Clinical observation of Maxingshigan decoction combined with methylprednisolone on PD-1 inhibitor-induced immune pneumonia

doi:10.3877/cma.j.issn.1674-6902.2022.06.008

Abstract

Abstract:

Objective

Checkpoint inhibitor pneumonitis (CIP)is more prevalent in Asian populationswith extremely high lethal rate. In order to search for highly effective therapeutic alternatives, we observed the effect of Ma Xing Shi Gan decoction (MXD) combined with methylprednisolone on immune-related pneumonitis caused by PD-1 inhibitors in cancer patients.

Methods

Thirty-five cancer patients with immune-related pneumonitis were divided into two groups. Control group: methylprednisolone 18 cases, experimental group: Ma Xing Shi Gan decoction (MXD) combined with methylprednisolone 17 cases. Comparison was made on the difference of CIP score, serum inflammatory cytokines, CRP score and Karnofsky score after 6 consecutive weeks of treatment.

Results

After treatments, control group CIP is (1.78±0.61), experimental groupis (1.44±0.24). CIP scores decreased in both groups, and the experimentalgroup decreased significantly compared with the control group. CRP were significantly decreased in both groups(P<0.05)in both groups, while Karnofsky scorewas significantly increased (P<0.05)in both groups after treatments.

Conclusion

Combination therapy of Ma Xing Shi Gan decoction (MXD) plus methylprednisolone was more effective at treating immune-related pneumonitis than methylprednisolone monotherapy in cancer patients, which contributes to regulate immunosuppression state, enhance immune function and improve quality of life.

Key words: Ma Xing Shi Gan decoction, Methylprednisolone, Immune pneumonia

Daifang Chu, Haitao Zhang, Faguang Jin, Qi An. Clinical observation of Maxingshigan decoction combined with methylprednisolone on PD-1 inhibitor-induced immune pneumonia[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2022, 15(06): 806-809.

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URL: https://zhfbjbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6902.2022.06.008

https://zhfbjbzz.cma-cmc.com.cn/EN/Y2022/V15/I06/806

Figures/Tables 3

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组　别	例数	TNF-α (pg/ml)		IL-1β (pg/ml)
组　别	例数	治疗前	治疗后	治疗前	治疗后
观察组	17	19.38±0.25	9.56±0.33^ab	16.38±0.25	6.56±0.33^ab
对照组	18	20.65±0.36	12.35±0.42^a	15.65±0.36	9.35±0.42^a

组　别	例数	TNF-α (pg/ml)		IL-1β (pg/ml)
组　别	例数	治疗前	治疗后	治疗前	治疗后
观察组	17	19.38±0.25	9.56±0.33^ab	16.38±0.25	6.56±0.33^ab
对照组	18	20.65±0.36	12.35±0.42^a	15.65±0.36	9.35±0.42^a

组　别	例数	临床评分(C)		影像评分(R)		生理评分(P)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	17	28.55±2.25	16.53±1.15^a	14.39±1.58	8.12±0.95^ab	19.28±3.53	10.11±2.46^ab
对照组	18	27.98±1.31	17.66±3.22^a	13.54±2.11	9.66±0.68^a	21.75±3.12	14.71±4.30^a

组　别	例数	临床评分(C)		影像评分(R)		生理评分(P)
组　别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	17	28.55±2.25	16.53±1.15^a	14.39±1.58	8.12±0.95^ab	19.28±3.53	10.11±2.46^ab
对照组	18	27.98±1.31	17.66±3.22^a	13.54±2.11	9.66±0.68^a	21.75±3.12	14.71±4.30^a

组　别	例数	Karnofsky评分(治疗前)	Karnofsky评分(治疗后)
观察组	17	52.17±5.18	77.49±5.76^ab
对照组	18	53.26±6.57	69.18±7.15^a

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