解毒消瘰方联合R-CHOP对初治弥漫大B细胞淋巴瘤免疫微环境及临床疗效的影响OA

Objective To investigate the impact of Jiedu Xiaoluo Decoction(JDX)combined with the R-CHOP regimen on the immune microenvironment and clinical efficacy in newly diagnosed diffuse large B-cell lymphoma(DLBCL)patients.Methods Eighty eligible newly diagnosed DLBCL patients were selected from the First Affiliated Hospital of Zhejiang Chinese Medical University from September 2020 to December 2023 were randomly divided into a control group(n=40,standard 6 cycles R-CHOP)and a treatment group(n=40,standard 6 cycles R-CHOP plus JDX).The remission rate,Traditional Chinese Medicine(TCM)syndrome scores,and changes in lymphocyte subpopulations,macrophages,dendritic cells(DCs),immunoglobulins,and cytokines were analyzed.Results Before treatment,immune parameters and TCM syndrome scores were comparable between the two groups.After treatment,the treatment group showed significantly higher levels of CD4+T cells,Treg cells,M1 macrophages,IgA and IgM,and significantly lower levels of M2 macrophages,IL-6,IL-10,TCM syndrome score,liver dysfunction and gastrointestinal reactions compared with the control group(all P＜0.05).No significant differences were observed in CD8+T cells,NK cells,DCs or IgG between the two groups(all P＞0.05).The treatment group also demonstrated a significant improvement in overall survival(OS)(x2=4.255,P=0.039),although the prolongation of progression-free survival(PFS)did not reach statistical significance.Conclusion R-CHOP combined with JDX is superior to R-CHOP alone in improving overall survival,enhancing immune function and alleviating TCM syndrome scores,with better tolerance and fewer adverse effects.