01),单纯化疗组及恩度联合化疗组治疗前后FOXP3无差异(P>0.05),这两组对FOXP3降低作用明显优于单纯化疗组及恩度联合化疗组(P<0.05),而这两组比较没有统计学差异(P>0.05)。治疗后各组VEGF水平均下降,与治疗前相比,有统计学差异(P<0.01),VEGF组间比较恩度联合化疗组对VEGF的降低作用优于其他三组(P<0.01或0.05),茶多酚联合化疗组及参一联合化疗组对VEGF改善作用亦优于单纯化疗组(P<0.05),这两组之间没有统计学差异(P>0.05)。结论茶多酚胶囊联合化疗治疗晚期非小细胞肺癌,可以减轻患者症状、改善免疫功能、下调VEGF表达水平。更多还原

【Abstract】 Objective:To confirm the clinical efficacy of green tea polyphenols capsule combined with chemotherapy in advanced non-small cell lung cancer and select optimal regimen,and to explore tea polyphenols’ mechanism of the inhibition of lung cancer angiogenesis.M ethods:The subjects for this study were 116 patients with stage Ⅲb or Ⅳ non-small cell lung cancer.In combination of chemotherapy,tea polyphenols capsule was the observing drug compared with Shenyi capsule,Endostar and chemotherapy alone group to observe the clinical effective rate,clinical benefit rate,clinical symptoms,immune function index and the expression level of angiogenesis associated factors.Results:The clinical effective rate and clinical benefit rate between four groups didn’t show statistical difference(P>0.05).In aspect of improving symptoms,it showed significant descent of the symptom score(P<0.01) in tea polyphenols capsule combined with chemotherapy group and Shenyi capsule combined with chemotherapy group compared to that before treatment;but there was no difference in chemotherapy alone group and Endostar combined with chemotherapy group(P > 0.05).When compared between groups,the symptom improvement in tea polyphenols capsule combined with chemotherapy group and Shenyi capsule combined with chemotherapy group was better than that in the other two groups(P<0.01),but the difference between tea polyphenols’ and Shenyi’s combination group was not statistically significant(P>0.05).The rise of CD4+/CD8+ ratio between pre-treatment and post-treatment of tea polyphenols capsule combined with chemotherapy group and Shenyi capsule combined with chemotherapy group were of statistical significance(P<0.05),while the CD4+/CD8+ratio reduced significantly in chemotherapy alone group after the treatment(P<0.01) and decreased also in Endostar combined with chemotherapy group without statistical significance(P>0.05).The descent of FOXP3 from pre-treatment to post-treatment in tea polyphenols capsule combined with chemotherapy group and Shenyi capsule combined with chemotherapy group were statistically significant(P<0.01),but there was no difference in the other two groups(P>0.05).The mean descent of VEGF from pre-treatment to post-treatment in every group was statistically significant(P<0.01).For the function of decreasing VEGF,Endostar combined with chemotherapy group was better than all other three groups(P<0.01 or 0.05),tea polyphenols capsule combined with chemotherapy group and Shenyi capsule combined with chemotherapy group were better than the chemotherapy alone group(P<0.05),but there was no difference between tea polyphenols and Shenyi combination groups statistically(P>0.05).Conclusion:Tea polyphenols capsule combined with chemotherapy can alleviate symptoms,improve immune function and down-regulate the expression of VEGF in advanced non-small cell lung cancer.更多还原