青桑合剂对晚期肿瘤安宁疗护患者呼吸道症状及免疫调节功能的影响

Effect of Qingsang Mixture on Respiratory Symptoms and Immune Function in Patients with Advanced Cancer Receiving Hospice Care

摘要: 目的：评估青桑合剂对晚期肿瘤安宁疗护患者呼吸道症状改善情况、用药安全性及免疫调节功能的影响，为安宁疗护阶段中医药辅助干预提供临床依据。方法：收集2024年12月至2026年5月青岛市妇女儿童医院安宁疗护中心收治的晚期恶性肿瘤患者，根据治疗方案，分为青桑合剂组患者60例(标准化安宁疗护对症支持，同步口服院内制剂青桑合剂50 ml日两次，服药5~7 d)，常规治疗组50例(仅接受标准化安宁疗护对症支持，无中药、免疫调节药物干预)。收集两组患者的临床基本资料及实验室指标。评估青桑合剂组患者呼吸道症状改善情况及用药安全性评价。t检验进行组内及组间免疫指标(Treg)及炎性指标(NLR、MLR、PLR)对比。结果：两组患者临床基本特征及实验室指标基线无显著差异(P > 0.05)。青桑合剂组患者呼吸道症状改善总有效率高达91.7%，用药期间无药物不良反应发生。组内对比：青桑合剂组用药后NLR低于用药前(P < 0.05)，Treg、MLR、PLR用药前后无显著差异(P > 0.05)；常规治疗组Treg前后差异有统计学意义，后者高于前者(P < 0.05)。NLR、MLR、PLR整体均无明显波动(P > 0.05)。组间对比：青桑合剂组用药后Treg、NLR低于常规治疗组，差异显著(P < 0.05)，MLR、PLR两组对比无显著性差异(P > 0.05)。结论：青桑合剂可显著改善患者呼吸道症状，降低机体炎症负荷、稳定免疫抑制性Treg水平，具有止咳化痰、调节免疫失衡、抗炎作用，在晚期肿瘤安宁疗护患者应用中安全有效。

Abstract: Objective: To evaluate the efficacy of Qingsang Mixture in improving respiratory symptoms, its safety profile, and its impact on immune function in patients with advanced cancer receiving hospice care, thereby providing clinical evidence for adjuvant traditional Chinese medicine (TCM) intervention in the hospice setting. Methods: Patients with advanced malignant tumors admitted to the Hospice Care Center of Qingdao Women and Children’s Hospital from December 2024 to May 2026 were enrolled. A total of 60 patients in the Qingsang Mixture group received standard hospice supportive care plus oral Qingsang Mixture for 5~7 days, while 50 patients in the conventional treatment group received standard hospice supportive care only (without any TCM or immunomodulatory agents). Baseline clinical characteristics and laboratory parameters were collected. Respiratory symptom improvement and adverse events were assessed in the Qingsang Mixture group. Paired ttests were used for withingroup and betweengroup comparisons of immune (Treg) and inflammatory markers (NLR, MLR, PLR). Results: There were no significant differences in the baseline clinical characteristics and laboratory parameters between the two groups (P > 0.05). The overall response rate for improvement of respiratory symptoms in the Qingsang Mixture group was as high as 91.7%, and no adverse drug reactions occurred during medication. Within-group comparisons: In the Qingsang Mixture group, NLR decreased significantly after treatment compared with before treatment (P < 0.05), while Treg, MLR, and PLR showed no significant differences before and after treatment (P > 0.05). In conventional treatment group, the difference in Treg before and after the observation period was statistically significant, with the latter higher than the former (P < 0.05). However, NLR, MLR, and PLR showed no significant fluctuations overall between the two time points (P > 0.05). Between-group comparisons: After treatment, Treg and NLR in the Qingsang Mixture group were significantly lower than those in the conventional treatment group (P < 0.05). No significant differences were found in MLR or PLR between the two groups (P > 0.05). Conclusion: Qingsang Mixture significantly improves respiratory symptoms, reduces systemic inflammatory burden, and stabilize immunosuppressive Treg levels in patients with advanced cancer receiving hospice care. It exhibits antitussive, expectorant, immunomodulatory, and antiinflammatory effects, and appears safe and effective in this patient population.