1.石河子大学第一附属医院,新疆维吾尔自治区石河子市北二路108号,832008
2.石河子市人民医院
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收稿:2024-11-15,
修回:2025-06-18,
纸质出版:2025-09-02
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袁明,杨帆,邹楠等.鹿蓉三草汤加减对分化型甲状腺癌术后患者生活质量和免疫功能影响的随机对照试验[J].中医杂志,2025,66(17):1777-1782.
YUAN Ming,YANG Fan,ZOU Nan,et al.Effect of Modified Lurong Sancao Decoction (鹿蓉三草汤) on Quality of Life and Immune Function in Differentiated Thyroid Cancer Patients after Surgery:A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2025,66(17):1777-1782.
袁明,杨帆,邹楠等.鹿蓉三草汤加减对分化型甲状腺癌术后患者生活质量和免疫功能影响的随机对照试验[J].中医杂志,2025,66(17):1777-1782. DOI: 10.13288/j.11-2166/r.2025.17.008.
YUAN Ming,YANG Fan,ZOU Nan,et al.Effect of Modified Lurong Sancao Decoction (鹿蓉三草汤) on Quality of Life and Immune Function in Differentiated Thyroid Cancer Patients after Surgery:A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2025,66(17):1777-1782. DOI: 10.13288/j.11-2166/r.2025.17.008.
目的
2
观察鹿蓉三草汤加减对分化型甲状腺癌术后患者生活质量及免疫功能的影响。
方法
2
将328例接受甲状腺癌手术的患者随机分为对照组和试验组,每组164例。术后次日开始两组患者均口服左甲状腺素钠片口服,试验组加服鹿蓉三草汤加减,每日1剂。两组共治疗3个月,于治疗前后采用中文版欧洲癌症研究与治疗组织生命质量核心量表C30(EORTC QLQ-C30)进行生活质量评价(包括躯体、角色、认知、情绪和社会5个功能领域和整体生活质量评分);检测细胞免疫相关指标(CD3
+
T、CD4
+
T、CD8
+
T、CD4
+
T/CD8
+
T)和体液免疫相关指标[免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)];对中医症状(包括咽部异物感/颈部不适感、烦躁易怒、倦怠乏力)进行评分,治疗后比较中医证候疗效。治疗前后进行心电图、血常规、肝功能、肾功能检查,评价安全性。
结果
2
与本组治疗前比较,两组患者治疗后躯体功能、角色功能、认知功能、情绪功能、社会功能及整体生活质量评分均升高,CD3
+
T、CD4
+
T、CD4
+
T/CD8
+
T、IgG、IgM及IgA水平均升高,CD8
+
T水平则降低;试验组患者咽部异物感/颈部不适感、烦躁易怒、倦怠乏力评分降低,对照组患者仅咽部异物感/颈部不适感评分降低(
P
<0.05)。治疗后组间比较,除CD8
+
T外,试验组其余各指标改善效果均优于对照组(
P
<0.05)。试验组中医证候疗效总有效率为84.76%(139/164),显著高于对照组的53.66%(88/164,
P
<0.05)。两组治疗前后心电图、血常规、肝功能、肾功能均在正常范围内。
结论
2
鹿蓉三草汤加减能显著提高分化型甲状腺癌术后患者生活质量,增强机体免疫功能,改善中医证候从而提高中医证候疗效。
Objective
2
To investigate the effect of
Lurong Sancao Decoction
(鹿蓉三草汤, LSD) on the improvement of immune function and quality of life for patients with differentiated thyroid cancer (DTC) after surgery.
Methods
2
A total of 328 patients undergoing thyroid cancer surgery were randomly divided into a control group and a trial group, with 164 cases in each group. Both groups were treated with levothyroxine sodium tablets from the day after surgery, and the trial group was additionally treated with LSD, one dose daily. Both groups were treated for 3 months. Before and after treatment, quality of life was evaluated using the Chinese version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), which included assessments of 5 functional domains (physical, role, cognitive, emotional, and social functions) and the global quality of life score. Cell immune indica
tors such as CD3
+
T, CD4
+
T, CD8
+
T, CD4
+
T/CD8
+
T and humoral immune function indicators including immunoglobulin G (IgG), immunoglobulin M (IgM), immunoglobulin A (IgA) were detected. Scores for traditional Chinese medicine (TCM) symptoms including pharyngeal foreign body sensation or neck discomfort, irritability, and fatigue were recorded, and the TCM syndrome improvement was compared after treatment. Electrocardiogram, blood routine, liver function, and renal function tests were conducted before and after treatment to evaluate safety.
Results
2
Compared with those before treatment, increased scores in physical function, role function, cognitive function, emotional function, social function, and global quality of life, significant increased levels in CD3
+
T, CD4
+
T, CD4
+
T/CD8
+
T, IgG, IgM and IgA, as well as decreased CD8
+
T were observed in both groups after treatment. In the trial group, the scores of pharyngeal foreign body sensation or neck discomfort, irritability, and fatigue were reduced, while in the control group, only the score of pharyngeal foreign body sensation or neck discomfort was decreased (
P
<0.05). After treatment, in comparisons between groups, the improvement effects of all indicators but CD8
+
T in the trial group were superior to those in the control group (
P
<0.05). The total effective rate of TCM syndrome in the trial group was 84.76% (139/164), which was significantly higher than that in the control group (53.66%, 88/164,
P
<0.05). The electrocardiogram, blood routine, liver function, and renal function of both groups of patients were all within normal ranges and after treatment.
Conclusion
2
The modified
Lurong Sancao Decoction
could significantly improve quality of life of DTC patients after surgery, enhance immune function, and relieve TCM symptoms, th
ereby improving TCM syndrome.
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