Effect Of Erchen Decoction On CD4+ T Lymphocyte Subsets In Patients With Metastatic Non-small Cell Lung Cancer With Chemotherapy

[Research Background]Lung cancer is the highest incidence and mortality of malignancies in China and even in the world.Among them,non-small cell lung cancer(NSCLC)accounts for more than 80%of the total number of lung cancers,and most patients are advanced at the time of diagnosis and lose the best treatment opportunity.Western medicine is nothing more than surgery,radiotherapy,chemotherapy and targeted therapy,but the effect is not satisfactory.Therefore,it is urgent to seek a treatment to improve symptoms and improve the quality of life.Erchen Decoction(ECD)is a classic phlegm prescription,which could strengthen the spleen and reduce phlegm.Phlegm syndrome is common syndromes of non-small cell lung cancer(NSCLC),According to the principles of diagnosis and treatment,ECD should be a basis prescription for advanced NSCLC.The previous research conducted by the mentor found that ECD can improve the quality of life and the levels of CD3+ and CD4+ lymphocytes in patients with advanced NSCLC,the combination with platinum regimen chemotherapy can also improve the quality of life and immunity of patients,especially for CD4+ T lymphocytes.On the basis of previous clinical studies,this research further explored the effect of ECD on CD4+ T lymphocyte subsets and its cytokines in lung cancer patients.[Research purposes]The study adopted a prospective,non-randomized concurrent control and self-control study method,the combination of ECD and platinum regimen chemotherapy was used to observe the immune function,quality of life,and clinical efficacy of patients with metastatic NSCLC.[Research methods]In this study,60 patients with metastatic NSCLC who were enrolled from August 2017 to February 2018 were divided into experimental group and control group,with 30 patients in each group.The experimental group was treated with ECD and platinum-based chemotherapy.The control group was given a platinum-based chemotherapy.The quality of life,TCM symptoms,KPS scores,tumor size,tumor markers and CD4+ T lymphocyte subsets-related cytokines were calculated before and after the treatment(42 days)in the experimental group and control group.Tumor markers contains the Cyfra211,CEA,SCC,CA125.CD4+T lymphocyte subsets-related cytokines contains of Thl group(IL-2,IFN-y,TNF-a),Th2 group(IL-4,IL-6,IL-10),Th17 group(IL-17,),Treg group(TGF-?).The test data was statistically analyzed using SPSS20.0.[Research result]1.General information:The chi-square test was performed on the age,sex,pathological type,and chemotherapy regimens of 60 patients enrolled in the study.P>0.05.There was no statistical difference,and clinical curative effects could be observed.2.TCM symptom of patients with metastatic NSCLC:The experimental group had obvious improvement in cough,shortness of breath,chest pain,chest distress,expectoration,fatigue,lack of appetite,upset and insomnia,diarrhea,and constipation,the difference was statistically significant(P<0.05).The control group had a lower score after treatment of chest distress than before treatment,and the number of patients increased slightly after treatment with expectoration,and the difference was statistically significant(P<0.05);cough,expectoration,fatigue,lack of appetite,nausea,vomiting,and diarrhea,were significantly lowered in the experimental group compared with the control group,and the difference was statistically significant(P<0.05).The efficiency of the two groups before and after treatment was observed.The effective rate was 60%in the experimental group and 13.3%in the control group.The difference was statistically significant(P<0.05).3.Quality of life in patients with metastatic NSCLC:In this study,the quality of life in patients with QLQ-C30 and QLQ-LC13 of lung cancer was observed.The experimental group had significant improvement in overall quality of life,physical function,role function,cognitive function,emotional function,social function,fatigue,nausea and vomiting,shortness of breath,cough,and constipation(P<0.05).The difference was statistically significant.The social function and fatigue of the control group were improved after treatment compared with before treatment(P<0.05).The difference was statistically significant.After treatment in the two groups,in the overall quality of life,cognitive function,emotional function,social function,fatigue,nausea,vomiting,shortness of breath,cough,hemoptysis,loss of appetite,the experimental group significantly improved compared with the control group(P<0.05).4.Tumor markers in patients with metastatic NSCLC:The experimental group had significantly lower levels of Cyfra211,SCC,and CA125 than before treatment(P<0.05),and there was a statistical difference;in the control group,Cyfra-211 CEA,SCC,and CA125 were significantly decreased(P>0.05).There was no significant difference between the two groups.After treatment,the levels of CEA and SCC in the experimental group were lower than those in the control group(P<0.05),and there were significant differences.5.Related cytokines in CD4+ T lymphocyte subsets in patients with metastatic NSCLC:Thl/Th2 cell-related cytokines:IL-2,IFN-?,and TNF-? increased after treatment in the experimental group and the control group,but only the IL-2 difference was statistically significant(P<0.05).After treatment between the two groups,the IL-2 level in the experimental group was higher than in the control group,but the difference was not statistically significant(P>0.05).Th17 cell-related cytokines:In the experimental group,IL-17 were lower than before treatment,but only IL-17 difference was statistically significant(P<0.05);after treatment in the control group,IL-17 level was lower than before treatment,there was a statistically significant difference(P<0.05).The level of IL-17 in the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).Treg cell-related cytokines:The expression levels of TGF-? in the experimental group and the control group were lower than those before treatment,and there was a statistical difference(P<0.05);the control group Compared with the experimental group,the level of TGF-? was higher(P>0.05),and there was no statistical difference.6.Changes in tumors size of patients with metastatic NSCLC:In the 30 patients in the experimental group,the total effective rate was 36%;in the control group,the total effective rate was 33%in the 30 patients,and the difference was not statistically significant(P>0.05).[Research conclusion]1.ECD can significantly reduce the level of IL-17,combined with the platinum two drugs chemotherapy can also reduce IL-10,increase IL-2 expression,suggesting that ECD has a regulatory effect on Thland Th2,and Inhibition on Thl7.ECD can regulate CD4 + T lymphocyte immune function.2.ECD has significant inhibitory effect on CEA and SCC in patients with squamous cell carcinoma of the lung.Combining changes in the changes of tumors in patients with lung squamous cell carcinoma may have a better trend in the control of lung squamous cell carcinoma.3.ECD can improve the symptoms of respiratory and digestive,and improve the overall quality of life of patients.