食管癌患者放射治疗前后中医辨证分型与TNF-α、IL-6的关系

目的:探讨食管癌患者在放射治疗前后中医辨证分型与TNF、IL-6之间的关系。方法:在食管癌患者放疗前后给予中医辨证分型,并检测其血清TNF、IL-6水平。结果:食管癌中医证型放射治疗前痰气互阻型27例(33.75%)、血瘀痰滞型34例(42.5%)、阴虚热毒型15例(18.75%)、气虚阳微型4例(5.00%);放射治疗后痰气互阻型5例(6.25%)血瘀痰滞型16例(20.0%)、阴虚热毒型45例(56.25%)、气虚阳微型14例(17.5%)。放射治疗前后中医辨证分型构成比具有显著差异性,P=0.0016。TNF-α、IL-6水平放疗前后比较差异性显著P<0.05。并且,放疗后表现为阴虚热毒证的食管癌患者差异性更加显著,而非阴虚热毒证的食管癌患者差异性不显著。结论:放射治疗使食管癌患者转变为阴虚热毒证的几率增加。放疗后阴虚热毒型食管癌患者过盛自分泌的TNF-α、IL-6明显得到遏制。

Study on Relations between TCM Syndrome and TNF-α and IL-6 in Patients with Esophageal Carcinoma Before and After Radiotherapy

Objective:After and before radiotherapy,to investigate the relation between TCM syndrome differentiation and the serum levels of TNF-α and IL-6 in patients with esophageal carcinoma.Methods:The classification of TCM syndromes was carried out in 80 esophageal carcinoma patients before and after radiotherapy.The 80 patients’ serum levels of TNF-α and IL-6 were measured by method in ELISA Test and Electrochemiluminescence immunoassay.Results:Before radiotherapy the syndromes of qi and phlegm stagnation were 27 cases,33.75%;phlegm and blood stasis were 34 cases,42.5%;Yin deficiency with noxious heat were 15 cases,18.75%;qi and yang deficiency were 4 cases,5.00%.However,after radiotherapy the syndromes of qi and phlegm stagnation decreased to 5 cases,6.25%;phlegm and blood stasis to 16 cases,20.0%;the syndromes of Yin deficiency with noxious heat to 45 cases 56.25%,qi and yang deficiency increased to 14 cases 17.5%.Before and after radiotherapy TCM syndrome constituent ratio had a significant difference,P=0.0016.The level of TNF-α was(34.34±25.28)pg/mL,which was much higher than that after radiotherapy(26.75±21.37)pg/mL(P=0.012).The level of IL-6 was(21.11±13.03)pg/mL,which was also much higher than that after radiotherapy(17.34±13.02)pg/mL(P=0.031).After radiotherapy the two levels in the Yin deficiency with noxious heat patients were statistically different,but the others were not.Conclusion:Radiotherapy makes patients with esophageal carcinoma become to be Yin deficiency with noxious heat.For patients with esophageal cancer of Yin deficiency with noxious heat type after radiotherapy,the excessive secretion of TNF-α,IL-6 were significantly inhibited.