摘要
目的观察酸枣仁汤治疗原发性肝癌患者肝血不足型失眠的临床疗效及其对神经-内分泌-免疫网络的调节作用。方法将70例原发性肝癌伴肝血不足型失眠患者随机分为治疗组与对照组,每组35例。两组均以常规中西医结合治疗原发性肝癌为基础,治疗组给予酸枣仁汤颗粒剂,对照组给予安慰剂,连续28 d。比较匹兹堡睡眠质量指数(PSQI)量表评分、中医证候评分、血红蛋白(Hb)、血小板(PLT)、前白蛋白(PAB)、血清5-羟色胺(5-HT)、褪黑素(MT)、白介素-2受体(IL-2R)、白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的变化情况。结果(1)治疗组总有效率88.2%,对照组总有效率27.3%,治疗组疗效优于对照组,差异有统计学意义(P<0.05);(2)治疗组治疗后PSQI总分及各成分评分、中医证候评分较对照组及治疗前显著降低(P<0.05),各评分治疗前后差值大于对照组(P<0.05);(3)治疗组治疗后血清5-HT、MT含量较对照组及治疗前显著升高(P<0.05),治疗组血清IL-2R、IL-8、TNF-α含量较对照组及治疗前显著降低(P<0.05),以上指标治疗前后差值均大于对照组(P<0.05),治疗组治疗后血清IL-6含量与对照组及治疗前比较,差异无统计学意义(P>0.05),治疗前后差值与对照组比较无显著差异(P>0.05);(4)治疗组治疗后Hb、PAB较对照组及治疗前显著升高(P<0.05),治疗前后差值大于对照组(P<0.05)。结论酸枣仁汤可有效改善原发性肝癌伴肝血不足型失眠患者的睡眠情况、营养水平以及肝血不足的症状,能提高患者血清5-HT、MT含量,降低血清IL-2R、IL-8、TNF-α含量,调节神经-内分泌-免疫网络,改善肝癌患者体内炎症环境,提示安神以扶正在恶性肿瘤虚证中具有辅助治疗作用。
Objective To observe the clinical effect of Suanzaoren Decoction on insomnia due to liver blood deficiency in patients with primary liver cancer(PLC)and its regulation on neuroendocrine-immune network.Methods Seventy PLC patients complicated with liver blood deficiency insomnia were randomly divided into treatment group and control group with 35 cases in each group.Both groups were treated with conventional integrated traditional Chinese and western medicine for PLC.The treatment group was also given Suanzaoren Decoction granules,while the control groupwas given placebo.Both were treated for 28 days.The changes of Pittsburgh Sleep Quality Index(PSQI)score,TCM syndrome score,hemoglobin(Hb),platelet(PLT),prealbumin(PAB),serum 5-hydroxytryptamine(5-HT),melatonin(MT),interleukin-2 receptor(IL-2 R),interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)levels were compared.Results(1)The total effective rate was 88.2% in the treatment group and 27.3% in the control group.The overall therapeutic effect of Suanzaoren Decoction was better than that of placebo,and the difference was statistically significant(P<0.05).(2)After treatment,the total score of PSQI,the level of each serum component and TCM syndrome score in the treatment group were significantly lower than those in the control group and before treatment(P<0.05),and the difference of each score before and after treatment in the treatment group was greater than that in the control group(P<0.05).(3)Serum 5-HT and MT levels in the treatment group were significantly higher than those in the control group and before treatment(P<0.05).The levels of serum IL-2 R,IL-8 and TNF-α in the treatment group were significantly lower than those in the control group and before treatment(P<0.05).The differences of the above indexes before and after treatment in the treatment group were greater than those in the control group(P<0.05).After treatment,there was no significant difference in serum IL-6 level between the treatment group and the control group(P>0.05),and the differences before and after treatment showed no significant difference between two groups(P>0.05).(4)After treatment,the levels of Hb and PAB in the treatment group were significantly higher than those in the control group and those before treatment(P<0.05),and the differences before and after treatment were greater than those in the control group(P<0.05).Conclusion Suanzaoren Decoction can effectively improve the sleep condition,nutrition level and liver blood deficiency symptoms of PLC patients with liver blood deficiency insomnia,increase the levels of serum 5-HT and MT,reduce the levels of serum IL-2 R,IL-8 and TNF-α,regulate the neuroendocrine-immune network and improve the inflammatory environment in PLC patients to control the occurrence and development of tumors,indicating that tranquilizing mind and strengthening body resistance have therapeutic auxiliary effects in the treatment of deficiency syndrome of malignant tumor.
作者
王思宇
陈矢
陈珏
刘龙
李霞
杨学
WANG Siyu;CHEN Shi;CHEN Jue;LIU Long;LI Xia;YANG Xue(Shulan Hospital,Hangzhou 310000,China;Department of Dermatology,Shanghai Jiangong Hospital,Shanghai 200083,China;Department of Traditional Chinese Medicine,Tianyou Hospital,Tongji University,Shanghai 200331,China;Department of Traditional Chinese Medicine,Naval Military Medical University,Shanghai 200433,China;Department of Traditional Chinese Medicine,Changhai Hospital,Naval Military Medical University,Shanghai 200433,China;Department of Traditional Chinese Medicine,Yangpu Hospital,Tongji University,Shanghai 200093,China)
出处
《上海中医药杂志》
2020年第10期50-56,共7页
Shanghai Journal of Traditional Chinese Medicine
基金
国家自然科学基金面上项目(81873215)
上海市卫健委中医药传承和科技创新项目(ZYCC2019011)
上海市卫健委中医特色诊疗技术提升项目(zyjx-2017028)
上海市杨浦区骨干中医师培养项目(YP18ZY01)。
关键词
原发性肝癌
肝血不足
失眠
酸枣仁汤
primary liver cancer
liver blood deficiency
insomnia
Suanzaoren Decoction
作者简介
王思宇,女,硕士研究生,住院医师,主要从事经方的临床运用及研究工作;通信作者:杨学,副主任医师,副教授,硕士研究生导师。E-mail:yxkxl@163.com。
