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[目的]探究阿片类药物对肝癌患者血清中调节性T细胞表达变化的影响以及小半夏加茯苓汤的干预作用。[方法]收录肝癌患者68例,采用流式细胞仪检测其外周血调节性T细胞的表达水平,并比较使用阿片类药物前后1周T细胞的表达变化;根据患者意愿于阿片类使用1周后开始给予小半夏加茯苓汤干预一周后观察T细胞的表达变化。[结果]肝细胞癌组外周血中辅助性T细胞CD4~+T(CD3~+CD4~+)、抑制性T细胞CD8~+T(CD3~+CD8~+)、调节性T细胞(CD4~+CD25~+)较健康对照组明显减少(P<0.05);肝细胞癌组外周血中NK细胞(CD3-CD16~+CD56~+)较健康对照组明显增加(P<0.05),服用阿片组外周血中CD4~+T、CD8~+T、CD4~+CD25~+较肝癌对照组明显减少(P<0.05);NK细胞较肝癌对照组明显增加(P<0.05);中药干预组明显升高阿片组外周血中CD4~+T、CD8~+T、CD4~+CD25~+,明显降低NK细胞数,差异有统计学意义(P<0.05)[结论]阿片类药物对肝癌患者血清中调节性T细胞功能有明显抑制作用,小半夏加茯苓颗粒能较好的缓解其抑制作用,值得临床推广。
[Objective] To investigate the influence of opioids on the expression of regulatory T cells in serum of patients with hepatocellular carcinoma and the effect of Xiaobanxia plus Fuling decoction. [Methods] Sixty-eight patients with hepatocellular carcinoma (HCC) were enrolled. Flow cytometry was used to detect the expression of Tregs in peripheral blood. The changes of T cells in one week before and after opioid treatment were compared. After giving a small Pinellia plus Poria Decoction intervention after a week to observe changes in T cell expression. [Results] The levels of CD4 ~ + T (CD3 ~ + CD4 ~ +), suppressor T cells CD8 ~ + T (CD3 ~ + CD8 ~ +), regulatory T cells (P <0.05). Compared with healthy control group, NK cells (CD3-CD16 ~ + CD56 ~ +) in hepatocellular carcinoma group were significantly increased (P <0.05) The levels of CD4 ~ + T, CD8 ~ + T and CD4 ~ + CD25 ~ + in peripheral blood of opiate group were significantly lower than those of the control group (P <0.05) (P <0.05) .Conclusion: Opioids can significantly reduce the number of NK cells in CD4 ~ + T, CD8 ~ + T and CD4 ~ + CD25 ~ Serum T regulatory function of cells have a significant inhibitory effect of small pinellia plus Poria particles can better alleviate its inhibitory effect, is worth clinical promotion.